Clinical research progress of PD-1/PD-L1 inhibitor induction therapy in unresectable stage III non-small-cell lung cancer

DOI: 10.12201/bmr.202501.00025

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  Abstract: Non-small-cell lung cancer (NSCLC) is the most common malignant tumor, and its incidence and mortality rate rank first in China. For patients with unresectable locally advanced NSCLC, radical concurrent chemoradiotherapy(cCRT) has been the standard treatment for a long time. However, less than 30% of patients in China actually receive radical cCRT, and more patients adopt sequential CRT. Therefore, how to further optimize the mode of CRT has been a research hotspot. Based on the PACIFIC study and the GEMSTONE-301 study, giving immunotherapy as consolidation after CRT has become the standard treatment for patients with unresectable locally advanced NSCLC. However, about 1/4 of these patients still failed due to tumor progression or toxic reactions during CRT. In order to improve the efficacy of these patients, studies on immune-induction therapy has emerged. PD-1/PD-L1 inhibitors are the most commonly used immunotherapy in China. This paper summarized the latest clinical study on the immune-induction therapy model, such as immune-monotherapy(AFT-16 study), immunotherapy combined with chemotherapy (KEYNOTE-799 study, GASTO-1091 study), and immunotherapy combined with chemotherapy and anti-VEGFR-targeted therapy (GASTO-1086 study). These studies have preliminarily demonstrated the feasibility and safety of immune-induction therapy in patients with unresectable locally advanced NSCLC. However, since most of the current clinical studies are single-arm or retrospective studies, it still needs further support from more phase Ⅲ randomized controlled study data.

  Key words: Carcinoma, Non-Small-Cell Lung; Immune Checkpoint Inhibitors; Neoadjuvant Therapy; Radiotherapy.

  Submit time: 9 January 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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