Overcoming immunotherapy resistance in NSCLC
Mené aux Etats-Unis entre 2017 et 2019 sur 90 patients atteints d'un cancer du poumon non à petites cellules métastatique et réfractaire au traitement anti-PD-(L)1 (durée médiane de suivi : 12,4 mois), cet essai randomisé multicentrique de phase II évalue l'intérêt, du point de vue du taux de réponse globale, d'ajouter une radiothérapie de faible dose ou hypofractionnée à un traitement combinant durvalumab et tremelimumab
Systemic therapy regimens that contain immune checkpoint blockade immunotherapy, primarily monoclonal antibodies directed against PD-1, PD-L1, or CTLA-4, can induce substantial therapeutic responses in patients with advanced non-small-cell lung cancer (NSCLC). With immune checkpoint blockade, improved survival can be attained for a minority of patients who would otherwise have a poor prognosis; some might even be cured. Key randomised controlled trials have revolutionised the management of newly diagnosed, non-driver mutation-driven NSCLC by showing improved overall survival for regimens containing immune checkpoint inhibitors compared with chemotherapy alone and for immunotherapy with a PD-1 inhibitor plus a CTLA-4 inhibitor combined with chemotherapy compared with chemotherapy alone.
The Lancet Oncology , commentaire, 2021