Abstract
STATE OF THE ART AND PERSPECTIVES: Immune checkpoint inhibitors (ICI) are monoclonal antibodies that inhibit molecular interaction between an immune checkpoint and its ligand, which leads to increased anti-tumoral immune response, Programmed Death 1 (PD-1) and Cytotoxic T-Lymphocyte Associated-4 (CTLA-4) are the most commonly known immune checkpoints. ICIs are currently placed early in the course of the treatment of patients with non-small cell lung cancer (NSCLC). In France, approvals have been pronounced for nivolumab and pembrolizumab (anti-PD-1 antibodies) as second-line treatments after chemotherapy in patients with advanced NSCLC, and pembrolizumab has been approved as a first-line treatment in patients with advanced NSCLC, without EGFR mutation or ALK rearrangement, with strong (≥50%) PD-L1 (Programmed Death Ligand 1) expression. Atezolizumab is currently soon to be approved as a second-line treatment. Numerous studies are currently evaluating ICIs in thoracic oncology. In this article, we will develop perspectives regarding ICIs for early stage or locally advanced NSCLCs, ICIs used in other thoracic cancers (small cell lung cancer, malignant pleural mesothelioma, thymic epithelial tumors), and trials with combinations involving ICIs: two ICIs combined, or ICIs combined with chemotherapy, radiotherapy or other anti-cancer treatments.
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