Apport de l’immunothérapie dans les stades non métastatiques et non résécables: Contribution of immunotherapy in non-metastatic and unresectable stages

Abstract

Since many years, the standard treatment of locally advanced non-small cell cancer is based on a association of chemotherapy and radiotherapy. A concurrent plan is to be favored to a sequential plan. Since 2017, following results of PACIFIC study, consolidation immunotherapy with durvalumab (anti-PD-L1 monoclonal antibody) after concurrent chemo-radiotherapy became a standard of care in patients with a PD-L1 expressing tumor. Others studies confirm this strategy. Recently, a real-life study, PACIFIC-R, shows same results than PACIFIC trial in terms of progression-free survival and safety. The next step is to integrate chekpoints inhibitors during concurrent chemo-radiotherapy or before chemo-radiotherapy as induction treatment. Many phase I/II trials show that this approach is faisabile in terms of toxicity, particularly in terms of pulmonary toxicity. Nevertheless, these studies are not able to show a survival benefit. We wait results of currently phase III studies in this setting.© 2022 SPLF. Published by Elsevier Masson SAS. All rights reserved.