Moving immune checkpoint blockade in thoracic tumors beyond non-small cell lung cancer.

Journal of thoracic oncology: official publication of the International Association for the Study of Lung Cancer 2016 June 8 [Epub ahead of print] [Link]

Facchinetti F, Marabelle A, Rossi G, Soria JC, Besse B, Tiseo M.


Small cell lung cancer (SCLC) and malignant pleural mesothelioma (MPM) are historically characterized by a disappointing lack of significant therapeutic breakthroughs for novel agents and both malignancies represent true unmet medical needs. Given promising results of anti-CTLA-4 and anti-PD-1/PD-L1 antibodies in the treatment of advanced non-small cell lung cancers, these immune checkpoint inhibitors are now also under investigation in SCLC and MPM, as well as in thymic epithelial tumors (TETs). Here, we review the biological and clinical rationale for immune checkpoint inhibition in SCLC, MPM and TETs, and present preliminary clinical results with available antibodies. Immunotherapeutic perspectives for these malignancies in terms of novel agents currently under evaluation or anticipated in the near future are also discussed. Current immune checkpoint blockers targeting CTLA-4 and the PD-1/PD-L1 axis, administered alone or in combination and as multimodality treatment, are likely to be a valuable addition to the therapeutic array for managing SCLC and MPM; studies in TETs, currently in their infancy, are merited. Close attention to potential toxicities will be important to the success of such strategies in these settings.