Article Text

Download PDFPDF

Immune checkpoint inhibitors for every patient with non-small cell lung cancer? Update on immunotherapy in patients with lung cancer
  1. Johan F Vansteenkiste
  1. Respiratory Oncology Unit and Trial Unit, Department of Respiratory Diseases, University Hospitals KU Leuven, Catholic University Leuven, Leuven, Belgium
  1. Correspondence to Dr Johan F Vansteenkiste; johan.vansteenkiste{at}
  • Podcasts

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

View Full Text

Statistics from

Several phase III trials on immune checkpoint inhibitor therapy in non-small cell lung cancer were recently published and changed the clinical practice. Here, non-small cell lung cancer has to be categorised first according to the presence of activating mutations and, second, according to the programmed cell death ligand 1 (PDL1) expression. Approximately 25% of patients present with a driver mutation and should be treated with tyrosine kinase inhibitors as the first-line treatment strategy for metastatic non-small cell lung cancer. Approximately 75% of patients do not present with a driver mutation and should be treated according to the presence of PDL1 expression. Patients with high PDL1 (≥50% of tumour cells) expression are candidates for immune checkpoint inhibitor monotherapy, although a combination with chemotherapy can be suggested in patients with high tumour load and fast progressing disease. Patients with intermediate (1%–49% of tumour cells) PDL1 expression are on the other hand candidates for the combination of chemotherapy with immune checkpoint inhibitor therapy according to the recently published data. Further, combination of immune checkpoint inhibitor-based therapy with chemotherapy and bevacizumab could be an option in patients with a driver mutation after the failure of available tyrosine kinase inhibitors.

View Abstract


  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.