4.4 Review

Immune checkpoints and immunotherapy in non-small cell lung cancer: Novel study progression, challenges and solutions

Journal

ONCOLOGY LETTERS
Volume 22, Issue 5, Pages -

Publisher

SPANDIDOS PUBL LTD
DOI: 10.3892/ol.2021.13048

Keywords

non-small cell lung cancer; immune checkpoints; biomarker; resistance; combination therapy

Categories

Funding

  1. Science and Technology Development Fund, Macau SAR [0011/2021/A]
  2. Faculty Research Grant Projects of Macau University of Science and Technology [FRG-19-028-FC]

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Lung cancer is the most common type of cancer globally with the highest mortality rate, and immunotherapy has shown promising results in treating it. However, only a small number of patients benefit from immunotherapy, posing challenges. Combating these challenges through combination therapy is considered the most suitable choice, and traditional Chinese medicine may play a promising role in cancer treatment.
Lung cancer is the most common type of cancer with the highest mortality rate worldwide. Non-small cell lung cancer (NSCLC) accounts for similar to 85% of the total number of lung cancer cases. In the past two decades, immunotherapy has become a more promising treatment method than traditional treatments (surgery, radiotherapy and chemotherapy). Immunotherapy has been shown to improve the survival rate of patients and to have a superior effect when controlling lung cancer than traditional therapy. However, only a small number of patients can benefit from immunotherapy, and not all patients who qualify experience long-term benefits. In the clinic, the objective response rate of programmed cell death protein 1 treatment without the prior screening of patients is only 15-20%. Immunotherapy is associated with both opportunities and challenges for patients with NSCLC. The current challenges of immunotherapy include the lack of accurate biomarkers, inevitable resistance and insufficient understanding of immune checkpoints. In previous years, several methods for overcoming the challenges posed by immunotherapy have been proposed, but combination therapy is the most suitable choice. A large number of studies have shown that the combination of drugs can significantly improve their efficacy, compared with monotherapy, and that some therapeutic combinations have been approved by the Food and Drug Administration for the treatment of NSCLC. Traditional Chinese medicine (TCM) is a traditional medical practice in China that can play an important role in immunotherapy. Most agents used in TCM originate from plants, and have the advantages of low toxicity and multiple targets. In addition, TCM includes a unique class of drugs that can improve autoimmunity. Therefore, TCM may be a promising treatment method for all types of cancer.

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