Immune Checkpoint Inhibitors in Special NSCLC Populations: A Viable Approach?

Over the last decade, the therapeutic scenario for advanced non-small-cell lung cancer (NSCLC) has undergone a major paradigm shift. Immune checkpoint inhibitors (ICIs) have shown a meaningful clinical and survival improvement in different settings of the disease. However, the real benefit of this therapeutic approach remains controversial in selected NSCLC subsets, such as those of the elderly with active brain metastases or oncogene-addicted mutations. This is mainly due to the exclusion or underrepresentation of these patient subpopulations in most pivotal phase III studies; this precludes the generalization of ICI efficacy in this context. Moreover, no predictive biomarkers of ICI response exist that can help with patient selection for this therapeutic approach. Here, we critically summarize the current state of ICI efficacy in the most common special NSCLC subpopulations.

Automated summary

In the past decade, immune checkpoint inhibitors (ICIs) have brought significant clinical and survival improvements in various settings of advanced non-small-cell lung cancer (NSCLC). However, their efficacy in specific NSCLC subpopulations, such as elderly patients with active brain metastases or oncogene-addicted mutations, remains controversial due to their exclusion or underrepresentation in pivotal phase III studies. Additionally, there are currently no predictive biomarkers available to aid in patient selection for this therapeutic approach. This article critically summarizes the current state of ICI efficacy in the most common special NSCLC subpopulations.