Neoadjuvant immunotherapy in non-small cell lung cancer: the sooner the better?

Recently, Forde et al. reported in the New England Journal of Medicine a pilot study in which two neoadjuvant doses of the PD-1 inhibitor nivolumab were administered in a preoperative fashion to 21 patients with untreated, surgically resectable early (stage I–IIIA) non-small cell lung cancer (NSCLC)...

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Detalles Bibliográficos
Autores: Perez-Gracia, J.L. (Jose Luis)|||/items/7be82c5d-4858-4e04-bd77-7ef5a883021b, Fernández-de-Sanmamed-Gutiérrez, M. (Miguel)|||/items/35ac602c-f0ff-4664-bbd2-506afc96db09, Melero, I. (Ignacio)|||/items/82113ea8-7ce1-49d5-9ee3-42cf20db1c4e
Tipo de recurso: artículo
Fecha de publicación:2018
País:España
Institución:Universidad de Navarra
Repositorio:Dadun. Depósito Académico Digital de la Universidad de Navarra
Idioma:inglés
OAI Identifier:oai:dadun.unav.edu:10171/65451
Acceso en línea:https://hdl.handle.net/10171/65451
Access Level:acceso abierto
Palabra clave:PD-1 inhibitor nivolumab
Cell lung cancer
Descripción
Sumario:Recently, Forde et al. reported in the New England Journal of Medicine a pilot study in which two neoadjuvant doses of the PD-1 inhibitor nivolumab were administered in a preoperative fashion to 21 patients with untreated, surgically resectable early (stage I–IIIA) non-small cell lung cancer (NSCLC) (1). Surgery was performed 4 weeks after the first dose of nivolumab. In addition to an acceptable toxicity profile, which did not cause delays in surgery, nivolumab induced a major pathological response in 9 of 20 resected tumors (45%). Pathological responses were observed in patients presenting PD-L1 positive and negative tumors and, interestingly, they correlated with pretreatment tumor mutational burden. The authors found that the number of T-cell clones observed in the tumor and peripheral blood increased following nivolumab in eight of nine patients. Remarkably, the authors described one patient presenting a complete response in which neoantigen-specific T-cell clones from the primary tumor rapidly expanded in peripheral blood following treatment. Moreover, some of these clones were not detected before treatment with nivolumab, thus suggesting that PD-1 blockade induced their expansion.