期刊
ANNALS OF ONCOLOGY
卷 32, 期 12, 页码 1597-1607出版社
ELSEVIER
DOI: 10.1016/j.annonc.2021.08.2151
关键词
PD-(L)1 blockade; checkpoint inhibitor; immunotherapy; acquired resistance; lung cancer
类别
资金
- Memorial Sloan Kettering Cancer Center Support Grant/Core Grant [P30 CA008748]
- Druckenmiller Center for Lung Cancer Research at Memorial Sloan Kettering
- Damon Runyon Cancer Research Foundation [CI-98-18]
- Parker Institute for Cancer Immunotherapy
The study examines the considerations and potential controversies in developing a patient-level definition of AR in NSCLC treated with PD-(L)1 blockade, proposing a practical, clinical definition of AR for use in clinical reports and prospective clinical trials. Patients need to meet specific criteria, including receiving PD-(L)1 blockade treatment, experiencing objective response, and having progressive disease within a certain timeframe.
Acquired resistance (AR) to programmed cell death protein 1/programmed death-ligand 1 [PD-(L)1] blockade is frequent in non-small-cell lung cancer (NSCLC), occurring in a majority of initial responders. Patients with AR may have unique properties of persistent antitumor immunity that could be re-harnessed by investigational immunotherapies. The absence of a consistent clinical definition of AR to PD-(L)1 blockade and lack of uniform criteria for ensuing enrollment in clinical trials remains a major barrier to progress; such clinical definitions have advanced biologic and therapeutic discovery. We examine the considerations and potential controversies in developing a patient-level definition of AR in NSCLC treated with PD-(L)1 blockade. Taking into account the specifics of NSCLC biology and corresponding treatment strategies, we propose a practical, clinical definition of AR to PD-(L)1 blockade for use in clinical reports and prospective clinical trials. Patients should meet the following criteria: received treatment that includes PD-(L)1 blockade; experienced objective response on PD-(L)1 blockade (inclusion of a subset of stable disease will require future investigation); have progressive disease occurring within 6 months of last anti-PD-(L)1 antibody treatment or rechallenge with anti-PD-(L)1 antibody in patients not exposed to anti-PD-(L)1 in 6 months.
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