Checkpoints inhibitors in first line therapy of metastatic non-small cell lung cancer patients

Lung cancer is still the leader cause of mortality due to cancer worldwide (1,2). Five-year overall survival (OS) in unresectable and metastatic non-small cell lung cancer (NSCLC) patients (stage IIIB/IV) is less than 5%, regardless of the number of cytotoxic chemotherapy lines given (3). NSCLC is characterized for having different genetic and epigenetic alterations, where high rates of somatic mutations generate a variety of tumor specific antigens that enhance immunogenicity (4). Cancer is the result of the failure of different immunological mechanisms that attempt to eliminate cancer antigens that finally escape the immune system allowing tumor growth (5). Immunotherapy in a very short period of time not only became a reality but also achieved the most spectacular results ever in different types of cancer including NSCLC patients.