Moving the mountain in advanced non-small-cell lung cancer: evolving immunotherapies for a dire disease

Despite advances in diagnostic, surgical/interventional, and supportive care strategies, lung cancer remains a lethal entity representing the most common cause of cancer-related mortality worldwide (1). Non-small cell lung cancers (NSCLCs) represent the vast majority of these cases. With more than half of all patients presenting with advanced stage disease at initial diagnosis, there has been a persistent and pressing need for improved systemic therapies—both with regards to efficacy and toxicity. Even so, platinum doublets have remained the mainstay of palliative therapy for the past several decades. Based on a number of randomized trials, platinum doublet chemotherapy administered to fit and willing patients achieves improved survival and quality of life (QoL) as compared to best supportive care alone and has long remained the unchallenged standard of care (2). Though many chemotherapeutic agents have been studied in combination with a platinum agent, none has demonstrated superior outcomes in unselected cohorts (3).