Le cancer du poumon est très diversifié

L’immunothérapie dans le cancer bronchique non à petites cellules métastatique : différents patients, différentes options

Plusieurs études montrent que l’immunothérapie, en monothérapie ou en association avec la chimiothérapie, peut améliorer la survie globale des patients atteints de cancer bronchique non à petites cellules (CBNPC) métastatique. Divers groupes de patients atteints de CBNPC métastatique peuvent bénéficier de ce traitement innovant, indépendamment de l’expression de PD-L1, des métastases cérébrales, des métastases hépatiques et de l’âge.1,2,3


CBNPC = cancer bronchique non à petites cellules; PD-L1 TPS = programmed death-ligand 1 tumor proportion score

* Ce cas est celui d’un patient fictif et n’a qu’un but illustratif

  1. Reck M, et al. First-Line Immunotherapy for Non-Small-Cell Lung Cancer. J Clin Oncol. 2022 Feb;40(6):586-597.
  2. Bossageon M, et al. First-Line Treatment of Advanced Non-Small-Cell Lung Cancer with Immune-Checkpoint Inhibitors: New Combinations and Long-Term Data. BioDrugs. 2022 Mar;36(2):137-151.
  3. Qin BD, et al. The effect of liver metastasis on efficacy of immunotherapy plus chemotherapy in advanced lung cancer. Crit Rev Oncol Hematol. 2020 Mar;147:102893.
  4. Longkanker Nederland. (z.d.). Vragen en antwoorden over immunotherapie. Geraadpleegd op 22 april 2022, van Longkanker Nederland. (z.d.). Vragen en antwoorden over immunotherapie. Geraadpleegd op 22 april 2022, van https://www.longkankernederland.nl/vragen-en-antwoorden-over-immuuntherapie
  5. Kleinovink JW, et al. PD-L1 expression on malignant cells is no prerequisite for checkpoint therapy. Oncoimmunology. 2017 Feb 21;6(4):e1294299.
  6. Niu J, et al. Systemic therapy in patients with NSCLC with brain metastasis: the emerging role of immunotherapy. Neuroimmunol Neuroinflammation. 2018 Aug;5:32.
  7. Southall, J. (2021, 14 september). Older adults with late-stage NSCLC benefit from immunotherapy. Kitadai R, et al. The efficacy of immune checkpoint inhibitors in advanced non-small-cell lung cancer with liver metastases. Journal of Cancer Research and Clinical Oncology. 2019;146(3):777–785.
  8. Southall J, et al. Older adults with late-stage NSCLC benefit from immunotherapy. Healio. 2021 Sep. Geraadpleegd op 22 april 2022, van https://www.healio.com/news/hematology-oncology/20210914/older-adults-with-latestage-nsclc-benefit-from-immunotherapy
  9. Mielgo-Rubio X, et al. Immunotherapy in non-small cell lung cancer: Update and new insights. J Clin Transl Res. 2021 Jan 20;7(1):1-21.
  10. Gibson AJW, et al. Impact of number versus location of metastases on survival in stage IV M1b non-small cell lung cancer. Med Oncol. 2018;35:117.
  11. Choi MG, et al. Different prognostic implications of hepatic metastasis according to front-line treatment in non-small cell lung cancer: a real-world retrospective study. Translational Lung Cancer Research. 2021 Jun;10(6):2551-2561.
  12. Sacher AG, et al. Elderly patients with advanced NSCLC in phase III clinical trials: are the elderly excluded from practice-changing trials in advanced NSCLC? J Thorac Oncol. 2013 Mar;8(3):366-8.