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1000
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Abstract/Summary
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Lung cancer is still the leading cause of death among all malignancies worldwide. The development of targeted therapies against driver mutations such as EGFR, ALK1, ROS1 and BRAF have led to a significant improvement in patient progression free survival and to a benefit in quality of life of patients suffering from advanced and metastasized non-small cell lung cancer. But since these genetic aberrations are found only in a small subset of lung cancer more globally directed therapeutic approaches are needed to address the therapeutic dilemma of this highly diverse disease. For a long time, it is known that lung cancer is a so called immunogenic disease, i. e. it often evokes a host immune response. Likewise, lung cancers are also developing mechanisms to escape these anti-cancerous immune reactions. One immunogenic axis is that of PD1 and PD-L1. In investigation of this activation-deactivation chain involving lymphocytes, tumor cells but also stromal fibroblasts and macrophages new humanized antibodies have been developed and approved for the treatment of non-small cell lung cancer (NSCLC). Clinical trials have shown effectiveness of these agents, but a valid and reproducible predictive marker has not been found so far. Here we review the current literature on the PD1/PD-L1 axis in NSCLC, its biological function on histological subtype. Together with meta-analytic data performed for this review and results from our own investigations we also give a comprehensive outlook on future developments considering predictive testing and therapeutic options.
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