PD-1/PD-L1 Inhibitors as Monotherapy in the First-Line Treatment of Advanced Non-Small Cell Lung Cancer Patients with High PD-L1 Expression : An Expert Position Statement
Isla, Dolores (University Hospital Lozano Blesa)
Sánchez Hernández, Alfredo (Consorci Hospitalari Provincial de Castelló)
Casal, Joaquín (Hospital Álvaro Cunqueiro (Vigo))
Cobo, Manuel (Instituto de Investigación Biomédica de Málaga)
Majem Tarruella, Margarita (Institut d'Investigació Biomèdica Sant Pau)
Reguart, Noemi (Hospital Clínic i Provincial de Barcelona)
Zugazagoitia, Jon (Hospital Universitario 12 de Octubre (Madrid))
Bernabé, Reyes (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Universitat Autònoma de Barcelona

Data:	2023
Resum:	There are currently three first-line immunotherapy options used as monotherapy in advanced non-small cell lung cancer (NSCLC) patients with high programmed death ligand 1 (PD-L1) expression (≥50%). This manuscript aims to evaluate the available data on atezolizumab (AT), cemiplimab (CEMI), and pembrolizumab (PEMBRO) and to study the results obtained during pivotal trials, especially regarding patient subgroups. Nominal group and Delphi techniques were used. Eight Spanish experts in lung cancer (the scientific committee of the project) analyzed the use of immunotherapy monotherapy as first-line treatment in patients with NSCLC and high PD-L1 expression. The expert scientific committee formulated several statements based on a scientific review and their own clinical experience. Subsequently, 17 additional Spanish lung cancer experts were selected to appraise the committee's statements through two Delphi rounds. They completed a Delphi round via an online platform and voted according to a scale from 1 (strongly disagree) to 10 (strongly agree). The statements were approved if ≥70% of experts voted 7 or more. A total of 20 statements were proposed covering the following areas: (1) general characteristics of pivotal clinical trials; (2) overall main outcomes of pivotal clinical trials; and (3) subgroup analysis. All statements reached consensus in the first round. AT, CEMI, and PEMBRO as monotherapy can be considered the standard of care in patients with advanced NSCLC and high PD-L1 expression (≥50%). Moreover, some differences noted among the drugs analyzed in this document might facilitate treatment decision-making, especially in clinically relevant patient subgroups, when using PD-1/PD-L1 inhibitors. The high level of agreement reached among experts supports the proposed statements.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	PD-(L)1 inhibitors ; Consensus ; Efficacy ; First-line treatment ; Immunotherapy ; Lung cancer ; Monotherapy ; Non-small cell lung cancer ; Safety
Publicat a:	Journal of clinical medicine, Vol. 12 Núm. 15 (august 2023) , p. 5063, ISSN 2077-0383

DOI: 10.3390/jcm12155063
PMID: 37568465

16 p, 635.9 KB

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