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Advances in immunotherapy of advanced non-small cell lung cancer with EGFR mutation
Received date: 2022-09-30
Accepted date: 2023-03-14
Online published: 2023-07-11
Supported by
National Natural Science Foundation of China(82030045);Beijing Xisike Clinical Oncology Research Foundation(Y-HR2020MS-0982)
The incidence of epidermal growth factor receptor (EGFR) mutation in non-small cell lung cancer (NSCLC) in Asians is significantly higher than that in Westerners. For the past few years, immune checkpoint inhibitors (ICIs) that target the programmed cell death 1 (PD-1) /programmed cell death ligand 1 (PD-L1) axis have become a part of the treatment paradigm for advanced NSCLC, opening a new era of immunotherapy for lung cancer. However, previous clinical trials reported that advanced NSCLC patients with EGFR mutation could not benefit from ICIs monotherapy. The immunotherapy outcomes of different EGFR mutant subtypes showed diverse. The interim results of the latest clinical trial ORIENT-31 showed that immunotherapy combined with chemotherapy and anti-angiogenesis significantly improved the progression-free survival of EGFR tyrosine kinase inhibitors (TKIs) resistant advanced NSCLC patients, providing a new therapeutic strategy for those EGFR mutant patients. The tumor microenvironment of EGFR-mutated NSCLC is immunosuppressed. Targeting the key immunomodulatory factors that play important roles in the immunosuppression may promote the response of EGFR-mutated tumors to immunotherapy and provide a new synergistic immune combination therapy strategy, which will enrich the clinical treatment options and improve the survival prognosis of EGFR-TKIs-resistant NSCLC patients. This article summarizes the latest clinical progression of immunotherapy in advanced NSCLC with EGFR mutation, the differences of immunotherapy efficacy among different EGFR mutation subtypes, the synergistic mechanism of combined immunotherapy and the potential molecular target combining with immunotherapy in EGFR-mutated NSCLC.
Huayan HUANG , Wendi XU-ZHANG , Liliang XIA , Yongfeng YU , Shun LU . Advances in immunotherapy of advanced non-small cell lung cancer with EGFR mutation[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2023 , 43(5) : 611 -618 . DOI: 10.3969/j.issn.1674-8115.2023.05.012
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