Keywords
Lung cancer
Non-small cells
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Abstract
Objective: To evaluate the efficacy and safety of immunotherapeutics alone or in combination with other therapies, compared to traditional treatments for patients with non-small cell lung cancer (NSCLC) across various stages and lines of treatment. Methods: Integrative review, in the National Library of Medicine and National Institutes of Health (PubMed) and Virtual Health Library (BVS) databases. The search was carried out in April 2025. The DeCS descriptors were lung cancer, non-small cell cancer and immunotherapy, and their English counterparts with the Boolean operator “AND”. The inclusion criteria were: publications from the last 5 years, freely accessible, available in full in Portuguese, English and Spanish. Rayyan was used to select articles in an impartial manner. Results: This study analyzed 30 articles comparing immunotherapy, whether or not associated with conventional treatments or isolated therapies. The results obtained were presented in tables 1 and 2, which present the authors and the main findings. Final considerations: Given the results analyzed, it was concluded that the choice of immunotherapy must consider histology, PD-L1 and associated adverse effects. In general, combinations with chemotherapy are more beneficial compared to the isolated use of immunotherapy.
References
ALTAN M, et al. High peripheral T cell diversity is associated with lower risk of toxicity and superior response to dual immune checkpoint inhibitor therapy in patients with metastatic NSCLC. J Immunother Cancer, 2024; 12(12):e008950.
BARAMIDZE A, et al. Cemiplimab plus chemotherapy versus chemotherapy alone in non-small cell lung cancer with PD-L1 ≥ 1 %: A subgroup analysis from the EMPOWER-Lung 3 part 2 trial. Lung Cancer, 2024; 193(107821):107821.
BORGHAEI H, et al. Nivolumab plus chemotherapy in first-line metastatic non-small-cell lung cancer: results of the phase III CheckMate 227 Part 2 trial. ESMO Open, 2023; 8(6):102065.
BORGHAEI H, et al. SAPPHIRE: phase III study of sitravatinib plus nivolumab versus docetaxel in advanced nonsquamous non-small-cell lung cancer. Ann Oncol, 2024; 35(1):66-76.
CARBONE DP, et al. Four-year clinical update and treatment switching-adjusted outcomes with first-line nivolumab plus ipilimumab with chemotherapy for metastatic non-small cell lung cancer in the CheckMate 9LA randomized trial. J Immunother Cancer, 2024; 12, 12(2): e008189.
DAMONTE A, et al. Resultados quirúrgicos post neoadyuvancia con inmunoterapia en cáncer de pulmón: CheckMate 816 en subpoblación Argentina. Medicina (B Aires), 2025;85(1):47–55.
FORDE PM, et al. Neoadjuvant nivolumab plus chemotherapy in resectable lung cancer. N Engl J Med, 2022; 386 (21): 1973–85.
GARON EB, et al. Patient-reported outcomes with durvalumab, with or without tremelimumab, plus chemotherapy as first-line treatment for metastatic non-small-cell lung cancer (POSEIDON). Lung Cancer, 2024;186(107422):107422.
GETTINGER SN, et al. Nivolumab plus ipilimumab vs nivolumab for previously treated patients with stage IV squamous cell lung cancer: The lung-MAP S1400I phase 3 randomized clinical trial: The lung-MAP S1400I phase 3 randomized clinical trial. JAMA Oncol [Internet]. 2021;7(9):1368–77.
JOHN T, et al. First-line nivolumab plus ipilimumab combined with two cycles of chemotherapy in advanced non-small cell lung cancer: a subanalysis of Asian patients in CheckMate 9LA. Int J Clin Oncol, 2022; 27(4):695–706.
LU S, et al. Nivolumab versus docetaxel in a predominantly Chinese patient population with previously treated advanced non-small cell lung cancer: 2-year follow-up from a randomized, open-label, phase 3 study (CheckMate 078). Lung Cancer, 2021; 152:7–14.
MAKHARADZE T, et al. Cemiplimab plus chemotherapy versus chemotherapy alone in advanced NSCLC: 2-year follow-up from the phase 3 EMPOWER-Lung 3 part 2 trial. J Thorac Oncol, 2023; 18(6):755–68.
NEAL J, et al. CONTACT-01: A randomized phase III trial of atezolizumab + cabozantinib versus docetaxel for metastatic non-small cell lung cancer after a checkpoint inhibitor and chemotherapy. J Clin Oncol, 2024; 42(20):2393–403.
PARK K, et al. Avelumab versus docetaxel in patients with platinum-treated advanced NSCLC: 2-year follow-up from the JAVELIN Lung 200 phase 3 trial. J Thorac Oncol, 2021; 16(8):1369–78.
PASSARO A, et al. Amivantamab plus chemotherapy with and without lazertinib in EGFR-mutant advanced NSCLC after disease progression on osimertinib: primary results from the phase III MARIPOSA-2 study. Ann Oncol, 2024; 35 (1): 77–90.
PETERS S, et al. Atezolizumab versus chemotherapy in advanced or metastatic NSCLC with high blood-based tumor mutational burden: primary analysis of BFAST cohort C randomized phase 3 trial. Nat med, 2022; 28(9):1831–9.
PETERS S, et al. Long-term survival outcomes with first-line nivolumab plus ipilimumab-based treatment in patients with metastatic NSCLC and tumor programmed death-ligand 1 lower than 1%: A pooled analysis. J Thorac Oncol, 2025; 20(1):94–108.
PROVENCIO M, et al. Perioperative chemotherapy and nivolumab in non-small-cell lung cancer (NADIM): 5-year clinical outcomes from a multicentre, single-arm, phase 2 trial. Lancet Oncol, 2024; 25(11):1453-1464. Erratum in: Lancet Oncol. 2024; 25(11):e542.
RECK M, et al. Five-year outcomes with pembrolizumab versus chemotherapy for metastatic non-small-cell lung cancer with PD-L1 tumor proportion score ≥ 50. J Clin Oncol, 2021;39(21):2339–49.
RECK M, et al. Safety and patient-reported outcomes of atezolizumab plus chemotherapy with or without bevacizumab versus bevacizumab plus chemotherapy in non-small-cell Lung Cancer. J Clin Oncol, 2020; 38(22):2530–42.
SENAN S, et al. Outcomes with durvalumab after chemoradiotherapy in stage IIIA-N2 non-small-cell lung cancer: an exploratory analysis from the PACIFIC trial. ESMO Open, 2022; 7(2):100410.
SHI Y, et al. Sintilimab versus docetaxel as second-line treatment in advanced or metastatic squamous non-small-cell lung cancer: an open-label, randomized controlled phase 3 trial (ORIENT-3). Cancer Commun, 2022; 42(12):1314–30.
SUGAWARA S, et al. Pembrolizumab plus chemotherapy in Japanese patients with metastatic squamous non-small-cell lung cancer in KEYNOTE-407. Cancer Sci, 2023;114(8):3330–41.
WANG C, et al. Neoadjuvant nivolumab plus chemotherapy versus chemotherapy for resectable NSCLC: subpopulation analysis of Chinese patients in CheckMate 816. ESMO Open, 2023; 8(6):102040.
WANG J, et al. Tislelizumab plus chemotherapy versus chemotherapy alone as first-line treatment for advanced squamous non-small-cell lung cancer: final analysis of the randomized, phase III RATIONALE-307 trial. ESMO Open, 2024; 9(10):103727.
WEST HJ, et al. Clinical efficacy of atezolizumab plus bevacizumab and chemotherapy in KRAS-mutated non-small cell lung cancer with STK11, KEAP1, or TP53 comutations: subgroup results from the phase III IMpower150 trial. J Immunother Cancer, 2022; 10(2):e003027.
ZHOU C, et al. Camrelizumab plus carboplatin and pemetrexed as first-line treatment for advanced nonsquamous NSCLC: Extended follow-up of CameL phase 3 trial. J Thorac Oncol, 2023; 18(5):628–39.
ZHOU C, et al. Camrelizumab plus carboplatin and pemetrexed as first-line therapy for advanced non-squamous non-small-cell lung cancer: 5-year outcomes of the CameL randomized phase 3 study. J Immunother Cancer, 2024; 12(11).
ZHOU C, et al. A global phase 3 study of serplulimab plus chemotherapy as first-line treatment for advanced squamous non-small-cell lung cancer (ASTRUM-004). Cancer Cell, 2024; 12; 42(2):198-208.e3.
ZHOU H-Q, et al. Gefitinib (an EGFR tyrosine kinase inhibitor) plus anlotinib (an multikinase inhibitor) for untreated, EGFR-mutated, advanced non-small cell lung cancer (FL-ALTER): a multicenter phase III trial. Signal Transduct Target Ther, 2024; 9(1):215.