Profile of atezolizumab in the treatment of metastatic non-small-cell lung cancer: patient selection and perspectives

• Published in: Drug design, development and therapy Vol. 12; pp. 2857 - 2873
• Main Authors: Facchinetti, Francesco, Bordi, Paola, Leonetti, Alessandro, Buti, Sebastiano, Tiseo, Marcello
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01-01-2018; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Alectinib; Angiogenesis; Antiangiogenic agents; Antiangiogenics; Antibodies, Monoclonal - therapeutic use; Antineoplastic Agents - therapeutic use; Apoptosis; Atezolizumab; Atezolizumab development; Avelumab; Bevacizumab; Biochemistry; Biological markers; Biomarkers; Cancer metastasis; Cancer therapies; Cancer treatment; Carboplatin; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - pathology; Care and treatment; Cell death; Chemotherapy; Clinical medicine; Clinical trials; Disease; Drug development; Drugs; Durvalumab; FDA approval; Humans; Immune checkpoint blockers (ICB); Immunoglobulins; Immunology; Immunosuppressive agents; Immunotherapy; Ligands; Lung cancer; Lung Neoplasms - drug therapy; Lung Neoplasms - pathology; Medical research; Melanoma; Metastases; Metastasis; Monoclonal antibodies; Nivolumab; Non-small cell lung cancer; Non-small cell lung cancer (NSCLC); Non-small cell lung carcinoma; Patient Selection; Patients; PD-1; PD-1 protein; PD-L1; PD-L1 protein; Pembrolizumab; Randomized Controlled Trials as Topic; Review; Small cell lung cancer; Targeted cancer therapy; United States > US; non-small cell lung cancer; NSCLC; biomarkers; PD-L1; ICB; immune checkpoint blockers; PD-1; atezolizumab development
• ISSN: 1177-8881; 1177-8881
• DOI: 10.2147/dddt.s124380

Programed cell death-1/programed death ligand-1 (PD-1/PD-L1) blockade represents an affirmed reality in the treatment of advanced non-small-cell lung cancer (NSCLC) patients. Atezolizumab, an anti-PD-L1 agent, figures among the drugs that provide previously unenvisaged outcomes in the pretreated setting of metastatic NSCLC. Increasing evidence vouches for the early administration of PD-1/PD-L1 blockers in untreated patients, encompassing atezolizumab combinations with chemotherapy and the anti-angiogenic agent bevacizumab. Moreover, the development of atezolizumab allowed to derive several hints regarding clinical and immunological factors predictive of its activity and efficacy, some of them exclusive among this class of drugs. This review provides an overview of atezolizumab development throughout clinical trials toward its applicability in the routine practice, with a particular focus on patient selection based on clinical and immune-related factors.