In 2013, the journal Science considered immunotherapy to be the scientific breakthrough of the year, and one of the disciplines in which it has undoubtedly advanced the most is NSCLC as a result of the use of PD 1 and CTLA-4 immune checkpoint inhibitors (ICIs). The other fundamental milestone that has helped the drastic and rapidly changing scenario of NSCLC, with a significant improvement in the overall survival (OS) of patients and an improvement in their quality of life, is immunotherapy, which is also changing the landscape of small cell lung carcinoma.
These therapies have helped to significantly increase survival and quality of life in those patients with tumors that carry these mutations, beginning with the discovery of EGFR back in 2004, and have continued with the progressive discovery of new targets. The treatment of non-small-cell lung carcinoma (NSCLC) has changed significantly in recent years, beginning with the discovery of oncogenic mutations as a molecular pathway responsible for some lung tumors, mainly not tobacco-related, for which anti-target therapies with excellent anti-tumor efficacy results have been developed. During the last few years, efforts have focused on the introduction of immunotherapy in earlier stages as neoadjuvant treatment for potentially resectable tumors and in an adjuvant setting, with some very promising results. With regard to earlier stages, consolidation immunotherapy after chemoradiation has also changed the paradigm of unresectable NSCLC, with marked benefits in terms of disease-free and overall survival. Initial successful results came from an improvement in overall survival for pretreated patients, and immunotherapy subsequently moved to a first-line palliative setting as monotherapy, in combination with chemotherapy or as double-checkpoint inhibition. The most widely used immunotherapy strategy in clinical practice is currently PD-1 and CTLA-4 immune checkpoint inhibition-based immunotherapy. Since 2015, immunotherapy has been changing the paradigm of NSCLC treatment in different settings and has contributed to improve the quality of life of these patients. The treatment of non-small-cell lung carcinoma (NSCLC) has changed markedly in recent years as a result of two major treatment milestones: Targeted therapy and immunotherapy.
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