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Role of CTLA Inhibition in Management of Non-Small Cell Lung Cancer

  • Lung Cancer (H Borghaei, Section Editor)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The use of single-agent or combination immunotherapy strategies has revolutionized the management of patients with non-small cell lung cancer (NSCLC). Here, we review the current role for CTLA-4 inhibitors in early-stage resectable NSCLC, unresectable stage III NSCLC, and in metastatic NSCLC.

Recent Findings

Immunotherapy agents alone, or in combination with chemotherapy, represent the new standard of care for the management of metastatic squamous and non-squamous NSCLC without driver mutations. Combination CTLA-4 and PD-1/L1 inhibitors can be efficacious, particularly in tumor mutation burden (TMB) high tumors, providing a chemotherapy-free strategy for metastatic patients. Early signals from neoadjuvant trials suggest a benefit for combination CTLA-4 and PD-1 inhibitions prior to surgery, with improved rates of major pathologic response (MPR). The role for CTLA4 inhibitors is currently unknown in the adjuvant and unresectable stage III setting, although clinical trials are ongoing to evaluate this approach.

Summary

There is a growing role for CTLA-4 inhibition in the neoadjuvant and metastatic settings for patients with NSCLC. Biomarker selection in ongoing clinical trials will be crucial to guide patient selection for CTLA4 inhibitor therapy. Combination strategies with PD-1/L1 inhibition have demonstrated the greatest efficacy to date.

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Authors and Affiliations

  1. Division of Medical Oncology, the Huntsman Cancer Institute at The University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA

    Kathleen Kerrigan & Sonam Puri

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  1. Kathleen Kerrigan
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  2. Sonam Puri
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Correspondence to Sonam Puri.

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This article is part of the Topical Collection on Lung Cancer

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Kerrigan, K., Puri, S. Role of CTLA Inhibition in Management of Non-Small Cell Lung Cancer. Curr Oncol Rep 24, 113–123 (2022). https://doi.org/10.1007/s11912-021-01164-1

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