What is the Optimal Treatment Duration of Immunotherapy for NSCLC?

Abstract

Non-small cell lung cancer (NSCLC) is the most frequent type of lung cancer in the world. The majority of patients with NSCLC without driver alterations in the metastatic setting and, increasingly, in the advanced setting, are treated with immunotherapy (IO) targeting the programmed cell death protein 1/programmed death-ligand 1 (PD-[L]1) pathway. Currently, in the perioperative setting, most studies have set a maximum duration of one year for OI, while for metastatic NSCLC the treatment is typically administered for a maximum of two years. However, there is an ongoing debate about whether treatment should be continued indefinitely or can be safely discontinued after two years. Additionally, identifying patient cohorts suitable for IO discontinuation remains a pivotal concern. This article aims to explore the available data from recent clinical trials, as well as emerging approaches to biomarker analysis that may help to determine the optimal duration of IO treatment for patients with NSCLC. PEER REVIEWED ARTICLE **Peer reviewers:** Prof. Markus Jörger (Cantonal Hospital St.Gallen, St.Gallen, Switzerland) Dr Wolf-Dieter Janthur (Cantonal Hospital Aarau, Aarau, Switzerland) Three anonymous peer reviewers Submitted on February 12, 2024; accepted after peer review on March 21, 2024; published online on March 26, 2024.