Advanced-Stage Non–Small Cell Lung Cancer: Advances in Thoracic Oncology 2018

Jordi Remon, Myung Ju Ahn, Nicolas Girard, Melissa Johnson, Dong Wan Kim, Gilberto Lopes, Rathi N. Pillai, Benjamin Solomon, Guillermo Villacampa, Qing Zhou

Research output: Contribution to journalReview articlepeer-review

41 Scopus citations


In 2018 research in the field of advanced NSCLCs led to an expanded reach and impact of immune checkpoint inhibitors (ICIs) as part of a frontline treatment strategy, regardless of histologic subtype, with ICI use extended to include stage III disease, shifting the prognosis of all these patients. This new standard first-line approach opens a gap in standard second-line treatment, and older combinations may again become standard of care after progression during treatment with an ICI. The characterization of predictive biomarkers, patient selection, the definition of strategies with ICI combinations upon progression during treatment with ICIs, as well as prospective evaluation of the efficacy of ICIs in subpopulations (such as patients with poor performance status or brain metastases) represent upcoming challenges in advanced thoracic malignancies. In oncogene-addicted NSCLC three major steps were taken during 2018: next-generation tyrosine kinase inhibitors have overtaken more established agents as the new standard of care in EGFR and ALK receptor tyrosine kinase gene (ALK)-positive tumors. Mechanisms of acquired resistance have been reported among patients treated with next-generation EGFR tyrosine kinase inhibitors, reflecting the diversity of the landscape. One major step forward was the approval of personalized treatment in very uncommon genomic alterations, mainly fusions. This raises a new question about the challenge of implementation of next-generation sequencing in daily clinical practice to detect new and uncommon genomic alterations and to capture the heterogeneity of the mechanisms of acquired resistance during treatment, as well as the need to extend research into new therapeutic strategies to overcome them.

Original languageEnglish (US)
Pages (from-to)1134-1155
Number of pages22
JournalJournal of Thoracic Oncology
Issue number7
StatePublished - Jul 2019


  • Advanced
  • Immune checkpoint inhibitors
  • Non–small cell lung cancer
  • Oncogenic drivers

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine


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