TIME for biomarker-driven immunotherapy in non-small-cell lung cancer patients

More than 85% of lung cancer cases are classified as non-small-cell lung cancer (NSCLC), with predicted 5-year survival of 16% (1). However, after many years of dismal prognosis we are now experiencing a revolution in lung cancer treatment. Apart from targeted therapies, the potential of immunotherapy has created great excitement in the oncology community and has ushered in a new era of optimism. Cancer immunotherapy encompasses different approaches designed either to boost or restore immune functions. Therapeutic cancer vaccines are designed to stimulate the immune system of a cancer patient to act against tumor antigens (2). Sipuleucel-T, a vaccine designed to stimulate an immune response to prostatic acid phosphatase (PAP), was the first cancer vaccine approved for treatment of metastatic prostate cancer (3). Talimogene laherparepvec (T-VEC) is the first oncolytic virus therapy approved for inoperable metastatic melanoma. Unfortunately, other therapeutic cancer vaccines such as MAGE-A3 or tecemotide have not proved successful in the treatment of NSCLC (4,5). Checkpoint blockade therapy releases the ’brakes’ of the immune system and enhances the anti-tumor T-cell response (6) and in 2015 two such therapies, nivolumab (7,8) and pembrolizumab (9) were approved for the treatment of NSCLC.