Atezolizumab in lung cancer—appreciating the differences

Once felt to be a non-immunogenic tumor, non-small cell lung cancer (NSCLC) has become an example of the transformative potential of immunotherapy in oncology. Nivolumab and pembrolizumab, two monoclonal antibodies that target PD-1, have become firmly established as standard second-line therapy for patients with advanced NSCLC. Nivolumab was compared to second-line docetaxel in squamous NSCLC [Checkmate 017 (1)] and non-squamous NSCLC [Checkmate 057 (2)] and in both histologic subtypes, demonstrated an improvement in overall survival. Similarly, pembrolizumab was compared to second line docetaxel in the KEYNOTE-010 study (3) and also showed a significant improvement in overall survival.