Immune checkpoint inhibitors (ICIs) have occupied a central role in first-line management of advanced non-small-cell lung cancer (NSCLC) for over a decade, with demonstrated survival benefits both as standalone therapy and when combined with chemotherapy. This has shifted expectations for outcomes in metastatic NSCLC, expanding options beyond chemotherapy alone.
However, the benefit is not universal. In the reported context, a substantial subset of patients—approximately 18%—show minimal or no clinical improvement with ICI approaches.
Additionally, a proportion of patients experience rapid deterioration due to primary resistance to ICIs, indicating that initial responses are not guaranteed for all individuals. Overall, while ICIs have transformed the treatment paradigm and contributed to improved survival for many patients, gaps in efficacy persist, including nonresponse and early decline in a meaningful fraction of patients.
This underscores the ongoing need to identify predictive biomarkers, optimize patient selection, and develop alternative or complementary strategies to address those unlikely to benefit from ICI-based regimens in the first-line setting of advanced NSCLC.
The Lancet Oncology published a clinical update in Oncology on 01 Apr 2026.
The item focuses on Beyond monotherapy: chemotherapy-free strategies in first-line advanced non-small-cell lung cancer.
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