How to Select Patients with Thoracic Cancers for Immunotherapy-Chemotherapy or Immunotherapy-Angiogenesis Inhibitor Combinations?

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About this Research Topic

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Background

Nowadays, immune checkpoint inhibitors (ICIs) have become the standard treatment for first- and second-line treatment of patients with thoracic cancer. As not all cancer patients exhibit the same response rates to immunotherapy, it is of utmost importance to identify the immunodominant population. Pathological type, tolerance of toxicity, performance status (PS) score, age, and biomarkers (such as TMB, PD-L1) are crucial factors for beneficiary selection.

More immunotherapies were selected based on tumor subgroups ("cold tumor" and "hot tumor"). Novel treatment strategies are needed to turn "cold" tumors into "hot" by reactivating the immune system and altering the immune microenvironment. One of the important treatment strategies is to combine ICI with anti-angiogenesis agents. Angiogenesis inhibitors can optimize the immune microenvironment and promote the recruitment of T cells. However, more related clinicopathological features and biomarkers need to be discovered and developed to identify subpopulations of differential drug response.

Chemotherapy was previously considered an immune suppressive therapy. However, immunotherapy-chemotherapy combination has demonstrated improvement in overall survival rate comparing with chemotherapy or immunotherapy alone. For example, for Non-Small Cell Lung Cancer (NSCLC) patients with tumor PD-L1 expression ≥50%, the role of combination chemotherapy in addition to pembrolizumab is warranted in clinical trials. Immunotherapy could also increase the sensitivity of microenvironment to chemotherapy by remodeling tumor vasculature and reducing cancer cell support.

To better identify the dominant population who benefit from ICI in combination with chemotherapy or anti-angiogenesis agents in thoracic cancer patients, this Research Topic aims to enhance our understanding of the impact of the tumor microenvironment, genetic features (EGFR, ALK, ROS1, RET, BRAF, etc.), and clinicopathologic factors on thoracic cancer patients treated with immunotherapy-chemotherapy combination or immunotherapy-antiangiogenesis combination, which would consequently benefit thoracic cancer patients in clinical settings. Manuscripts providing more information on clinical trial design and improving patient outcomes are also welcome.

We welcome submissions of Original Research and Reviews, focusing on the dominant population selection of thoracic cancer patients for ICI in combination with angiogenesis inhibitors or chemotherapy agents, encompassing clinical trials, translational, and basic research. Topics of interest include, but are not limited to, the following aspects:

- Predictive biomarkers facilitating patient selection for immunotherapy-chemotherapy or immunotherapy-angiogenesis inhibitor combinations
- The interaction between the gene variation spectrum and the tumor microenvironment in thoracic cancer patients with immunotherapy in combination with chemotherapy or with angiogenesis inhibition
- Changes in the tumor microenvironment during immunotherapy in combination with chemotherapy or with angiogenesis inhibition
- Heterogeneity of response to immunotherapy in combination with chemotherapy or with angiogenesis inhibition among different metastatic lesions especially brain or liver metastases and its underlying causes and mechanisms
- Genetic and molecular characteristics, clinicopathologic factors, and tumor microenvironment-related factors involved in combination with chemotherapy or angiogenesis inhibition including neoadjuvant therapy and adjuvant therapy
- The effects of radiotherapy on efficacy, adverse events, and changes in the tumor microenvironment of immunotherapy-chemotherapy or immunotherapy-angiogenesis inhibitor combinations

Please note: Manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent cohort or biological validation in vitro or in vivo) will not be accepted in any of the sections of Frontiers in Oncology.

Keywords: Thoracic Cancer, Angiogenesis, Immune Checkpoint Inhibitors, Tumor Microenvironment, Biomarker

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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