Immunotherapy in Specific Patients with Lung Cancer

Numerous randomized trials have demonstrated the dramatic anticancer benefits of immune checkpoint inhibitors (ICIs), targeting cytotoxic T lymphocyte antigen-4 (CTLA-4), or programmed cell death protein 1 (PD-1) and its ligand (PD-L1), resulting in their roles as standard treatments for a large lung cancer population. However, in those trials, as well as the swarmed ongoing trials, patients were selected under a relatively similar inclusion criterion, and thus, the efficacy and safety outcomes of ICIs in other patients who were routinely excluded or underrepresented in trials remain unclear. Such trial-ineligible patients seen in routine clinical practice are generally characterized by sensitizing driver gene alterations (e.g., EGFR, ALK, etc), organ-specific metastases (e.g., brain, liver, bone, etc), immunodeficiency (e.g., solid organ transplant, HIV infection, etc), active viral hepatitis (e.g., hepatitis B or C), autoimmune disorders, elderly age, and poor performance status. Moreover, the remaining value of ICIs in patients who had oligoprogression, pseudoprogression, hyperprogression, immune-related adverse events, and dissociated response after immunotherapy have not been completely investigated, especially in the context of the combination treatment era. Therefore, immunotherapy in those specific patients is an extremely common source of confusion for both clinical and academic communities.

This Research Topic aims at publishing high-quality Original Research, Reviews, Perspective and Opinion articles, and unique Case Reports on immunotherapy in specific lung cancer patients who were routinely excluded or underrepresented in clinical trials.

Potential topics of interest include but are not limited to:

1. Novel value of immunotherapy in patients with sensitizing driver gene alterations (e.g., EGFR mutations, ALK fusion oncogene, etc) including those harboring primary or acquired resistance of molecular targeted therapies with tyrosine kinase inhibitors.

2. Novel value of immunotherapy in patients with organ-specific metastases (e.g., brain, liver, bone, etc)

3. Novel value of immunotherapy in patients with abnormal basic immune conditions including immunodeficiency (e.g., solid organ transplant, HIV infection, etc) and autoimmune disorders.

4. Novel value of immunotherapy in patients with active viral hepatitis B or C.

5. Novel value of immunotherapy in patients with some identified demographic characteristics (e.g., elderly age and poor performance status, etc)

6. The remaining value of immunotherapy in specific clinical progression scenarios including pseudoprogression, oligoprogression, hyperprogression, and dissociated progression (concomitant regression in some tumors and progression in other tumors) after immunotherapy.

7. The remaining value of immunotherapy in patients with immune-related adverse events.