Over the past decade, immune checkpoint inhibitors (ICIs) have transformed the management of multiple malignancies including lung cancer. However, the optimal use of these agents in terms of duration, dose and administration frequency remains unknown. Focusing on anti-PD1 agents nivolumab and pembrolizumab in the context of non-small cell lung cancer, we argue that several lines of evidence suggest current administration regimens of these drugs may result in overtreatment with potentially important implications for cost, quality of life and toxicity. This review summarizes evidence for the scope to optimize anti-PD1 regimens, the limitations of existing data and potential approaches to solve these problems including with a novel multi-arm clinical trial design implemented in the recently opened REFINE-Lung study.

中文翻译：

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非小细胞肺癌抗PD1治疗的最佳持续时间、剂量和频率是多少？

在过去的十年中，免疫检查点抑制剂（ICIs）已经改变了包括肺癌在内的多种恶性肿瘤的治疗方法。然而，这些药物在持续时间、剂量和给药频率方面的最佳使用仍然未知。重点关注非小细胞肺癌背景下的抗 PD1 药物纳武单抗和派姆单抗，我们认为，多项证据表明这些药物的当前给药方案可能会导致过度治疗，从而对成本、生活质量和毒性产生潜在的重要影响。本综述总结了优化抗 PD1 治疗方案的范围、现有数据的局限性以及解决这些问题的潜在方法的证据，包括在最近开放的 REFINE-Lung 研究中实施的新型多臂临床试验设计。