Immunotherapy as an Innovative Treatment for Non-Small Cell Lung Cancer – A Comprehensive Literature Review

Lung cancer has, for several decades, been the second most frequently diagnosed malignancy and the leading cause of cancer death worldwide. It continues to pose a significant burden on healthcare systems and a serious challenge for clinicians and patients. The majority of patients present with advanced disease at diagnosis, and most survive less than five years. Although novel targeted therapies have been introduced in recent years, there remains a significant demand for treatments capable of improving response and prolonging survival while having minimal impact on quality of life. Recent clinical evidence supporting immunotherapeutic approaches indicates that they may represent the next major therapeutic breakthrough in lung cancer management. Non-small cell lung cancer (NSCLC), which accounts for about 85% of lung cancers, was once considered a non-immunogenic disease; yet, as with several other malignancies, emerging data suggest that in most cases, the lack of immune response is functional and can be therapeutically overcome. Purpose: To provide a comprehensive review of immunotherapy as an innovative therapeutic approach for non-small cell lung cancer (NSCLC), highlighting the role of key immune mechanisms and checkpoint inhibitors. Material and Methods: The authors conducted a detailed literature review examining the immune context of NSCLC, discussing the significance of PD-1/PD-L1 and CTLA-4 checkpoints, relevant clinical trials, and emerging biomarkers like PD-L1 expression and tumor mutational burden. Findings: Immunotherapy, particularly PD-1/PD-L1 inhibitors, substantially improves survival in advanced NSCLC and can be enhanced by combination strategies. Biomarkers help identify patients most likely to benefit while guiding treatment choices.