A retrospective analysis of immunotherapy in non-small cell lung cancer patients with targetable genetic mutations

Targeted therapy has greatly improved the survival time and quality of life of some patients with non-small cell lung cancer. The application of immunotherapy among populations without targetable oncogenes has also achieved great success. However, the decision is still inconclusive as to whether immunotherapy can be used in targeted populations. We screened studies related to immunotherapy for lung cancer from public data platforms and then rearranged the cases. We grouped these cases according to driver genes and analyzed the impact of different targetable genes on immunotherapy (including mono-immunotherapy and combined immunotherapy). In addition, we also identified the predictive efficacy of programmed death-ligand 1 and tumor mutation burden on immunotherapy in populations with different driver genes. We identified 926 cases of lung cancer doing immunotherapy, including 321 cases in the driver gene negative group, 289 cases in the non-sensitive mutations group, and 316 cases in the sensitive mutations group. Except for KRAS and BRAF-sensitive mutations, the other sensitive mutations seemed to impede the effectiveness of immunotherapy. While among the non-sensitive mutations, aside from the EGFR group, the others exhibited immune benefits. The predictive effects of programmed death-ligand 1 and tumor mutation burden on immunotherapy were no longer uniform in mono or combined immunotherapy and needed to be discussed separately. Our data suggest that certain driver gene mutations may influence the response to immunotherapy, though further validation in larger cohorts is needed to confirm these observations. Combined immunotherapy is also different from mono-immunotherapy in many aspects, so we need to consider it separately according to different situations in clinical treatment.