NSCLC – immunogenic after all?

Hauke Winter and colleagues (1) review the active immunotherapies in non-small cell lung cancer (NSCLC) which they rightly call the deadliest cancer in the world. Defying the efforts of researchers in the field, not a single pivotal trial has achieved a median overall survival (OS) of only one year in advanced NSCLC. Theoretically, cancer immunotherapies could result in long-term survival and hopefully, even cure of cancer patients. Yet, despite the desperate need for life-prolonging therapies in NSCLC, Winter and colleagues count only four randomized phase III trials with active immunotherapies in NSCLC, to which two randomized trials (2,3) with oral talactoferrin (TLF), an activator of dendritic cells leading to antigen-specific T-cell immunity (4,5) in advanced NSCLC could be added. So where does the disparity between therapeutic need and pivotal trials to address this need stem from?