The use of
immune checkpoint inhibitors (ICIs), especially anti-programmed cell death 1 (PD1) and anti-programmed cell death
ligand 1 (PD-L1), has changed practices in oncology, becoming a new standard of care in first or subsequent lines for several
cancer subtypes. Recent data have highlighted the ability of standard
chemotherapy to enhance immunogenicity and/or to break immunoresistance of the tumour and its microenvironment, leading to a rationale for the use of ICIs in combination with the standard
chemotherapy regimen to improve efficacy of
cancer treatment. Here, we propose to review randomised clinical trials evaluating concomitant administration of ICIs and
chemotherapy, to assess clinical efficacy and safety profiles in advanced solid tumours. Association of these two modes of action on treatments has shown improved overall survival and better objective response rates than standard
chemotherapy, especially in first-line treatment of
non-small cell lung cancer (NSCLC) and for PD1/PD-L1 enriched tumours, highlighting a potential synergistic effect of this treatment combination in certain tumour types. However, improved survival results with the use of anti-PD-L1
avelumab as a maintenance schedule for
bladder cancer raises the question of the most appropriate approach between sequential and concomitant administration of chemoimmunotherapy. To date, no trials have compared in a head-to-head protocol the administration of concomitant chemoimmunotherapy with
chemotherapy, used for tumour debulking, followed by administration of ICIs. Regarding the tolerance profile, no new safety signals were found with the combination tested to date. Interestingly, recent results have shown an improved Progression Free survival 2 (PFS2) (defined as the progression after the next line of
therapy) in head-and-
neck cancers or NSCLC after a first-line
pembrolizumab-
chemotherapy combination, suggesting a potential long-lasting effect of ICIs when used in combination in the first-line setting.