Clinical studies of immunotherapy in patients with non-small cell lung cancer have shown that certain patients do not benefit better from immunotherapy, “but many patients do,” the professor said. “We have to figure out which patients are the ones who didn’t benefit. When that happens, we have to think, can we still bring this treatment to patients with earlier lesions? That these drugs might work in maintenance therapy and adjuvant/neoadjuvant therapy? Of course, we are concerned about side effects such as pneumonia (which rarely occurs), but we still want these drugs to work in adjuvant therapy. But how are these drugs used in maintenance therapy? I think that needs to be explored further.” Using immunotherapy as first-line treatment for patients with stage IV lung cancer is also feasible, according to the professor. “If we had a marker, I think it would be much better, but some single-agent trials should be considered,” he said. “Other treatment possibilities for stage IV disease include immunotherapy combined with chemotherapy in combination with a tyrosine kinase inhibitor.” Adverse events associated with immunotherapy “are not the same as those that occur with chemotherapy,” the professor said. “For example, some endocrine events are not something we encounter very often. We are looking at how to deal with that.” The use of biomarkers and immune monitoring helps clinicians understand the effects of immunotherapy in patients with non-small cell lung cancer. The professor and his colleagues follow these patients who provide biopsy specimens at baseline, during treatment and at the end of treatment, “because after 1 year and beyond, you know: is this an active tumor? Or is it necrotic tissue?” He explained. “We now have ways to figure out who will respond to immunotherapy and why they will respond.” Another trend in the future of immunotherapy involves combining other drugs, which can address important mechanisms of positive and negative regulation of the immune system. The professor explained that the biological purposes of checkpoint inhibitor combinations include inducing antigen-specific T cells, providing more antigen-presenting cells (APCs), initiating/regulating APCs, driving T cell expansion to expand the number of antigen-specific cells, and simultaneously removing other regulatory checkpoint/T cell activation suppressors/peripheral expanders. ”The challenge now is to identify severe defects in individual patients,” the professor added. “We need to continue to investigate the biological significance of all potential ligand-receptor interactions in the tumor microenvironment.”