Dr. Patel Discusses Novel Targets in NSCLC

Sandip P. Patel, MD, associate professor, University of California, San Diego (UCSD), co-leader, Experimental Therapeutics, deputy director, San Diego Center for Precision Immunotherapy, director, Clinical Trials Office, UCSD Moores Cancer Center, UCSD Health Sciences, discusses novel targets in non–small cell lung cancer (NSCLC).

Research in NSCLC is generating significant enthusiasm for novel targets, Patel says. Some investigational targets, such as NRG1 fusions, are mRNA based and therefore best detected via RNA testing. Additional KRAS inhibitors directed toward pan-KRAS alterations or KRAS G12D mutations could shift the paradigm in NSCLC, Patel says. Novel immunotherapies, such as those directed toward TIGIT, as well as cellular therapies are also in development and could emerge for certain patient populations, Patel explains.

However, practice-changing efforts in NSCLC have been localized to the early-stage setting recently, Patel says. For example, on October 15, 2021, the FDA approved atezolizumab (Tecentriq) for use as adjuvant treatment following resection and platinum-based chemotherapy in patients with stage II to IIIA NSCLC whose tumors express PD-L1 of 1% or greater with the SP263 assay. Additionally, neoadjuvant nivolumab (Opdivo) in combination with chemotherapy improved pathologic complete response rate vs chemotherapy alone in patients with resectable NSCLC, suggesting this regimen could be a potential treatment option for patients. 

Obtaining molecular testing results prior to treatment selection is key to optimizing targeted options, Patel concludes.