H. Jack West, MD
In the setting of advanced non–small cell lung cancer (NSCLC), the choice of up-front immunotherapy or chemotherapy, or combinations of both, is aided by findings from several trials discussed during a recent expert panel presentation on the OncLive®
Some of the results from KEYNOTE-042, -189, and -407; CheckMate-227; and IMpower150 are practice-changing, according to the panel, moderated by H. Jack West, MD, medical director of the Thoracic Oncology Program at the Swedish Cancer Institute in Seattle, Washington. The panel discussed how these findings are likely to shape treatment and considered yet-unanswered questions.
In patients with nondriver mutations, KEYNOTE-042 results showed the difference high PD-L1 expression can make in the efficacy of frontline immune monotherapy. “The dramatic benefit with pembrolizumab monotherapy was in the 50% [PD-L1] or higher subset, and it diluted progressively as you added patients with a 20% cutoff or a 1% cutoff. And when you look at just the group of patients with 1% to 49% PD-L1, there was really no difference,” West said.
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