Immunotherapy in Lung Cancer

As treatments for patients with stage IV non–small cell lung cancer continue to evolve, patients with PD-L1–negative disease represent a unique cohort and chemotherapy/immunotherapy or immunotherapy doublet regimens appear to be effective.

The European Medicines Agency’s Committee for Medicinal Products for Human Use has recommended the approval of pembrolizumab as adjuvant treatment for adult patients with non–small cell lung cancer who are at high risk of recurrence following complete resection and platinum-based chemotherapy.

James Chih-Hsin Yang, MD, PhD, discusses the implications of the phase 3 KEYNOTE-789 trial and what directions investigators can examine in the future to help fill the unmet need for patients with TKI-resistant, EGFR-mutated metastatic non–small cell lung cancer.

Tony S.K. Mok, MD, BMSc, FRCPC, FASCO, provides perspective on the use of tumor treating fields in lung cancer, the use of anti–PD-L1 inhibitors approved in China, and the potential impact of the microbiome on response with immunotherapy.

Solange Peters, MD, PhD, discusses the successes and shortcomings of immunotherapy in patients with lung cancer; current challenges with defining resistance mechanisms to immunotherapy in this disease; and the potential applications of circulating tumor DNA monitoring in the early and metastatic disease settings.

Neoadjuvant treatment with nivolumab plus platinum-based chemotherapy followed by adjuvant nivolumab increased pathological complete response rates and prolonged survival compared with neoadjuvant chemotherapy alone in patients with resectable stage IIIA/B non–small cell lung cancer.

China’s National Medical Products Administration has accepted a supplemental new drug application seeking the approval of toripalimab in combination with platinum-based chemotherapy for the first-line treatment of patients with extensive-stage small cell lung cancer.

As antibody-drug conjugates become an established part of the lung cancer treatment paradigm, identifying which patients will benefit the most from treatment with these highly specific agents remains a challenge for clinicians.

Overview and clinical implications of the CheckMate-816 study of neoadjuvant nivolumab plus platinum chemotherapy versus chemotherapy alone in early-stage NSCLC.

The European Commission has approved nivolumab in combination with platinum-based chemotherapy for the neoadjuvant treatment of patients with resectable non–small cell lung cancer at high risk of recurrence with tumor cell PD-L1 expression of at least 1%.

Ben Levy, MD offers insight into how he approaches the selection of the optimal treatment strategy in early-stage non-small cell lung cancer.

A panel of experts who treat patients with non-small cell lung cancer provides an overview of staging, molecular testing and treatment options in stage I-IIIB non-small cell lung cancer.

Stephen V. Liu, MD, highlighted the importance of next-generation sequencing in lung cancer, key trials that have shifted the non–small cell lung cancer treatment landscape, and detailed ongoing research at Georgetown University Lombardi Comprehensive Cancer Center.

The addition of pembrolizumab to pemetrexed and platinum-based chemotherapy resulted in a numerical, but not statistically significant, improvement in progression-free survival or overall survival vs chemotherapy plus placebo in patients with TKI-resistant, EGFR-mutated, metastatic nonsquamous non–small cell lung cancer.

The addition of pembrolizumab to neoadjuvant platinum-based chemotherapy followed by resection and adjuvant pembrolizumab alone resulted in a significant improvement in event-free survival and pathological response for patients with early-stage non–small cell lung cancer.

Experts review data updates on chemotherapy / immunotherapy combination treatments in advanced NSCLC.

Closing their discussion, the panel shares their final thoughts on recent updates in advanced NSCLC and looks to the future of treatment.

John V. Heymach, MD, PhD, expands on the efficacy of perioperative durvalumab in the AEGAN trial, the significance of this unique approach for the non–small cell lung cancer treatment paradigm, and future research examining opportunities to build on or intensify the benefit achieved with this regimen.

Jarushka Naidoo, MD, M.B.B.Ch., explains the 5-year-data update from a study investigating single-agent pembrolizumab vs chemotherapy for advanced NSCLC.

The panel reviews data presented at ELCC from EMPOWERLung1 investigating cemiplimab versus chemotherapy in patients with advanced NSCLC.

Experts explain recent data updates on single-agent immunotherapy treatment for patient with advanced NSCLC.

Dr Solange Peters reviews data on the efficacy and toxicities of first-line nivolumab and ipilimumab for metastatic non-squamous NSCLC.

Jarushka Naidoo, MD, M.B.B.Ch., explains the debate on the gender differences in advanced NSCLC treatment.

Solange Peters, MD, PhD, detail the subgroups of patients with advanced NSCLC and how treatment varies.

The panel discusses how patients with advanced NSCLC are sub-grouped in NSCLC and how to approach treatment for each group.

Marina Garassino, MD, reviews the role of PD-L1 testing in advanced non-small cell lung cancer.

Data for adjuvant atezolizumab following neoadjuvant atezolizumab and resection demonstrated an improvement in disease-free survival and a trend toward improved overall survival in patients with resectable stage IB to IIIB non–small cell lung cancer compared with those who did not receive adjuvant atezolizumab.

The combination of tusamitamab ravtansine and pembrolizumab with or without chemotherapy generated responses and was well tolerated when used as first-line treatment for patients with CEACAM5-positive nonsquamous non–small cell lung cancer.

The use of 4 cycles of chemotherapy plus durvalumab with or without tremelimumab-actl was associated with improved or sustained response and similar toxicity compared with chemotherapy alone as frontline therapy in patients with metastatic non–small cell lung cancer, according to post hoc exploratory findings from the phase 3 POSEIDON trial.

Luis Paz-Ares, MD, PhD, highlight adverse events to monitor with pembrolizumab in this setting as well as its role in the treatment landscape.