Dr. Drilon on the Utility of Immunotherapy in ALK+ NSCLC

Alexander Drilon, MD, research director, Early Drug Development, Memorial Sloan Kettering Cancer Center, discusses the potential utility of immunotherapy in ALK fusion—positive non­–small cell lung cancer (NSCLC).

Historically, the likelihood of achieving a response with immunotherapy in ALK-positive NSCLC was lower than in unselected patients with NSCLC, says Drilon. However, the combination of chemotherapy and immunotherapy could lead to improved response rates and provide a role for immune-based treatment in this subset of patients.

A subgroup analysis from the phase III IMpower150 trial showed that previously untreated patients with EGFR or ALK mutations derived benefit from the addition of atezolizumab (Tecentriq) to bevacizumab (Avastin) and chemotherapy. However, it appears that the benefit was mainly seen in EGFR-mutated patients rather than those with ALK alterations, says Drilon.

Prospective data regarding whether patients with ALK-positive NSCLC may derive benefit from chemoimmunotherapy is needed to confirm the preliminary signal of benefit that was reported in the IMpower150 trial, concludes Drilon.