Dr. Kris on Immunotherapy in NSCLC Without Driver Mutations

Mark G. Kris, MD, William and Joy Ruane Chair in Thoracic Oncology, Memorial Sloan Kettering Cancer Center, discusses the role of immunotherapy in patients with non–small cell lung cancer (NSCLC) without driver mutations.

Currently, most patients with NSCLC can receive immunotherapy, although driver mutation tests may indicate the optimal frontline choice for patients with mutations is targeted therapy, Kris says. Genomic testing can also determine which patients have no driver mutations and are therefore good candidates for immunotherapy, Kris explains.

In March 2022, the FDA approved neoadjuvant nivolumab (Opdivo) plus chemotherapy in patients with NSCLC with no EGFR or ALK mutations, and in November 2022, the FDA approved cemiplimab-rwlc (Libtayo) plus chemotherapy in patients with advanced NSCLC without EGFR, ALK, or ROS1 aberrations, Kris notes. Molecular testing can help rule in immunotherapy options such as nivolumab or cemiplimab or determine effective targeted therapies, depending on a patient’s mutation profile, Kris says.

Immunotherapy is a standard of care in NSCLC because it is an effective treatment, lengthening life and even leading to cures in some patients, including those with advanced disease, Kris emphasizes. Additionally, in the average patient, immunotherapy agents are compatible with a good quality of life, and this, in combination with their efficacy, tolerable safety profile, and curative potential, makes them ideal drugs for patients without driver mutations, Kris concludes.