Heather Wakelee, MD, associate professor of medicine, Stanford University Medical Center, discusses unmet needs for immunotherapy in the treatment of patients with non–small cell lung cancer.
Heather Wakelee, MD, associate professor of medicine, Stanford University Medical Center, discusses unmet needs for immunotherapy in the treatment of patients with non—small cell lung cancer (NSCLC).
Currently, when one looks at the data with combination chemotherapy and immunotherapy in metastatic disease, there is not a subgroup of patients with NSCLC where this therapy clearly did not show at least some benefit other than those with oncogene-driven disease. Although there are some other effective options available for patients with driver mutations, immunotherapy research in these patients is still a challenge.
To date, checkpoint inhibitors in combination with TKIs have been shown to be very toxic, and even in the absence of toxicity, this approach was not found to be very effective, Wakelee notes. Although chemotherapy combined with immunotherapy may be a potential option in those patients, early data have not been too promising.
Another area of unmet need is in the patients with underlying autoimmunity as well as those who have had organ transplants. In terms of autoimmunity, the big question to answer is how much investigators are willing to risk a severe flare versus not giving the patient the best available treatment? That’s an ongoing area of research, Wakelee concludes.