NSCLC: PD-L1 Expression and Treatment Decision-Making
Clinical insights on how the level of PD-L1 expression informs treatment decisions for patients with non–small cell lung cancer.
EP: 1.First-Line Treatment Strategies for Advanced Non–Small Cell Lung Cancer
EP: 2.The Role of CTLA-4 Inhibitors in NSCLC
EP: 3.NSCLC: PD-L1 Expression and Treatment Decision-Making
EP: 4.TROPION-Lung01: Dato-DXd in Previously Treated Advanced NSCLC
EP: 5.Expert Perspectives on the Results of the TROPION-Lung01 Study in NSCLC
EP: 6.EVOKE-02: Sacituzumab Govitecan Plus Pembrolizumab in Advanced NSCLC
EP: 7.TROPION-Lung04: Dato-DXd Plus Immunotherapy in Advanced NSCLC
EP: 8.A Role for Biomarkers in Selecting Appropriate Patients for ADCs in NSCLC
EP: 9.First-Line Treatment for EGFR-Mutant Advanced Lung Cancer
EP: 10.FLAURA2: Osimertinib and Chemotherapy in Frontline EGFR-Mutant NSCLC
EP: 11.MARIPOSA: Amivantamab and Lazertinib in Frontline EGFR-Mutant NSCLC
EP: 12.Treatment Options in EGFR-Mutant NSCLC in Second Line and Beyond
EP: 13.MARIPOSA-2: Amivantamab and Chemotherapy in EGFR-Mutant NSCLC in Second Line and Beyond
EP: 14.Antibody-Drug Conjugates in EGFR-Mutant NSCLC
EP: 15.Clinical Pearls and Future Perspectives in Advanced NSCLC
This is a synopsis of a Peer Exchange video series featuring Benjamin P. Levy, MD, of Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins; Solange Peters, MD, PhD, of University Hospital of Lausanne; Joshua K. Sabari, MD, of NYU Langone’s Perlmutter Cancer Center; Edward B. Garon, MD, MS, of UCLA Jonsson Comprehensive Cancer Center; and Marina Chiara Garassino, MD, of University of Chicago Medicine Comprehensive Cancer Center.
The panel discussed whether to use immunotherapy alone or chemoimmunotherapy for patients with stage IV NSCLC [non–small cell lung cancer] with PD-L1 expression above 50%. Dr Garon said higher PD-L1 levels correlate with greater likelihood of benefit from immunotherapy, so he may use pembrolizumab monotherapy more for levels above 70% to 90% versus 50%. He is cautious using monotherapy in never-smokers, who seem to derive less benefit from PD-1 inhibitors alone per the data.
Dr Sabari agreed, noting he often adds chemotherapy for squamous histology and uses clinical factors to personalize first-line treatment. Dr Peters cautioned that a third of patients progress on pembrolizumab monotherapy in trials, so ensuring fitness for subsequent chemotherapy is important if not using upfront chemoimmunotherapy. Dr Levy remarked that chemoimmunotherapy and pembrolizumab alone have similar outcomes for PD-L1 greater than 50% patients in subset analyses from KEYNOTE-024 and KEYNOTE-189.
In conclusion, the experts emphasized that patient factors like smoking status, gender, histology, and disease burden help guide optimal first-line regimen in PD-L1–positive NSCLC. If not using initial chemoimmunotherapy, sequencing to chemotherapy after progression on PD-1 inhibitors remains critical.
*Video synopsis is AI-generated and reviewed by OncLive editorial staff.
