Corey Langer, MD
While challenges remain for patients with non-driver non-small lung cancer (NSCLC), there continues to be ongoing trials that are evaluating and testing various immunotherapy and chemotherapy combinations in the frontline setting, according to Corey Langer, MD.
, Langer, who is director of thoracic oncology at the University of Pennsylvania, provided further detail of the goals and implications of this clinical trial. Moreover, he discussed the current arena in NSCLC treatment and the obstacles that remain in effectively treating patients with non-driver mutations.
OncLive: What is the prevalence of patients with non-driver NSCLC?
The incidence of patients with non-driver mutations in NSCLC, specifically adenocarcinoma, is close to 70%. In squamous cell carcinoma, it’s 95% or higher. The vast majority of individuals we treat with advanced NSCLC, either metastatic at diagnosis or recurrent, do not have driver mutations or translocations. For those individuals, specifically with nonsquamous disease, the standard options generally include pemetrexed with carboplatin or a taxane with carboplatin. Now, [we have] the option of pembrolizumab combined with a platinum-based combination and, of course, bevacizumab combined with a platinum-based combination.
What are the current treatment strategies for nonsquamous NSCLC? Also, what are the considering factors for bevacizumab?
The standard approach for nonsquamous NSCLC, at least in 2017, involves a platinum combination in individuals who do not have an oncogenic driver. Usually that platinum combination in the United States is carboplatin and pemetrexed. In individuals who are not candidates for pemetrexed, it is carboplatin plus a taxane either every 3 weeks or weekly.
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