The Case for Immunotherapy Alone for Patients With PD-L1-High NSCLC in the First-Line Setting
At the Great Debates & Updates meeting in New York, New York, Jamie Chaft, MD, Memorial Sloan Kettering Cancer Center, New York, New York, debated in favor of using immunotherapy alone in the first-line setting for patients with high PD-L1 expression and non-small cell lung cancer.
Transcript:
Hi, I’m Jamie Chaft, a Thoracic Medical Oncologist at Memorial Sloan Kettering Cancer Center, here at Great Debates & Updates in Lung Cancer 2023. My first talk is about how to handle patients with high tumor expression of PD-L1 –that's defined as PD-L1 expression in at least 50% of the cancer cells— and the reality in clinical practice today is that we have a whole plethora of treatment options.
I'm focusing specifically on patients with non-small cell lung cancer who don't have actionable oncogene driver mutations. We can make life really easy and give everyone chemoimmunotherapy without thinking, but we have to really focus on what's best for the patient. That is not only the treatment that's best, but the treatment that's least toxic. My debate today will cover all the data, much of which has to be extrapolated and looked at side-by-side and not in a perfectly comparative fashion.
My conclusion here is that for patients with tumors that have high PD-L1 expression, we offer less toxicity and equivalent chance of long-term survival by administering immunotherapy only, saving chemoimmunotherapy for patients with low tumor PD-L1 expression or a very extreme burden of disease.
Source:
Chaft J. Debate: How to handle PD-L1 >50%- IO only. Presented at Great Debates & Updates in Lung Cancer; September 21-23. New York, NY.
