Treatment Landscape for Patients With Metastatic NSCLC Without Actionable Mutations

At the Great Debates & Updates in Lung Cancer Meeting in New York, New York, Karen Reckamp, MD, Cedars Sinai Medical Center, Los Angles, California, gave an overview of the treatment landscape for patients with metastatic non-small cell lung cancers that do not have actionable mutations.

Transcript:

Hi, I’m Karen Reckamp, I'm the Division Director of Medical Oncology and Professor of Medicine at Cedars Sinai Medical Center in Los Angeles, California. We're here at Great Debates & Updates in Lung Cancer in New York, New York. Today, I talked about the birds-eye view of non-small cell lung cancer treatment for patients with non-targetable non-small cell lung cancer.

This encompasses a large variety of lung cancers but we kind of took a step back and understood the history where before we knew about genomic alterations in lung cancer, we treated lung cancer whether it was small cell or non-small cell with different agents, and over the past 2 decades we have really moved to molecular subtypes but for those without an actionable alteration, we have less to go on and the biology that we look at, at this moment in time is generally PD-L1 to define the potential for monotherapy, for immunotherapy, and whether we need to use combination therapy.

PD-L1 is not a perfect biomarker, but it is still the best we have and based on some early phase 1 data showing that those who have PD-L1 >50% or more expression on their tumors at the time of treatment, that they are more likely to have responses to immunotherapy, and we've seen that play out in multiple trials. We have 3 agents, pembrolizumab, atezolizumab, and cemiplimab that are approved as monotherapy immune checkpoint inhibitor for patients who have high PD-L1, and this was improved over chemotherapy. We now have prolonged follow-up for many of these and continue to see about 20% of patients who have more long-term benefits, which is really exciting for patients.

Source:

Reckamp K. Birdseye view of the current treatment landscape in metastatic NSCLC without actionable mutations. Presented at Great Debates & Updates in Lung Cancer; September 21-23; New York, NY.