Can immunotherapy, alone or with chemo, be considered for ROS1+ NSCLC after exhausting ROS1 targeted therapy options?

Following evidence in more common driving mutations (especially those not associated with a history of tobacco use), I would not recommend immunotherapy alone for this group. When using chemotherapy, it is reasonable to consider adding immunotherapy, but there is no strong evidence to support it.

In general, I use chemotherapy alone after exhausting ROS1 options.

I would not give single agent immunotherapy to a ROS1 patient as their response rate would be expected to recapitulate the response rate of single agent immunotherapy in other genomic driver subsets like EGFR mt lung cancer where the response rates are on the order of 5%. There is not enough data on...

I would not use single agent checkpoint inhibitors among patients with ROS1 NSCLC. Some of these patients may even have high PDL1 expression, though I believe this to be a red herring. The elevated PDL1 expression potentially reflects activation of multiple signaling pathways from the ROS1 gene fusi...