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Thoracic Malignancies • Medical Oncology • NCI-CCC Tumor Board Question • Ohio State University
Do you offer pembrolizumab monotherapy or carbo-pemetrexed-pembrolizumab to a patient with Stage IV large cell NSCLC with PD-L1 of 80% and KRAS+STK11 mutation?
Some retrospective data reports that STK11 (AKA LKB1) makes NSCLC resistant to immunotherapy.
Answer from: Medical Oncologist at Academic Institution
This is a good question. My opinion is first that the KRAS is irrelevant and only studied because of the mouse model. The entire effect is from LKB1, independent of KRAS. Second, that this has not been tested in any of the randomized trials looking at IO vs. IO/chemo vs. chemo, so ...
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Answer from: Medical Oncologist at Community Practice
I would approach this patient as usual with a discussion of risks (ie toxicities) and benefits (ie efficacy) of each course of therapy. Focusing just on the questions of montherapy with pembrolizumab vs the combination, I would focus on the "toxicities leading to death" in the respective studies (Ta...
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Medical Oncologist at NYU Winthrop Hospital
Shall we check all Metastases Lung Cancer for STK-...
Shall we check all Metastases Lung Cancer for STK-...