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For patients with advanced NSCLC who have radiographic disease progression on their follow-up scan after starting a PD-1 inhibitor, what characteristics (either clinical or radiographic) do you use to determine whether to continue with therapy or switch to something else?

2 Answers
Mednet Member
Mednet Member
Medical Oncology · Wexner Medical Center at The Ohio State University

I agree with @Dr. First Last - there are two situations in which I would consider continuing therapy for another 4 or 6 weeks, 1) if as he has noted, there is some inconsistency (ie some areas worse and some better) AND the patient is feeling well, 2) if there is modest radiographic progression BUT ...

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Mednet Member
Mednet Member
Medical Oncology · University of California Los Angeles

True pseudoprogression is very rare in non-small cell lung cancer. There are instances in which the scan results are inconsistent (e.g. some areas improved and some worsened), and I think that in such cases, it is reasonable to individualize treatment decisions. If scans at or after 8 weeks are clea...

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