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?
I ask this question recognizing there is no great data here, and that "pseudo-progression" is rare, but I am looking for any guidance with regard to how you approach this decision (it comes up a lot!)
2 Answers
Mednet MemberInvited Expert
Medical Oncology · Wexner Medical Center at The Ohio State University
Answered on
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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Medical Oncology · University of California Los Angeles
Answered on
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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