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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
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 ...
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...