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How would use of adjuvant atezolizumab for PDL1+ NSCLC potentially impact your treatment choice at recurrence?

Is there a certain time interval where you would feel comfortable to rechallenge with immunotherapy at recurrence (6m vs 1y vs 2y?) Does degree of PDL1 expression impact your approach?
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How would you treat a patient with PDL1 1-49% lung adenoca with metastatic relapse ~12 months after adjuvant atezolizumab?

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2 Answers
Mednet Member
Mednet MemberInvited Expert
Medical Oncology · University of Virginia
Answered on

Certainly pattern of relapse is important, and those with local or locoregional recurrences could be treated with definitive intent SBRT, surgery, or concurrent chemotherapy and radiation for mediastinal recurrence.

For those with recurrent not amenable to local therapy, this is a challenging questi...

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Mednet Member
Mednet Member
Medical Oncology · Case Comprehensive Cancer Center
Answered on

A disease that recurs within a short period of time from completion of systemic therapy is typically considered refractory to it. My usual cut off for considering re-challenge is 6 months, which is amply utilized in clinical trials as eligibility criteria for patients presenting with metastatic recu...

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