In patients with metastatic lung SCC who are on pembrolizumab maintenance after starting pembrolizumab/carboplatin/nab-paclitaxel, what is your treatment strategy if they progress while on pembrolizumab alone?

Topics: Lung Cancer • Thoracic Malignancies • Medical Oncology • Non-small cell lung cancer

Would you continue pembrolizumab with a re-challenge with carboplatin/taxane or move to second line therapy?

Answer from: Medical Oncologist at Academic Institution

Several great questions here, largely unanswered. What is the role of platinum rechallenge in stage IV NSCLC? I generally do not revisit platinum (recall the higher risk of a carboplatin infusion reaction with multiple courses), but if the initial response was remarkable, it would be worth consider...

Comments

Medical Oncologist at University of Pittsburgh
I agree with Dr. @Stephen V. Liu. If the response...

Medical Oncologist at Northwest Georgia Oncology Centers
We've also continued IO and added a dash of radiat...

Answer from: Medical Oncologist at Community Practice

Like any therapy progression, if the patient's progression is slow and the patient minimally symptomatic, with no data published in this particular space of any effective therapy, I would continue the immunotherapy. I assume the patient is several months on therapy and survival after 12 months is ou...

Answer from: Medical Oncologist at Community Practice

Second line rx.

Answer from: Medical Oncologist at Academic Institution

If the response was over 6 months, I would consider enrollment into QUILT-3.055 which would be Pembrolizumab + ALT-803 (super IL-15). In the absence of this study, but with durable response, I would consider Ipi + Nivo before I consider chemotherapy. This patient has clearly shown its ability to res...

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