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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?

Would you continue pembrolizumab with a re-challenge with carboplatin/taxane or move to second line therapy?
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How do you manage Stage IV NSCLC patients who progress on pembro maintenance therapy after chemoimmunotherapy?

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4 Answers
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Medical Oncology · Georgetown University Hospital
Answered on

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 consideri...

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Medical Oncology · Siri Onclogy and hematology Infusion Service
Answered on

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...

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Medical Oncology · Midwestern Reg Medcl Center
Answered on

Second line rx.

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Medical Oncology · University of Miami Sylvester Comprehensive Cancer Center
Answered on

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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