What is the preferred second line, systemic therapy for NSCLC patients following first line chemoimmunotherapy?

This is as usual a quite complex question, and for a sophisticated audience such as theMednet readers, I always want to provide a nuanced answer; so here is what my preferred second line systemic therapy currently is:

None.

None.

Still none…

Indeed, now that chemo/immunotherapy has become the de facto s...

The more things change, the more they stay the same. The simple answer is docetaxel or pemetrexed, depending upon prior therapy and histology. For a patient with a non-squamous carcinoma treated with carboplatin/pemetrexed/pembroluzimab, docetaxel is probably the correct choice. This is based upon t...

Other than clinical trials, patients (non-squamous) who received carbo/Taxol/BEV/Atezo, second-line therapy with pemetrexed second line is an option.
Patients who received carbo/pem/Pembro (Adenocarcinoma or non-squamous) or patients who received carbo/nab-paclitaxel/Atezo (squamous), second line Doc...

This is a simple question with a complex answer. Second line is dependent on histology, tumor NGS, depth of response to chemoimmunotherapy, DoR, velocity of progression, site/sites of progression, availability of clinical trials, and patient's PS. If there is a potential target (NTRK or MET exon 14)...

Gandara et al. presented an abstract (#9001) at ASCO 2017 that looked at atezolizumab beyond progression (for transparency, I was an al.) Interestingly, over 50% of patients in the Oak study were treated beyond progression and over 50% had either stable disease or even responded. This was not purely...

For patients with metastatic NSCLC without a targetable alteration who have progressed on first-line chemoimmunotherapy, I think the preferred second line therapy remains ramucirumab plus docetaxel, based on the REVEL study (Garon et al., PMID 24933332). But, as with the fragmentation by molecular a...

While many exciting agents are being tried in the post-chemo-IO setting for NSCLC, with some showing encouraging early signs of efficacy, as of now, the landscape of approved therapies is limited except for tumors where actionable driver mutations are present. For patients with targetable driver mut...

The emergence of molecular targeted therapies and immune checkpoint inhibitors as standard first-line treatments for non-small cell lung cancer (NSCLC), has led to a growing population of patients where the posed question becomes very relevant when molecular targeted therapies and immune checkpoint ...

I am offering my patients access to clinical trials where I continue IO and change its partner: docetaxel/ramucirumab with pembrolizumab; vorolanib with nivolumab; Lung MAP. Don’t hesitate to reach out to me if you are considering one of these options for your patient.

Taxotere