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What is your preferred first line approach to patients with good PS stage IV non-squamous NSCLC that is EGFR/ROS1/ALK/BRAF WT and PDL-1 < 1%?

Do you prefer carboplatin-paclitaxel-bevacizumab, carboplatin-pemetrexed-pembrolizumab, or chemotherapy alone?
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What is your preferred first line approach to patients with good PS stage IV non-squamous NSCLC that is PD-L1 and driver mutation negative?

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2 Answers
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Medical Oncology · Fox Chase Cancer Center
Answered on · Updated on

At least two phase III studies have now demonstrated the benefit of chemoimmunotherapy as first line therapy. The carboplatin/pemetrexed/pembroluzimab regimen, initially reported and FDA approved on the basis of a randomized phase II study has now been validated in the phase III setting (Keynote 189...

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Mednet Member
Mednet MemberInvited Expert
Medical Oncology · Wexner Medical Center at The Ohio State University
Answered on

I agree with @Dr. First Last's approach and the regimen(s) used. I tend to use pemetrexed and carboplatin as my "go to" regimen for non-squamous histology given its excellent tolerability, and use paclitaxel, carboplatin and bevacizumab generally for those not able to use pemetrexed (renal function ...

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