What is your preferred first line regimen for PDL1-negative squamous cell lung cancer?
What is your general rationale for selecting from available options?
Answer from: Medical Oncologist at Academic Institution
Firstly, I think clinical trials, where available, should be considered for all patients particularly those with squamous and/or PD-L1 negative tumors as the benefits from chemo-IO in this setting have not been as striking as in PD-L1 positive or non squamous tumors, we have more work to do to impro...
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Answer from: Medical Oncologist at Academic Institution
Trials which demonstrated improved OS over standard platinum doublet in mNSCLC include:
1. KEYNOTE-407 (Carboplatin-Paclitaxel-Pembrolizumab -> Pembrolizumab) (Squamous histology)
2. CheckMate-9LA (Platinum-doublet-Nivo-IpiX2 cycle ->Nivo-Ipi)
3. CheckMate-227 (Nivo-Ipi Combination)
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Answer from: Medical Oncologist at Community Practice
I still use pembrolizumab with chemotherapy for the majority of patients with PD-L1 negative lung cancer using carboplatin and paclitaxel or nab-paclitaxel for SCC. The 9LA regimen is also a viable choice.
Answer from: Medical Oncologist at Community Practice
Absent clinical trial, I am treating these patients with KN-407 regimen, however, I have also utilized CM9LA regimen as discussed here (Q9560) in patients with recurrent disease. Off label CM227 is also attractive as outlined above, but since there does not seem to be a significant OS advantage that...
Answer from: Medical Oncologist at Academic Institution
As mentioned in this question, the answer to this question is not defined. In most situations, I will use KEYNOTE-407 regimen of carboplatin/paclitaxel + pembrolizumab. Any of the approved chemotherapy/immunotherapy options are appropriate (i.e. platinum doublet + pembrolizumab, atezo...
Answer from: Medical Oncologist at Community Practice
9LA trial
PDL-1 negative tumors