What is your preferred first line treatment option for a fit patient with non-squamous NSCLC who is PDL1 positive (1-49%) with no driver mutations?
My preferred first line option for patients with advanced NSCLC and PDL1 TPS score of >1% and <50-% remains chemotherapy with immunotherapy. I prefer carboplatin- pemetrexed -pembrolizumab for nonsquamous and carboplatin-taxane-pembrolizumab for squamous cell NSCLC. I might consider Nivolumab Ipilim...
This is a group of patients that often gets combination chemo-immunotherapy. However, during the pandemic, many institutions including my own treated patients on single agent immunotherapy (on the basis of the KN-042 study) to avoid chemotherapy-induced risks. My preference now is to discuss the INS...
For chemo eligible patients, I still favor chemo-IO combination (KEYNOTE-189 regimen). This trial has the best data so far for PD-L1 (22c3) TPS: 1-49% (ORR ~ 49% Md DOR 12.9 mo, Md OS 21.8 months) (Gadgeel et al., PMID 32150489, Gandhi et al., PMID 29658856).
For chemo-ineligible patients, Nivo-Ip...