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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?

Does the 2020 approval of Nivolumab and Ipilimumab for mNSCLC with PDL1 >1% impact your decision?
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What is your preferred front line treatment for metastatic NSCLC without a driver mutation with PDL1 1-49%?

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3 Answers
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Mednet MemberInvited Expert
Medical Oncology · Indiana University
Answered on

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...

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Medical Oncology · Yale School of Medicine
Answered on

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...

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Mednet Member
Mednet MemberInvited Expert
Medical Oncology · University of Maryland
Answered on · Updated on

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...

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