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What is your recommended adjuvant approach to resected NSCLC with both PD-L1>1% and EGFR mutation?

What would you do for a patient with a non-EGFR actionable mutation? IMpower010 included EGFR and ALK mutated NSCLC. Is there any concern in the use of adjuvant immunotherapy for these patients?
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How would you treat resected NSCLC with both PD-L1>1% and EGFR mutation?

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2 Answers
Mednet Member
Mednet MemberInvited Expert
Medical Oncology · University of Virginia
Answered on

IMpower010 included patients with EGFR mutations, which made up about 10% of the patients enrolled in the trial. In the subgroup analysis of EGFR patients whose tumors expressed PDL1 ≥1%, the HR of 0.57 favored atezolizumab, but had a wide confidence interval (95% CI, 0.26-1.24). Other studies of im...

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Mednet Member
Mednet Member
Medical Oncology · Case Comprehensive Cancer Center
Answered on

For patients with EGFR exon 19del and L858R mutations, I discuss the benefit in preventing disease recurrence by 3 years of osimertinib therapy following completion of adjuvant chemotherapy and I offer the treatment. I do not offer adjuvant atezolizumab to those patients.

Though patients with EGFR a...

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