Would you consider starting immunotherapy in a patient with stage IV NSCLC, a high PDL1 level, and active, untreated hepatitis C?

The short answer is yes, while also sending the patient to hepatology for HCV treatment. If the patient has minimal disease burden and systemic therapy can be delayed, one small study in patients with NSCLC showed that starting ICI about 14 days after HCV treatment appeared safe. Although patients with active hepB/C were excluded from most landmark phase 3 trials, there are multiple studies, ranging from meta-analyses (Pu et al., PMID 32000444) to single-center studies (Alkrekshi and Tamaskar, P...