Would you recommend adjuvant immunotherapy after platinum-based chemotherapy for patients with in resected NSCLC with HER2 mutations?

The benefit of immunotherapy in HER2 mutant NSCLC is an active topic of debate. I do not typically recommend adjuvant immunotherapy after platinum-based chemotherapy for patients with resected HER2-mutant NSCLC. Tumors with oncogenic drivers, specifically EGFR, ALK, ROS, RET, and HER2, show reduced benefit from immunotherapy, and I factor this into my decision-making. HER2-mutant NSCLC typically have a low TMB and a never-smoker phenotype, factors that are associated with limited ICI responsiveness. Although adjuvant atezolizumab or pembrolizumab have labeled indications for resected stage II–IIIA NSCLC post-chemotherapy that do not have EGFR mut or ALK fusions, the expected benefit in HER2-mutant disease is low, especially in individuals w...