Oncologists want definitive guidance on whether patients with resectable NSCLC benefit from immunotherapy before and after surgery or whether adjuvant therapy is unnecessary.
Since October 2023, the US Food and Drug Administration has approved three checkpoint inhibitors — pembrolizumab , durvalumab , and most recently nivolumab — alongside platinum-containing chemotherapy before surgery and as monotherapy after surgery to treat resectable NSCLC .
Without this understanding, patients may be taking immunotherapy unnecessarily, at significant expense and toxicity risk., a thoracic medical oncologist at Georgetown University’s Lombardi Comprehensive Cancer Center in Washington, DC. And these “risks definitely continue into the adjuvant period.
For patients who have viable disease after neoadjuvant therapy, continuing an immunotherapy postoperatively when it didn't work preoperatively “is not going to make a difference,” Chaft explained. In these cases, Chaft would look to enroll them in a clinical trial evaluating a different regimen because of the risk for relapse.
That"isn't exactly the kind of the level one evidence that one likes to see when making treatment decisions," said Reuss. “Without prospective data, all we can do is cross-trial comparisons and assessment of subgroups."
Nsclc Lung Cancer Lung Carcinoma Cancer Of The Lung Biologic Therapy Biologics Immunotherapy U.S. Food And Drug Administration United States Food And Drug Administration FDA Food And Drug Administration (FDA) Food And Drug Administration Neoadjuvant Surgery Cancer Malignant Neoplasia Carcinoma Malignant Neoplasm Toxicology Toxicity Poisoning Toxins
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