Dr. Brahmer on the Utility of Consolidative Immunotherapy Vs Targeted Therapy in NSCLC

Julie Renee Brahmer, MD, MSc, professor of oncology, co-director, Upper Aerodigestive Department, Bloomberg~Kimmel Institute for Cancer Immunotherapy, co-director, Cancer Immunology Program, director, Thoracic Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medicine, discusses questions regarding the role of consolidative immunotherapy vs targeted therapy in locally advanced non–small cell lung cancer (NSCLC).

Treatment selection between consolidative immunotherapy or targeted therapy remains uncertain in patients with oncogene-driven locally advanced NSCLC. Findings from the phase 3 PACIFIC trial (NCT02125461) demonstrated improved survival with durvalumab (Imfinzi) following concurrent chemoradiation in patients with stage III unresectable NSCLC. Although the sample size was limited, patients on the PACIFIC trial who harbored EGFR mutations did not appear to derive progression-free survival or overall survival benefit with durvalumab, Brahmer explains.

Data from the stage IV NSCLC setting, where adjuvant osimertinib (Tagrisso) and atezolizumab (Tecentriq) are utilized, could be extrapolated to inform decisions with consolidative targeted therapy and immunotherapy in the earlier-line setting, Brahmer concludes.