Dr. Langer on the Impact of Frontline Immunotherapy in Lung Cancer

Corey J. Langer, MD, director, Thoracic Oncology, Abramson Cancer Center, professor of medicine, Perelman School of Medicine, University of Pennsylvania, discusses the impact of frontline immunotherapy in lung cancer.

The introduction of immunotherapy upfront has changed the treatment paradigm, Langer says. Only a few years ago, the then standard of care docetaxel was either relegated to the third-line setting or rendered clinically irrelevant. In nonsquamous disease, platinum-based chemotherapy was generally administered in the frontline setting, followed by immunotherapy, regardless of PD-L1 status. If immunotherapy failed to show efficacy, the patient would go on to receive docetaxel and ramucirumab (Cyramza).

In the second-line setting, there are some cases where a physician would go with docetaxel alone—for example, if there’s ongoing bleeding. An agent such as gemcitabine could even be used as an alternative to ramucirumab.