Dr. Otterson on the Utility of Immunotherapy in NSCLC

Gregory A. Otterson, MD, professor of internal medicine, associate division director for Education, co-director of the Thoracic Oncology Program for the Division of Medical Oncology, and associate director for the Hematology and Medical Oncology Fellowship Program, The Ohio State University Comprehensive Cancer Center—The James, discusses data examining immunotherapy alone versus in combination in non–small cell lung cancer (NSCLC).

The phase 3 KEYNOTE-407 study looked at the data of chemotherapy plus immunotherapy or chemotherapy alone in patients with NSCLC, says Otterson. This study showed that chemotherapy plus immunotherapy was better than chemotherapy alone. After a median follow-up of 7.8 months, the median overall survival was 15.9 months (95% CI, 13.2-not reached) in the pembrolizumab-combination group and 11.3 months (95% CI, 9.5-14.8) in the placebo-combination group (HR, 0.64; 95% CI, 0.49-0.85; P < .001).

However, physicians still do not know how chemotherapy plus immunotherapy compares with immunotherapy alone in patients with NSCLC who have a greater than 50% PD-L1 expression. For those who have a PD-L1 expression of greater than 50% they should be given pembrolizumab alone and for those who fall within the 0% to 49% of PD-L1 expression, they should be given chemotherapy plus pembrolizumab, concludes Otterson.