Dr. Qin on Treatment Considerations for Immunotherapy in NSCLC

Angel Qin, MD, clinical assistant professor, University of Michigan Health, medical oncologist, Rogel Cancer Center, Michigan Medicine, discusses treatment considerations for immunotherapy in patients with newly diagnosed non–small cell lung cancer.

To make therapeutic decisions, it is necessary to know the staging of the patient, according to Qin. Brain imaging must also be done due to the high propensity for brain metastases, Qin says. Understanding a patient’s molecular testing and PD-1 expression status is needed to inform clinical decisions with immunotherapy, Qin explains. Currently, there are 9 alterations for which FDA-approved targeted therapies are available, and more are under exploration in ongoing trials, Qin explains.

Furthermore, it is important to understand a patient’s individual goal for treatment, such as whether they want to use a more aggressive approach or focus more on quality of life, Qin adds. It is possible to have both, but because of differing toxicity profiles, 1 therapeutic regimen may prove to be more favorable based on patient preferences, Qin adds. Finally, understanding a patient’s performance status is important and sometimes overlooked. Clinical trials often enroll patients with excellent performance status, and this is not always reflective of the patients who are seen in the clinic, Qin concludes.