Dr. West Discusses Chemotherapy Without Driver Mutations in NSCLC

H. Jack West, MD, thoracic oncologist, Swedish Cancer Institute at Swedish Medical Center, discusses chemotherapy in patients with non—small cell lung cancer (NSCLC) without driver mutations.

There is still a value in doing PD-L1 testing, even though the FDA indicates combining chemotherapy with immunotherapy regardless, explains West.

The FDA granted an accelerated approval of the combination of pembrolizumab (Keytruda) plus pemetrexed and carboplatin as a frontline treatment for patients with metastatic or advanced nonsquamous NSCLC, regardless of PD-L1 expression. The approval was based on part 2 of cohort G in the KEYNOTE-021 trial, in which the pembrolizumab combination elicited an objective response rate (ORR) of 55% compared with 29% with the chemotherapy agents alone (P = .0032).

According to West, it is an individualized decision on which treatment to give.