Dr. Borghaei on Immunotherapy versus Chemotherapy and Immunotherapy in NSCLC

Hossein Borghaei, DO, MS, chief, Division of Thoracic Medical Oncology, director, Lung Cancer Risk Assessment, professor, Department of Hematology/Oncology, co-director, Immune Monitoring Facility, Lung Cancer and Mesothelioma TRDG member, and Gloria and Edmund M. Dunn Chair in Thoracic Oncology, Fox Chase Cancer Center, discusses immunotherapy alone or in combination with chemotherapy in combination with immunotherapy in patients with advanced NSCLC.

PD-L1 expression is one of the first factors considered for patients undergoing a comprehensive genomic analysis with a sequencing panel. The next step of treatment involves assessing patients for genetic alterations, such as EGFR and BRAF mutations, and then directing them toward appropriate targeted therapy based on the testing results.

Genomic testing provides a genomic profile of NSCLC tumors. If a patient’s PD-L1 expression level is >50% (PD-L1—high) then the possibility of treatment with pembrolizumab (Keytruda) alone can be explored, or, potentially in the near future, with atezolizumab (Tecentriq), concludes Borghaei.