Dr. Lopes on Standard Durations of Checkpoint Inhibition in Metastatic Lung Cancer

Gilberto De Lima Lopes, MD, associate professor of clinical oncology and associate director of global oncology in the Sylvester Cancer Center at University of Miami Health System, discusses the standard of care for pembrolizumab (Keytruda) in patients with metastatic lung cancer.

Patients with stage III lung cancer receive pembrolizumab for a year, a timeline that was established in the PACIFIC trial, explains Lopes. Patients with metastatic disease should stop pembrolizumab if they experience progressive disease or toxicity. If the patient responds, they can continue treatment for up to 2 years before having a discussion regarding whether they want to continue or stop treatment, says Lopes.

Lopes often informs patients that it might be best to stop treatment after 2 years due to increased toxicity, but many patients resist the idea. The standard of care for pembrolizumab in patients with metastatic lung cancer is 2 years on the therapy, unless there is progression or toxicity, then stop. Other drugs do not have a stop rule in clinical trials, making the standard to continue treatment until progression or toxicity, concludes Lopes.

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