Dr. Natale on the Evolution of Immunotherapy in NSCLC

Ronald B. Natale, MD, medical director of the Clinical Lung Cancer Program and assistant clinical professor of medicine at Cedars-Sinai, discusses the evolution of immunotherapy in advanced non–small cell lung cancer (NSCLC).

Over the past 2 years, the role of immunotherapy in NSCLC has evolved from approvals for second-line treatment in advanced stage IV disease. Since then, results from randomized clinical trials have demonstrated that both nivolumab (Opdivo) and pembrolizumab (Keytruda) are more effective than docetaxel, but with those data, the immune checkpoint inhibitors have quickly moved into the first-line setting, explains Natale.

The first group of studies in this field were done with immune checkpoint inhibitors versus standard first-line chemotherapy. Results have indicated that, in patients with a high tumor proportion score of PD-L1, which constitutes about 25% to 30% of the patient population,single-agent pembrolizumab was superior to standard platinum-based chemotherapy in those with squamous or NSCLC, concludes Natale.