Dr. Gentzler on the Role of Chemotherapy in Metastatic NSCLC

Ryan D. Gentzler, MD, assistant professor, Division of Hematology/Oncology, University of Virginia Health System, discusses the role of chemotherapy in patients with metastatic non—small cell lung cancer (NSCLC).

Through the identification of different oncogenic drivers and development of targeted therapies, physicians have been able to delay the need for chemotherapy in patients with lung adenocarcinoma, explains Gentzler. Additionally, the use of immunotherapy has proven effective in smokers and patients who do not harbor oncogenic drivers.

Over the past year, data have shown that chemotherapy still has an important role in the treatment paradigm, says Gentzler. When physicians add chemotherapy to an immunotherapy regimen, it seems to show a better chance of response or a longer duration of response. Several studies have looked at chemotherapy as a backbone with immunotherapy. That combination has improved upfront responses, lengthened progression-free survival, and helped patients live longer. Now, trials are showing overall survival improvement by adding PD-1/PD-L1 inhibitors to standard chemotherapy, states Gentzler.