Dr. Gubens Discusses the Role of PD-L1 in Patients With NSCLC

Matthew A. Gubens, MD, MS, associate professor of thoracic medical oncology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, discusses an update to the National Comprehensive Cancer Network (NCCN) Guidelines regarding patients with PD-L1—positive non–small cell lung cancer (NSCLC).

It is important to test patients for PD-L1 expression, as high levels can be a marker for checkpoint inhibition. In the KEYNOTE-024 trial, patients with 50% or higher PD-L1 expression had a clear benefit to the PD-1 inhibitor pembrolizumab (Keytruda) as a single agent compared with a carboplatin/chemotherapy doublet, Gubens says.

In addition, Gubens highlighted data from the KEYNOTE-189 trial, in which pembrolizumab added to carboplatin and pemetrexed led to a higher response rate than single-agent pembrolizumab in KEYNOTE-024. For those with symptomatic burden, the immunotherapy/combination is a viable option for these patients regardless of PD-L1 expression, he adds. However, NCCN guidelines currently recommend pembrolizumab monotherapy as the preferred treatment option for patients with a good performance status and 50% or higher PD-L1 expression.

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