Dr. Mott on Sequencing of Treatments with NSCLC

Frank E. Mott, MD, associate professor, Department of Thoracic/Head and Neck Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, discusses the sequencing of treatments for patients with non—small cell lung cancer (NSCLC).

According to Mott, many factors go into sequencing, such as the histology and profile of the tumor, as well as the patient and their comorbidities. For example, immunotherapy indications are based on PD-L1 levels, which influence the choice of giving a PD-1 inhibitor early on in a patient's disease course.

Outside of immunotherapy, the decision of which tyrosine kinase inhibitor to use first is somewhat similar, says Mott. For example, the ALEX study suggests using alectinib (Alecensa) for patients with ALK-positive tumors as it has supplanted crizotinib (Xalkori) as the preferred first-line therapy.