Dr Perol on Unmet Need for Post Immunotherapy Strategies in Lung Cancer

"This is one of the biggest unmet need we have today in clinical practice. There are a lot of efforts to change the current standard of care, which is still docetaxel or docetaxel plus anti-angiogenic drugs…[but] all the attempts, especially with VEGFR TKIs, have failed."

Maurice Perol, MD, a medical oncologist with Léon Bérard Cancer Center in Lyon, France, discussed efforts to improve upon post-immunotherapy treatment strategies in non–small cell lung cancer (NSCLC).

This topic is one that Perol identified as one of the biggest unmet needs currently facing clinical practice in his presentation at the 2025 Global Bridging the Gaps in Lung Cancer consensus meeting.

Perol noted that despite significant efforts to change the treatment landscape, the current standard of care following progression on immunotherapy-based regimens remains either docetaxel or docetaxel combined with anti-angiogenic drugs. The specific regimen depends heavily on the reimbursement policies and standards of care within different countries, he said. However, he explained that all attempts made so far to improve upon this standard have failed to demonstrate superiority over docetaxel.

A persistent challenge involves treating patients who experience late disease progression after receiving immunotherapy. Clinicians often hypothesize that it might be possible to resensitize the tumor to immunotherapy by introducing a different drug. However, attempts to implement this strategy, particularly through the use of VEGFR TKIs, have proven unsuccessful.

Despite these failures, the possibility of achieving tumor resensitization to immunotherapy still exists. Perol highlighted that results from other studies are pending, specifically mentioning the phase 3 LATIFY study (NCT05450692). This trial is designed to evaluate the combination of ceralasertib plus durvalumab (Imfinzi) vs docetaxel in patients with NSCLC whose disease progressed following prior anti–PD-(L)1 therapy and platinum-based chemotherapy. Although strategies based on taxanes and anti-angiogenic treatments were initially developed for the post-chemoimmunotherapy setting, the development of antibody-drug conjugates (ADCs) is now largely moving toward the front line. Consequently, ADCs may not emerge as a clear treatment option for the post-immunotherapy setting in the near future, he concluded.