Dr Saxena on Shifts in Treatment With Targeted and Immune Therapies in NSCLC

Ashish Saxena, MD, PhD, assistant professor, medicine, Weill Cornell Medical College, assistant attending physician, the NewYork-Presbyterian Hospital, discusses recent shifts in treatment with the use of targeted and immune therapies in patients with non–small cell lung cancer (NSCLC).

In NSCLC, shifts have occurred in the use of targeted therapies and immunotherapies, including the advancements observed in the realm of EGFR-mutated lung cancers, where targeted therapies have emerged as a focal point of treatment innovation, Saxena begins. These therapies have garnered attention for their efficacy in various disease stages, including the neoadjuvant and adjuvant settings, he reports.

The integration of immunotherapy into NSCLC treatment paradigms represents another pivotal development, according to Saxena. Immunotherapeutic agents are now being employed across multiple disease stages, including in the stage IV setting, as well as in earlier stages post-chemotherapy and radiation, Saxena explains. Moreover, ongoing research indicates a potential role for perioperative chemoimmunotherapy in NSCLC management, hinting at a potential shift in standard care practices, he adds. However, the comparative efficacy of this approach vs traditional chemoimmunotherapy administration requires further investigation, Saxena notes.

The EGFR-mutated lung cancer treatment paradigm continues to evolve with the exploration of adjuvant EGFR inhibitors following surgical intervention, Saxena says. Encouraging preliminary findings from ongoing studies indicate promising additional therapeutic avenues for EGFR-mutated disease, Saxena states.

Exciting prospects also emerge from the realm of newer drugs, such as amivantamab-vmjw (Rybrevant), for the treatment of patients with EGFR-mutated lung cancers, Saxena emphasizes. Additionally, the efficacy of these agents in combination with upfront therapies for patients with stage IV disease holds promise for future treatment paradigms, Saxena reports. Similarly, antibody-drug conjugates have garnered attention for their potential in later lines of stage IV disease, with ongoing endeavors aiming to integrate them into upfront treatment strategies, he continues.

NSCLC management is undergoing a transformative phase characterized by the increasing integration of targeted therapies, immunotherapies, and novel agents across various disease stages, he concludes.