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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Thursday, February 1, 2024
For patients with metastatic non–small cell lung cancer (NSCLC), the use of dual immune checkpoint blocker therapy with or without chemotherapy may be beneficial as an initial treatment strategy, according to an article published in the Journal of Clinical Oncology. However, additional investigative efforts are needed to refine patient selection criteria and optimize the use of dual immunotherapy in this patient population, according to Dipesh Uprety, MD, of Barbara Ann Karmanos Cancer Institute, Detroit, and colleagues.
Currently, the literature strongly supports the use of immune checkpoint inhibitors in the treatment of metastatic NSCLC. However, an optimal immune strategy schedule for patients has not been established.
Numerous phase III studies—including KEYNOTE-598, MYSTIC, and NEPTUNE—have examined the clinical benefits of using dual immune checkpoint blockers with or without chemotherapy as first-line therapy for metastatic NSCLC, and they found no significant benefit with this therapeutic approach. However, other studies—including CheckMate 227, CheckMate 9LA, and POSEIDON—have demonstrated significantly improved overall survival and long-term clinical benefits with this immunotherapy strategy. Despite this support for clinical efficacy, the unfavorable safety profile seems to limit the widespread adoption of this therapeutic approach, according to the authors.
Further evaluation to determine the extent of the clinical efficacy of this treatment strategy has revealed improved survival benefits in tumors with specific mutations, including KEAP1, KRAS, and STK11. These findings may assist in selecting which patients may benefit most from dual immune checkpoint blocker therapy. Moreover, identifying the duration of treatment and the number of treatment cycles is critical before this therapeutic strategy could be considered a standard of care, Dr. Uprety and colleagues noted.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.
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