Sandip P. Patel, MD, medical oncologist, assistant professor of medicine, University of California, San Diego, discusses the impact of immunotherapy on the treatment of patients with non—small cell lung cancer (NSCLC).

Immunotherapy has revolutionized the treatment of many cancers, including NSCLC. Historically, the only option for this population was chemotherapy, says Patel. There are now a wealth of options in various settings of the disease, including anti—PD-1 therapy.

In stage III NSCLC, durvalumab (Imfinzi) was approved by the FDA based on findings from the PACIFIC study. In the phase III PACIFIC study, the PD-L1 inhibitor improved median progression-free survival (PFS) by 11.2 months compared with placebo. The 12-month PFS rate was 55.9% versus 35.3%, and the 18-month PFS rate was 44.2% versus 27.0%, favoring the durvalumab arm. As a result of these findings, patients in this setting can receive 1 year of durvalumab consolidation therapy after chemoradiation.

In the metastatic setting, findings from the KEYNOTE-189 study showed that combining pembrolizumab (Keytruda) with standard chemotherapy in the frontline setting reduced the risk of death by over 50% in patients with nonsquamous NSCLC without EGFR or ALK mutations.