Challenging the Standards of Care for ICI-Pretreated Patients With NSCLC

Karen L. Reckamp, MD, explains the need for more treatment options for patients with non–small cell lung cancer who have been previously treated with immune checkpoint inhibitors and develop resistance.

Karen L. Reckamp, MD, a professor in Medicine, and director of the Division of Medical Oncology at Cedars-Sinai Medical Center, as well as a medical oncologist at the Samuel Oschin Cancer Center, explains the need for more treatment options for patients with non–small cell lung cancer (NSCLC) who have been previously treated with immune checkpoint inhibitors (ICIs) and develop resistance.

As upfront treatment for NSCLC, the majority of patients are administered immunotherapy with chemotherapy or immunotherapy alone. Although these strategies are very beneficial to patients, disease progression is inevitable, and some patients become resistant to their frontline regimen.

Once a tumor grows too large or patients are ICI refractory, no effective therapies are available. The Lung-MAP nonmatched substudy S1800A was designed to address the need for treatment option after frontline ICI therapy in patients with NSCLC. The phase 2 clinical trial (NCT03971474) investigates the combination of ramucirumab (Cyramza) and pembrolizumab (Keytruda) vs standard of care.

Transcription:

0:08 | All patients now receive either a combination of immunotherapy and chemotherapy or immunotherapy alone as part of their frontline treatment for advanced non–small cell lung cancer. We're also starting to use immunotherapy in the treatment of earlier stage non–small cell lung cancer. So, most patients do get exposed to immune checkpoint inhibitors at some point during their therapy. And we know though there are great benefits that patients experience most will have tumor progression and develop some tumor resistance to immune checkpoint inhibitors.

0:47 | At this moment in time, we don't have the best therapies. We don't know the best therapies to provide patients once a tumor has grown on immune checkpoint inhibition and chemotherapy. So, this study is to evaluate what might be better therapies than our standard of care which generally include