Questioning When to Start Immunotherapy for Patients With Oncogenic Drivers

Karen Kelly, MD, discusses how oncogenic drivers affect the use and placement of immunotherapy for patients with lung cancer.

Karen Kelly, MD, associate director for clinical research at University of California (UC) Davis Comprehensive Cancer Center, and professor of medicine at UC Davis Health, discusses how oncogenic drivers affect the use and placement of immunotherapy for patients with lung cancer.

Data in the salvage setting for patients who have oncogenic drivers that have been given targeted therapies through clinical trials, including drivers such as the EGFR, ALK, and ROS1 mutations, show that immunotherapy as a single-agent is not effective. Kelly thinks that where physicians should position immunotherapy agents in the oncogenic driven space is not yet known.

The data from the IMMUNOTARGET Registry trial looked at all of the known oncogenic drivers for patients with non–small cell lung cancer and their responses to immunotherapy. According to Kelly, most of the patients didn’t do well, but the small number of patients that did have benefit were those with some degree of smoking history and those patients who had KRAS, BRAF, and MET exon 14 deletions. She says these are the patients that were expected to show benefit.

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