Updated phase 2 data showed a 60% ORR and 86% CNS ORR with frontline silevertinib in non-classical EGFR-mutant NSCLC; FDA discussion supported a phase 3 trial in 2027.
|Videos|September 20, 2018
A Chemoimmunotherapeutic Approach to Nondriver NSCLC
A Chemoimmunotherapeutic Approach to Nondriver NSCLC
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A 66-Year-Old Man With NSCLC
May 2018: H&P
- A 66-year-old man presented to primary care with complaints of persistent cough and shortness of breath with easy exertion.
- PE: Average height, very thin (BMI = 18 kg/m2); says he has been losing weight although not dieting; mild fever (100.6 degrees); intermittent hemoptysis
- Lab results: CrCL 75 mL/min; A1C 6.8%; WBC 15K/µL
- PMH: HTN managed on atenolol; former smoker (30 pack-years); attributes cough to smoking but has persisted for 3 years now since he quit
- Primary care suspected bronchitis and prescribed amoxicillin; referred to pulmonology
June 2018: Pulmonology evaluation
- Pulmonologist evaluated patient for COPD: diminished lung function on spirometry
- CT revealed a 3-cm mass in left lung and multiple (<2 cm) masses in right lung, pleura, and axial lymph nodes; patient referred to oncology.
July 2018: Oncology exam
- Biopsy identified adenocarcinoma in left lung with lymph node and pleural involvement
- Molecular testing:
- ALK& ROS1 rearrangement, negative
- EGFR, KRAS wild-type
- KRAS negative
- PD-L1 TPS: 45%
- Additional testing: Abdominal CT, NED; Brain MRI, NED
- Diagnosis: Stage IVA lung adenocarcinoma without molecular drivers
August 2018
- Patient begins treatment with pemetrexed/carboplatin plus pembrolizumab 200 mg q3 wks
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