Sequence: targeted therapy before immunotherapy in driver-positive NSCLC
If a lung cancer has a targetable mutation, give the pill first; immunotherapy works poorly in these tumours and raises the risk of severe side effects when a pill follows.
EGFR-, ALK-, ROS1-, and RET-driven NSCLC respond poorly to PD-1 blockade (IMMUNOTARGET) and osimertinib after PD-1 causes pneumonitis in up to 15%. LIBRETTO-431 and FLAURA/CROWN-type data make first-line targeted therapy standard; chemotherapy ± ADC or IO comes later.
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not linked directly; found by shared links- PersonMyung-Ju Ahn
Shares CROWN, Lorlatinib, ALK, Osimertinib.
- TrialLIBRETTO-531
Shares LIBRETTO-431, Selpercatinib, RET, Small-molecule kinase inhibitors.
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- PersonAlexander Drilon
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- InstitutionUniversity of Colorado Cancer Center
Shares ROS1, Lorlatinib, ALK, Small-molecule kinase inhibitors.