Is Lung Cancer Immunotherapy Clinic-Ready?
Is Lung Cancer Immunotherapy Clinic-Ready?
Dr. West:Is it possible at this point to distinguish any patterns of higher or lower levels of efficacy or differences in toxicity between the PD-1 and PD-L1 inhibitors? Or is the work on this still too early and immature to draw even provisional conclusions about differences between the classes?
Dr. Ramalingam: To me, the exciting part is that both PD-1-targeted and PD-L1-targeted approaches are yielding promising response rates in heavily pretreated NSCLC patients. Response rates appear to be more or less similar across trials. However, we are still interpreting data from phase 1 expansion cohorts as we make these assessments.
I would say that both groups of these drugs appear active. We haven't seen anything to say that one is better than the other so far. We should continue to investigate these agents in various subsets of NSCLC.
Dr. West:Do you think the safety profile of these agents is such that there is little or no toxicity? Or could toxicity be an issue, presenting as different patterns of side effects than we are used to seeing with chemotherapy and targeted therapies we routinely use in lung cancer?
Dr. Ramalingam: At our center across trials, we have treated more than 30 patients with PD-1- and PD-L1-targeted drugs. I would say that for the vast majority of these patients, toxicity is not a major issue. However, we do see occasional immune-related toxicities, such as hepatitis and pneumonitis -- which, when they occur, can be challenging to manage. Thankfully, the incidence of these events appears to be less than 5%. I would say that this group of drugs is tolerated well.
How Do Efficacies Compare?
Dr. West:Is it possible at this point to distinguish any patterns of higher or lower levels of efficacy or differences in toxicity between the PD-1 and PD-L1 inhibitors? Or is the work on this still too early and immature to draw even provisional conclusions about differences between the classes?
Dr. Ramalingam: To me, the exciting part is that both PD-1-targeted and PD-L1-targeted approaches are yielding promising response rates in heavily pretreated NSCLC patients. Response rates appear to be more or less similar across trials. However, we are still interpreting data from phase 1 expansion cohorts as we make these assessments.
I would say that both groups of these drugs appear active. We haven't seen anything to say that one is better than the other so far. We should continue to investigate these agents in various subsets of NSCLC.
Dr. West:Do you think the safety profile of these agents is such that there is little or no toxicity? Or could toxicity be an issue, presenting as different patterns of side effects than we are used to seeing with chemotherapy and targeted therapies we routinely use in lung cancer?
Dr. Ramalingam: At our center across trials, we have treated more than 30 patients with PD-1- and PD-L1-targeted drugs. I would say that for the vast majority of these patients, toxicity is not a major issue. However, we do see occasional immune-related toxicities, such as hepatitis and pneumonitis -- which, when they occur, can be challenging to manage. Thankfully, the incidence of these events appears to be less than 5%. I would say that this group of drugs is tolerated well.
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