New Thinking, New Strategies in the Treatment of Advanced NSCLC Without Driver Mutations

STATEMENT OF NEED

Of the estimated 228,150 patients diagnosed with lung cancer in the United States each year, 84% have non-small cell lung cancer (NSCLC). Most patients with NSCLC present with advanced disease, which is highly resistant to chemotherapy. The 5-year survival rates remain dismal (18%). Recently, the use of tumor histology in determining optimal treatment strategies and relevant molecular biomarkers to further refine selection of novel therapies has improved outcomes for some patients. However, a number of targeted treatments are not applicable to patients without driver mutations. For such patients, treatment after first-line platinum-based chemotherapy involves immunotherapies targeting the PD-1/PD-L1 pathways; antiangiogenic agents have also shown promise. The use of immunotherapies (eg, checkpoint inhibitors) makes molecular testing essential to guiding clinical management. Whereas several studies have demonstrated that tumor mutation burden has been associated with checkpoint inhibitor efficacy, uptake in testing for this biomarker is limited. The bleak survival rates for NSCLC also indicate a need for continued development of more effective approaches to tumor control.

TARGET AUDIENCE

Oncology physicians, oncology advanced practitioners, and other health care professionals involved in the treatment of patients with non-small cell lung cancer (NSCLC).

LEARNING OBJECTIVES

Upon completion of this activity, participants should be able to:

1. Assess molecular and clinical factors that can refine personalized care plans for patients with advanced NSCLC without driver mutations
2. Evaluate efficacy and safety data on first- and second-line treatment strategies for patients with advanced NSCLC without driver mutations
3. Discuss the rationale supporting angiogenesis as a therapeutic target in advanced NSCLC