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Do we have any data on sequencing of up front therapies for patients with high PD-L1 and targeted mutations?

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Mednet Member
Mednet Member
Medical Oncology · University of Colorado Cancer Center

Patients with EGFR and BRAF mutations or ALK and ROS1 fusions should receive 1st line approved TKI therapy and second line approved TKI therapy for EGFR and ALK. Checkpoint inhibitors should be used only after TKIs even if PD-L1 expression is high. For patients with PD-L1 expression >50%, it is not ...

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Mednet Member
Mednet Member
Medical Oncology · Henry Ford Cancer Institute/Henry Ford Hospital

@Dr. First Last makes a very important point. I have seen at least 2 cases where patients were started on pembrolizumab because the tumor PD-L1 was high and then subsequently tumor was found to be EGFR mutation positive.

As far as sequence of therapy, yes Osimertinib followed by chemotherapy (plati...

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Mednet Member
Mednet Member
Medical Oncology · Henry Ford Cancer Institute/Henry Ford Hospital

One clarification on my previous comment- In IMPOWER150 patients with EGFR and ALK NSCLCs were only enrolled after treatment with TKIs.

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