David P. Carbone, MD, PhD - Gaining an Advantage Over NSCLC: How to Achieve the Greatest Benefit With Immunotherapy From Advanced to Early Disease

Go online to PeerView.com/RGK860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. Cancer immunotherapies in the form of anti–PD-1, anti–PD-L1, and anti–CTLA-4 immune checkpoint inhibitors (ICIs) have transformed the treatment of advanced and metastatic NSCLC without actionable genomic alterations, with a number of single-agent and combinatorial options available for clinical use. In light of demonstrably improved outcomes in the metastatic setting, ICIs are transitioning to earlier disease settings as part of perioperative neoadjuvant and/or adjuvant treatment strategies, which will likely result in reduced recurrence rates and more patients achieving cure. The number of available ICIs is expected to grow, as many new agents and combinations are in the final stages of testing, and novel checkpoints such as TIGIT and LAG-3 are showing promise in clinical trials. Consequently, predictive biomarker testing to refine treatment selection is paramount, and there is increasing focus on new surrogate endpoints to assess ICI efficacy, especially in early-stage settings where pathologic complete response, major pathologic response, and disease-free survival are helping to move the field forward faster. However, these exceptional advances are not without challenges. Not all patients with lung cancer benefit from ICIs, while others who could benefit do not have access to these therapies due to persistent disparities in biomarker testing, clinical care, and research. Determining the best immunotherapy option for each individual patient at the right time and in alignment with the particular needs and preferences of each patient is not simple and requires multidisciplinary collaboration and patient-centric shared decision-making. In addition, astute vigilance is required to mitigate potential immune-related adverse events (irAEs) to keep more patients benefiting from these therapies. This activity, based on a PeerView Live Seminars & Practicum educational event held at the 2022 ASCO Annual Meeting, provides guidance for navigating the evidence supporting the use of current and emerging immunotherapies throughout the NSCLC disease continuum and translating evidence to practice with the goal of improving patient outcomes in both advanced/metastatic and early-stage settings. Produced in partnership with LUNGevity Foundation, patient perspectives are also emphasized to improve team-based collaboration, patient engagement, shared decision-making, and health equity in clinical care and research. Upon completion of this activity, participants should be better able to: Describe the latest evidence supporting the use of current and emerging immune checkpoint inhibitors (ICIs) and combinations in locally advanced or metastatic and early-stage non–small cell lung cancer (NSCLC); Select the most appropriate ICI-based treatment for eligible patients with locally advanced/metastatic and early-stage NSCLC, considering the disease presentation, tumor characteristics, biomarker results, patient needs and preferences, current evidence and guidelines, multidisciplinary perspectives, and other relevant factors; Implement multidisciplinary and patient-centric approaches to ensure optimal and equitable use of immunotherapies in the care of all eligible patients with NSCLC; and Apply current guidelines and best practices for monitoring and management of immune-related adverse events (irAEs) in patients with NSCLC who are receiving or have received immunotherapy.