Dr Mark Socinski Discusses the Impacts of Immunotherapy on Lung Cancer Outcomes

Mark A. Socinski, MD, executive director at AdventHealth Cancer Institute, discussed the impacts of immunotherapy on outcomes for certain patients with non–small cell lung cancer.

Transcript

How has the growing list of immunotherapy options impacted the lung cancer treatment paradigm?

If you look at cancer survival figures going back to around 2017, so 5 or 6 years ago, we've been seeing an annual reduction in cancer mortality in the United States. And, interestingly, if you look at the cancers that are leading the reduction in cancer mortality, it's principally 2 diseases that 20 or 30 years ago were felt to be diseases that do not get any significant benefit from treatment. It's melanoma and non–small cell lung cancer, the disease we're talking about today.

Part of it is leveraging the immune system to mount an immune response specifically against the patient's tumor. The development of these PD-1/PD-L1 inhibitors as well as the CTLA-4 inhibitors, has really opened up the concept that a significant minority of patients can have very significant and very durable responses, meaning they last a long time—sometimes out to 5 years or so. And then, we're beginning to question, "Are these patients cured of their cancer because of the immunotherapy?"

Now, I specifically said this is in a minority of patients, so it's important to think of this as a foot in the door if you will. We understand that our initial targets of PD-1 and CTLA-4 do change the outcome of patients and are leading to a reduction in cancer mortality, and we need to build on that. We need to understand other targets, and there are a number of investigational agents ongoing in this space in the form of clinical trials. And so we need to wait and see what will work and what will not work.