Dr Mark Socinski on the Importance of Targeted Therapy and Immunotherapy in NSCLC

Mark A. Socinski, MD, executive director of the AdventHealth Cancer Institute, shared his thoughts on the most important recent advances in non–small cell lung cancer (NSCLC), including a better understanding of patients who may benefit from immunotherapy.

Transcript

What are some notable recent advancements in the NSCLC treatment landscape?

I think the most important recent advances have been the continuation of understanding that non–small cell lung cancer is a group of very heterogeneous patients and diseases and that certainly, we've transitioned from 20 or 30 years ago, [when it was] kind of one-size-fits-all, to realizing that there are a number of biomarker findings that are important in deciding which treatment approach is best for the individual patient that that's in front of you. We know that genomic comprehensive testing at the time of diagnosis is important. Certainly, in those patients with actionable genomic alterations, the best first line treatment is targeted therapies.

We also know that we're beginning to understand who the patients that get greater benefit from immunotherapy [are], versus those patients that probably need a new idea from an immunotherapeutic point of view. With this better understanding of the underlying biology of non–small cell lung cancer, it's really created a number of new therapeutic options. In addition to the targeted agents that are there, we have validated the PD-1 and PD-L1 pathway, we've also validated the CTLA-4 pathway as a target of anti-cancer therapy.

In the targeted therapy space, I think we're on the verge of understanding patterns of resistance. We have some pretty good drugs to use in the first line, but the issue there is that most patients develop resistance. And so, we're beginning to understand a little bit about what those resistance mechanisms are, and then developing strategies that address how patients get around those very active first line drugs.

It's an exciting time in non–small cell lung cancer, but I think the important advances are understanding the underlying biology of each individual patient, which obviously there's a lot of overlap, but there's a lot of opportunity to personalize therapy as best we can. And I hope that we will continue along the lines that we've seen over the past 5 to 10 years.