What factors do you take into account for recommending chemo/IO vs IO/IO vs CheckMate 9LA regimen in front line therapy for PD-L1 negative advanced squamous cell carcinoma?
How do you interpret the comparative efficacy in squamous cell subsets among the CM vs KN studies?
Answer from: Medical Oncologist at Community Practice
As others have noted, the HR for the squamous subset of NSCLC seems to suggest that these patients benefit most from combined ICI, seen in both the CM227 and 9LA studies (with the caveat that comparator is chemotherapy alone which is now outdated.) In CM227, the HR for nivo-ipi vs chemo was 0.53 in ...
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Answer from: Medical Oncologist at Community Practice
It remains difficult to compare cohorts across studies due to the differing study designs and populations. The subpopulations in the analysis of SCC by PD-L1 expression are small and hypothesis generating at this time. The addition of chemotherapy to immunotherapy seems necessary to increase efficac...
Answer from: Medical Oncologist at Academic Institution
As noted previously, I think the data for squamous in CM-9LA are interesting, however, I am wary of subset analyses in general, it should also be noted that the uptake of subsequent IO in the chemo control arm of the 9LA study was generally lower than in the KN studies which may have affected the ti...
Answer from: Medical Oncologist at Academic Institution
My default is usually chemo/IO as in KEYNOTE-407. However, if a patient is somewhat frail at the outset, and perhaps is aversive to the chemotherapy, then might choose Checkmate 9LA regimen to reduce it to 2 cycles or possibly Nivo/Ipi, though in the latter case, this is not FDA appro...