Expert Point of View: Justin Gainor, MD

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Justin Gainor, MD

Regarding PD-L1 as a biomarker for response to therapy, obviously it tells part of the story but does not tell the whole story. We need to identify better biomarkers.

—Justin Gainor, MD

This is a very exciting time in lung cancer. Immunotherapy is extremely promising,” stated Justin Gainor, MD, a thoracic oncologist at Massachusetts General Hospital in Boston.

The promise of immunotherapy extends to a broad patient population. Targeted treatments have transformed the lives of patients with ALK rearrangements and EGFR mutations. Immunotherapy, on the other hand, may be an option for most patients with NSCLC, Dr. Gainor explained in an interview with The ASCO Post.

“Regarding PD-L1 as a biomarker for response to therapy, obviously it tells part of the story but does not tell the whole story,” he continued. There are patients who are PD-L1–positive who do not respond to immunotherapy, and responses are seen in those who are PD-L1–negative. “We need to identify better biomarkers,” Dr. Gainor said.

As with melanoma, one of the most encouraging aspects of immunotherapy in lung cancer is that responses have tended to be durable, according to preliminary data, he said.

Future challenges in immunotherapy for lung cancer include improving response rates and sorting out the mechanisms of resistance. Three combination strategies may increase response rates: combination with chemotherapy; combination with targeted therapies in lung cancers with mutations; and immunotherapy combinations with other immune checkpoint inhibitors or vaccines, Dr. Gainor said. ■

Disclosure: Dr. Gainor is a paid consultant for Boehringer Ingelheim, Jounce Therapeutics, and Kyowa Hakko Kirin Pharma.


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