Expert Point of View: Roy S. Herbst, MD, PhD


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Roy S. Herbst, MD, PhD

Nivolumab is a new standard of care, but we still have work to do on the endgame, because the results are not as good in biomarker-negative patients.

—Roy S. Herbst, MD, PhD

Results of CheckMate 057 represent excellent progress, but they are not truly ‘checkmate,’” said Roy S. Herbst, MD, PhD, Chief of Medical Oncology, Director of the Thoracic Oncology Research Program, Associate Director for Translational Research at Yale Cancer Center in New Haven, Connecticut.

“Nivolumab [Opdivo] is in my opinion the new standard of care for previously treated patients, but we still have work to do on the endgame, because the results are likely not as good in biomarker-negative patients,” he added. “We therefore need to develop better biomarkers than PD-L1.” Roche, ­Merck, and other industry and academic investigators are working on this, he said.

“Nivolumab appears to be more effective than docetaxel and is less toxic. I will consider  nivolumab after front-line chemotherapy in most of my patients with lung cancer,” he continued. “In the absence of a reliable biomarker, I will offer  it to all my patients right now who are suitable candidates (with no immune-related contraindications and reasonable performance status), but as we had to do before with the introduction of EGFR inhibitors, we will have to continue to work, explore, and  identify a reliable biomarker for improved response and survival, to identify a group of patients who might then benefit from other combination or alternative therapies. At this point, nivolumab seems to have more robust efficacy data in a large population of patients than we had with EGFR inhibitors.” ■

Disclosure: Dr. Herbst reported no potential conflicts of interest.

 


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