Do we have any data on sequencing of up front therapies for patients with high PD-L1 and targeted mutations?
First line pembrolizumab is only approved after progression on TKI - but would you ever offer chemo-immunotherapy prior to target therapy?
Answer from: Medical Oncologist at Academic Institution
Patients with EGFR and BRAF mutations or ALK and ROS1 fusions should receive 1st line approved TKI therapy and second line approved TKI therapy for EGFR and ALK. Checkpoint inhibitors should be used only after TKIs even if PD-L1 expression is high. For patients with PD-L1 expression >50%, it is n...
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Medical Oncologist at Saint Louise Regional Hospital Would it be fair to say then that PDL1 expression ...
Answer from: Medical Oncologist at Community Practice
@Paul A. Bunn makes a very important point. I have seen at least 2 cases where patients were started on pembrolizumab because the tumor PD-L1 was high and then subsequently tumor was found to be EGFR mutation positive.
As far as sequence of therapy, yes Osimertinib followed by chemothera...
Would it be fair to say then that PDL1 expression ...