How would you treat a patient with metastatic NSCLC >50% PDL-1 positive AND an EGFR or ALK gene mutation/rearrangement in the first-line setting?   

There have been multiple reports showing a positive association between EGFR activation (through mutational activation and/or signaling) and PDL1 expression (e.g. J Thorac Oncol 2015 Jun;10(6):910-23). Similarly, there are some reports of a similar association with ALK translocation (e.g. Clin Canc...

We now have data from IMpower150 which included a subgroup of patients with EGFR/ALK genetic alterations who had progression after 1st/2nd line EGFR TKI (Reck et al, Lancet Respir Med 2019). This study was the first immune checkpoint inhibitor study to report improved overall survival signal with th...