Unlocking the Potential of Neoadjuvant and Adjuvant Immunotherapy in Resectable NSCLC: The Role of Checkpoint Inhibitors

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Post-test Question #1
A 62-year-old female, with a history of smoking, presents to the clinic with a new cT3 pN1 cM0 adenocarcinoma of the LUL. NGS and PD-L1 are not available. Based on her stage, which statement could you share with the patient to guide her and make an educated decision on timing of systemic therapy?

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To determine the need for chemotherapy + immunotherapy, a final pathologic stage is necessary

Patients who undergo neoadjuvant chemotherapy + immunotherapy are more likely to complete planned systemic treatment than the ones receiving adjuvant therapy

The major indication for neoadjuvant chemotherapy + immunotherapy is to increase chances of successful surgical resection

Neoadjuvant chemotherapy and immunotherapy leads to slightly inferior rates of adequate surgical resection and higher rates of surgical complications but it is a risk worth taking

Post-test Question #2
For which of the following patients with NSCLC would neoadjuvant nivolumab and platinum-doublet chemotherapy be an FDA-approved option?

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Adenocarcinoma, 3.5cm, PD-L1 85%

Adenocarcinoma, 3.5cm with ipsilateral hilar node involved, EGFR exon 19 deletion, PD-L1 15%

Squamous cell carcinoma, 6cm, PD-L1 0%

Squamous cell carcinoma, 6cm with subcarinal node involved, PD-L1 100%

Post-test Question #3
What is the adjuvant treatment recommendation for a patient with resectable Stage IIB adenocarcinoma NSCLC KRAS G12C positive, PD-L1 of 95%?

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4 cycles of platinum-based chemotherapy

4 cycles of platinum-based chemotherapy followed by a year of immunotherapy

4 cycles of platinum-based chemotherapy followed by adjuvant KRASG12C inhibitor

4 cycles of platinum-based chemotherapy followed by immunotherapy plus KRASG12C inhibitor

Post-test Question #4
A 52-year-old male is diagnosed with stage III NSCLC with single-station N2 involvement with a 2cm LN. Which of the following biomarkers should be tested for prior to treatment initiation?

Select your answer. *

PD-L1

TMB

EGFR/ALK

RNAseq

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Unlocking the Potential of Neoadjuvant and Adjuvant Immunotherapy in Resectable NSCLC: The Role of Checkpoint Inhibitors