In a conversation with CancerNetwork®, Nicolas Girard, MD, highlighted directions of future research with nivolumab and chemotherapy in patients with resectable non–small cell lung cancer.
Nicolas Girard, MD, professor of respiratory medicine at Versailles Saint Quentin University and head of Curie-Montsouris Thorax Institute of Institut Curie in Paris, spoke with CancerNetwork® during the American Association for Cancer Research (AACR) 2022 Annual Meeting, about potential future research directions with nivolumab (Opdivo) and chemotherapy in resectable non–small cell lung cancer.
Although certain biomarkers have already been assessed in this patient population, including PD-L1 expression and circulating tumor DNA (ctDNA), other factors such as minimal residual disease (MRD) following surgery may provide additional insights into treatment decision making.
[There are still] many questions. The first ones is [with regard] to biomarkers [and] how to predict pathological complete response [pCR] rate, which is a surrogate for survival. We were able to report data based on PD-L1 expression. We were also able to study ctDNA clearance during the neoadjuvant treatment as a predictor of pathological complete response. But there are many biomarkers to be tested as well, [such as] minimal residual disease after surgery. These factors may be drivers of the decision making in the adjuvant setting in patients without pCR. What should we do? Should we go for additional adjuvant therapies? Which ones? How [should we] interpret these data in those patients? It’s something that is very interesting.
The second point is to optimize the surgical procedures for these patients because in a patient with a pCR, maybe we do not need to have an extensive surgery; maybe we do not need to do pneumonectomies. This is a next step. This requires [us] to be able to identify who as a patient has a pCR. Hopefully, with the availability of this regimen, it will be an opportunity for academic studies to answer those questions.
Forde PM, Spicer J, Lu S, et al. CheckMate 816 Investigators. Neoadjuvant nivolumab plus chemotherapy in resectable lung cancer. N Engl J Med. Published online April 11, 2022. doi:10.1056/NEJMoa2202170