15-07-2025
Emerging Options in Second-Line Therapy for Metastatic NSCLC
Standard treatment of metastatic non-small cell lung cancer (NSCLC) is immunotherapy in the first line, followed by combination therapy with docetaxel and ramucirumab in the second line. But a new antibody-drug conjugate (ADC) and other drugs currently in development are broadening the options for these patients.
Dr Tom Stinchcombe of Duke University in Durham, North Carolina, discusses ADCs, checkpoint inhibitors combined with tumor treating fields (TTF) therapy, and other targeted therapies being evaluated as second-ling therapies for metastatic NSCLC.
Dr Stinchcombe first describes telisotuzumab vedotin, a c-Met-directed antibody and microtubule inhibitor conjugate indicated for metastatic NSCLC patients with high c-Met protein overexpression. The drug received FDA-accelerated approval on the basis of the LUMINOSITY trial, in which telisotuzumab vedotin monotherapy provided clinically meaningful response and progression-free survival in this population.
He then describes TTF therapy, which delivers electrical impulses to the tumor site to disrupt processes critical for cancer cell division.
The LUNAR trial showed the benefit of TTF plus checkpoint inhibition in second-line treatment of metastatic NSCLC, suggesting an additive benefit of this combination.
Finally, he discussed two trials showing second-line therapies for patients with KRAS G12C mutations, in which sotorasib and adagrasib have shown potential benefit over docetaxel in this population.
