Key Immunotherapy and Chemoimmunotherapy Trials Shaping Metastatic NSCLC Management

In this episode, Key Immunotherapy and Chemoimmunotherapy Trials Shaping Metastatic NSCLC Management, the panelists explore the following questions:

Let’s now discuss some trials which investigated immunotherapy only. What are the key safety and efficacy takeaways for EMPOWER-Lung1, KEYNOTE-024, and IMPOWER110?

Next, let’s move into some of the key trials that examined an immunotherapy with chemotherapy in metastatic NSCLC. What were the main safety and efficacy takeaways from EMPOWER-Lung3, KEYNOTE-407, KEYNOTE-189, and EMPOWER150?

The oncologists examined deveral pivotal trials which have established the role of immunotherapy alone in metastatic NSCLC. The phase 3 EMPOWER-Lung 1 trial demonstrated that cemiplimab improved overall survival and progression-free survival compared with chemotherapy in patients with PD-L1–high tumors, with a safety profile consistent with other PD-1 inhibitors and manageable immune-related adverse events. Similarly, KEYNOTE-024 showed that pembrolizumab significantly extended survival versus chemotherapy in PD-L1–high NSCLC, with durable responses and predictable immune-mediated toxicities. The IMPOWER110 trial confirmed improved overall survival in PD-L1–selected patients, further supporting single-agent PD-1/PD-L1 inhibition as a standard first-line option for high-expressing tumors.

In metastatic NSCLC patients regardless of PD-L1 expression or those requiring rapid disease control, combining immunotherapy with chemotherapy has demonstrated substantial benefit. EMPOWER-Lung 3 showed superior overall survival and response rates compared with chemotherapy alone, with safety consistent with each individual agent. KEYNOTE-407 and KEYNOTE-189 both demonstrated improved survival across histologies, establishing chemoimmunotherapy as a standard first-line option. The phase 3 EMPOWER150 trial extended these findings by incorporating antiangiogenic therapy, offering another effective combination with manageable immune-related and chemotherapy-related adverse events. These studies collectively guide treatment selection based on PD-L1 status, histology, and patient-specific considerations.

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

The next episode in this series, Personalized Selection of Immunotherapy Strategies in Metastatic NSCLC and Future Evidence Gaps, features the panelists advancing their conversation on important decisions in the care of patients with lung cancer.