Patient Selection and Immune-Related Toxicity Monitoring for Adjuvant Immunotherapy in Resectable NSCLC

In this episode, Patient Selection and Immune-Related Toxicity Monitoring for Adjuvant Immunotherapy in Resectable NSCLC, the lung cancer panelists explore the following questions:

In your practice, how are you evaluating which patients will actually benefit from adjuvant immunotherapy?

Which adverse events are you monitoring in patients receiving immunotherapy for resectable NSCLC?

How are you managing the adverse events?

The lung cancer experts examined selection of patients for adjuvant immunotherapy in resectable NSCLC, which is based on recurrence risk, pathologic stage, PD-L1 expression, margin status, nodal involvement, and absence of targetable driver mutations that would favor adjuvant targeted therapy. Patients with stage II–IIIA disease, PD-L1–positive tumors, or residual disease after neoadjuvant therapy are generally considered most likely to benefit, particularly when they have adequate performance status and recovery from surgery. Multidisciplinary review of surgical pathology, molecular testing, and perioperative course is essential to balance potential benefit with the risk of immune-related toxicity.

The adverse events monitored most closely include pneumonitis, thyroid dysfunction, hepatitis, colitis, adrenal insufficiency, dermatologic toxicities, and less commonly myocarditis or neurologic immune-related events. Baseline and periodic laboratory testing—such as liver enzymes, thyroid function, and cortisol when clinically indicated—are used alongside symptom assessment to detect early toxicity. Patient education is critical so that new respiratory, gastrointestinal, or endocrine symptoms are reported promptly.

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, Defining Treatment Goals and PD-L1–Driven Strategies in Metastatic NSCLC: Applying Insights From CheckMate-9LA, features the panelists advancing their conversation on metastatic NSCLC.