Advanced NSCLC Monotherapy Treatment


Hypothetical Patients Based on Those Studied in EMPOWER-Lung 1

Case discussion: Nonsquamous Stage IV NSCLC with bone metastases and
PD-L1 expression of 60%

No EGFR, ALK, or ROS1 aberrations

Meet Nora, 57 years old

Libtayo Advanced NSCLC Hypothetical Patient Portrayal Nora
Hypothetical patient profile

Reasons for visit

  • Dry cough
  • difficult breathing
  • mild fatigue for ~6 months

Medical history

  • Osteoprosis, dyslipidemia, and asthma
  • ECOG PS 1
  • Active smoker (30 pack-years)
  • Treatment-naive

Social support

  • Lives alone and has limited support

Clinical information: Imaging and staging

Tumor locations

Tumor locations demonstrated on skeletal X-ray Tumor locations demonstrated on skeletal X-ray
  • Ipsilateral hilar lymph node involvement
  • Primary tumor: 3.5-cm mass in the left-lower lobe with small pleural effusion (asymptomatic)
  • Bone metastases in the thoracic spine (asymptomatic)
  • Bone metastases in the right ilium (asymptomatic)
  • For illustrative purposes only.

  • Chest X-ray revealed an increased opacity in the left-lower lung
  • Chest, abdominal, and pelvic PET-CT scans were performed
  • FDG avid
  • Brain MRI was negative for brain metastases
  • Stage IVB
  • TNM staging was T2a/N1/M1c
Compound microscope

Clinical information:

  • Biopsy of the ipsilateral hilar lymph node confirmed adenocarcinoma with the majority of cells positive for napsin A and TTF-1
  • Plasma and tissue NGS were unremarkable for actionable driver mutations, including EGFR, ALK, and ROS1
  • PD-L1 expression by IHC 22C3 pharmDx assay was 60%

Patient’s considerations for treatment:

Patient apprehensive to treatment with chemotherapy

  • ALK=anaplastic lymphoma kinase; CT=computed tomography; ECOG=Eastern Cooperative Oncology Group; EGFR=epidermal growth factor receptor; FDG=fluorodeoxglucose; IHC=immunohistochemistry; MRI=magnetic resonance imaging; NGS=next generation sequencing; PET=positron emission tomography; PD-L1=programmed death ligand 1; ROS1=ROS proto-oncogene 1, receptor tyrosine kinase; TTF-1=thyroid transcription factor-1.

Based on this clinical information, Nora is a potential
candidate for LIBTAYO monotherapy.

Review the data from EMPOWER-Lung 1 to help you understand how LIBTAYO may be
appropriate for patients like Nora.

See EMPOWER-LUNG 1 Study Design