DR LOVE: What’s your take right now on the risk of using checkpoint inhibitors in people with different autoimmune disease? And have you had to deal with it? And how would you deal with it?

DR BLUMENSCHEIN: Actually, I’m dealing with it right now. So my general approach has been not to enroll anybody who has an autoimmune illness. But as you mentioned, we’re starting to see some opening or relaxing of those rules, and we’re looking at patients and making determinations: Do they have to be on therapy for their autoimmune illness? Are they having symptoms from it? How severe is it? Those things are all getting factored in there. But in general, if someone has an autoimmune illness, I don’t offer them immunotherapy. I think the risk-benefit ratio is not there yet.

DR LOVE: I guess the arguments made, you get out to second-, third-line therapy in non-small cell, you’re looking at a very, very grim prognosis, “What do you have to lose?”

DR BLUMENSCHEIN: And that’s one way of looking at it. But again, with immunotherapy, in an unselected patient population, we're seeing responses on the order of about 18%. So the majority of people don’t respond. And when people have a bad autoimmune response, get a bad colitis or a pneumonitis, it can be devastating and sometimes fatal.

First- and second-generation EGFR tyrosine kinase inhibitors (TKIs) for EGFR mutation-positive non-small cell lung cancer (NSCLC)

Osimertinib and treatment options for patients with disease progression on an EGFR TKI

Other targetable mutations in NSCLC: ALK rearrangement; MET exon 14 splice mutation

Application of immune checkpoint inhibitors in NSCLC

Systemic and localized treatment approaches for NSCLC

Small cell lung cancer, mesothelioma and squamous NSCLC