The treatment of non-small cell lung cancer (NSCLC) is characterised by a significant level of clinical unmet need despite progress in recent years in the treatment and personalisation of therapy options. GlobalData notes four key clinical unmet needs identified by key opinion leaders (KOLs) in eight major markets (8MM: US, France, Germany, Italy, Spain, UK, Japan and China).

KOLs have highlighted the need for increased education about, application of, and refinement of molecular testing. Significant clinical development in the NSCLC space has led to a plethora of available agents for eight molecularly defined subpopulations in the US. KOLs note that the increasing complexity of therapy options requires efforts to educate oncologists on testing guidelines to promote their usage. Increasing access and application of next-generation sequencing is considered another essential approach to simplify testing.

The use of checkpoint inhibitors is commonplace throughout the 8MM for patients who do not harbour actionable mutations. However, there is a significant lack of targeted therapy options in the second line once a patient develops resistance to immune-checkpoint inhibitors (ICIs). In addition to effective therapy options post-ICIs, a personalised therapeutic approach requires further refinement for patients harbouring actionable mutations. Research and clinical development are required to establish an effective sequence of therapies in the clinic for these molecularly defined subpopulations.

Although outcomes for patients with NSCLC have been improved over the last decade, the probability of a cure in the advanced setting is rare. Promising approaches to increase curative outcomes for NSCLC patients include moving targeted therapy and immunotherapy into earlier lines, combined with a focus on earlier diagnosis and refinement of ICI approaches.

Figure 1: Unmet Needs and Opportunities in Non-small Cell Lung Cancer.

Credit: GlobalData.

IO = immuno-oncology; NGS = next-generation sequencing.