What can be done for people with PD1 Negative tumors??

Hello everyone, my mother was diagonsed with Stage 4 NSCLC back in October...

She did 6 treatments of Radiation (5 on her pelvic tumor, and 1 on her knee)  and 2 heavy doesages of Taxo/Carbo 


The results came back, and her tumors have grown, so now we're on the 2nd line treatment of Avastin/Vinorelbine 

We asked if we could try immunotherapy like Keytruda or Opdivo, but my mom's OC said that she's worried that Opdivo won't work fast enough, because the tumor near her pelvic region might get large to the point where my Mom can't walk anymore.  And she ran tests on my mom's tumor and she doesn't have any mutations, PDL1 negative and so on..

So I have a couple of questions, has/does anyone know any clincal trials that have worked for people with PDL1 negative patients?

and I've also been looking at other people's Radiation treatments with Lung Cancer, and they seem to have alot more then what my mom has had, only 6 compared to people I've read about having 1 everyday for for nearly a month... 


I'm getting a 2nd opinion and all this is so new and foreign to me, I have a hard time directing my mother in the right direction.


Thanks, and god bless you all!


  • Hi AnthonyM757,
    Sorry to hear what you are going through.
    I think you and your doctor are going very logically.
    Targeted therapy is known to act fast, but we need to find a target. May I ask you a few details:
    What kind of mutation test was done (IHC or genomic profile?), and what are the genes (and how many) that are looked at?
    As for whether immunotherapy makes sense in this case, apart from PD-L1 level, is any of these: Mis-Match Repair (MMR), Tumor Mutation Burden (TMB) or Micro-Satellite (MSS/MSI) status, known? Here is a recent publication that shows inadequacy of selecting a bio-marker restricted to PD-L1+ or dMMR for immunotherapy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5652789/.
    My thoughts are with you and your mother.