This is Part 3 of Emerging Treatment Options for Small Cell Lung Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. David Spigel, John Heymach, and Lauren Byers discuss treatment of newly diagnosed limited-stage small cell lung cancer (SCLC). The patient is a 69-year-old woman who presents to an outside hospital with increased swelling in her neck and face, hoarseness, and dyspnea. She is transferred to a cancer institute after a computed tomography identifies a large mediastinal mass with scattered nodules in both lungs. Positron-emission tomography reveals uptake in the mediastinal mass, but no distant metastases, and her brain MRI is clear. Endobronchial ultrasound confirms SCLC, and she is diagnosed with limited-stage SCLC with superior vena cava syndrome. In the conversation that follows, the faculty emphasize the importance of rapid initiation of systemic therapy in patients with symptomatic limited-stage disease, the role of prophylactic cranial irradiation, and the promising impact of immunotherapy with durvalumab. They also discuss emerging treatments like tarlatamab and lurbinectedin.
This is Part 2 of Emerging Treatment Options for Small Cell Lung Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. David Spigel, John Heymach, and Lauren Byers discuss the treatment of newly diagnosed extensive-stage small cell lung cancer (SCLC). The patient is a 66-year-old man who presents with neck swelling. A computed tomography scan reveals a right upper lobe lung mass, mediastinal lymphadenopathy, and liver lesions. He has experienced weight loss but no dyspnea or hemoptysis. Endobronchial ultrasound reveals SCLC, and his brain MRI is clear. He is diagnosed with extensive-stage disease and is currently hospitalized. In the conversation that follows, the faculty discuss the initial management of patients with SCLC who are hospitalized, stressing the importance of rapid initiation of systemic therapy. They review standard first-line immunotherapy options such as durvalumab or atezolizumab combined with platinum/etoposide, as well as the potential role of maintenance lurbinectedin and emerging agents such as tarlatamab.
This is Part 1 of Emerging Treatment Options for Small Cell Lung Cancer, a three-part video roundtable series. Scroll down to watch the other videos from this roundtable. In this video, Drs. David Spigel, John Heymach, and Lauren Byers discuss the treatment of relapsed small cell lung cancer (SCLC). The patient is a 62-year-old woman who presents to an outside hospital with low back pain following a motor vehicle accident. Imaging reveals multiple lytic lesions and a mass in the left lower lung lobe, leading to a diagnosis of extensive-stage small cell lung cancer (SCLC). She receives four cycles of carboplatin, etoposide, and atezolizumab, achieving a near complete response, and then transfers her care to a local oncologist for maintenance therapy. After several months, she returns to the hospital with worsening back pain and dyspnea and is found to have a large pleural effusion and a regrowth of the mass. Cytology confirms the recurrence of SCLC. In the conversation that follows, the faculty discuss the unique challenges that SCLC presents in emergency settings, the role of maintenance immunotherapy, whether rechallenge with platinum/etoposide is appropriate, and the importance of tailoring treatment strategies to individual patient needs.
Corticosteroids, which are commonly prescribed to alleviate cancer-related symptoms in patients with non–small cell lung cancer (NSCLC) treated with immunotherapy, may be the reason certain immunotherapies fail in treating the disease, according to new research published by Polyakov et al in Cancer ...
A large analysis of the mutational processes of lung cancers in never-smoker patients showed that exposure to fine-particulate air pollution was strongly associated with increased genomic changes, including in cancer-driving and cancer-promoting genetic mutations. Findings from the whole-genome...
On July 2, the U.S. Food and Drug Administration (FDA) granted accelerated approval to sunvozertinib (Zegfrovy), a selective EGFR tyrosine kinase inhibitor, for adults with locally advanced or metastatic non–small cell lung cancer (NSCLC) with EGFR exon 20 insertion mutations, as detected by an...
As reported in the Journal of Clinical Oncology by Steuer et al, findings in a cohort of a phase I trial indicated activity of the HER3-directed antibody-drug conjugate patritumab deruxtecan (HER3-DXd) in patients with advanced squamous or nonsquamous non–small cell lung cancer (NSCLC) without a...
In 2022, I had a computed tomography (CT) coronary calcium scan to see whether there were any signs of narrowing or blockage in my heart arteries. Heart disease runs in my family. My father died of a heart attack the year before, and I worried that I was at risk for the same fate. It was a complete ...
On June 23, the U.S. Food and Drug Administration (FDA) granted accelerated approval to datopotamab deruxtecan-dlnk (Datroway), an antibody-drug conjugate that targets trophoblast cell surface antigen 2 (TROP2), for adults with locally advanced or metastatic EGFR-mutated non–small cell lung cancer...
In a retrospective cohort study reported in JAMA Oncology, Ricciuti et al examined whether neoadjuvant PD-1/PD-L1 inhibition plus platinum-based chemotherapy showed activity in patients with borderline-resectable/unresectable stage III non–small cell lung cancer (NSCLC). Study Details The study...
In an analysis from the phase III CheckMate 816 trial reported at the 2025 ASCO Annual Meeting and in The New England Journal of Medicine, Forde et al examined overall survival outcomes with the addition of neoadjuvant nivolumab to platinum-based chemotherapy in patients with stage IB to IIIA...
The U.S. Food and Drug Administration (FDA) has approved the oral next-generation ROS1 tyrosine kinase inhibitor (TKI) talectrectinib (Ibtrozi) for the treatment of adults with ROS1-positive locally advanced or metastatic non–small cell lung cancer (NSCLC). Investigators reported that the agent has ...
Maintenance treatment with the alkylating agent lurbinectedin plus the monoclonal antibody atezolizumab significantly improved both progression-free survival and overall survival compared with atezolizumab alone in patients with extensive-stage small cell lung cancer (SCLC), according to data...
In a study (VERITAS) reported in The New England Journal of Medicine, Lentz et al evaluated whether the diagnostic accuracy of navigational bronchoscopy was noninferior to that of transthoracic needle biopsy for malignancy or specific benign conditions in patients with peripheral pulmonary nodules. ...
Luis G. Paz-Ares, MD, PhD, of Hospital Universitario 12 de Octubre, H12O-CNIO Lung Cancer Unit, Universidad Complutense and Ciberonc, discusses data from the TIGOS trial, a phase III study comparing the first-line use of atigotatug (an antifucosyl-GM1 monoclonal antibody) plus nivolumab fixed-dose combination with chemotherapy vs atezolizumab with chemotherapy in patients with extensive-stage small cell lung cancer (SCLC) (Abstract TPS8127).
Luis G. Paz-Ares, MD, PhD, of Hospital Universitario 12 de Octubre, H12O-CNIO Lung Cancer Unit, Universidad Complutense and Ciberonc, presents primary results from the phase III IMforte trial, which evaluated lurbinectedin plus atezolizumab as first-line maintenance treatment in patients with extensive-stage small cell lung cancer (SCLC) (Abstract 8006).
Although the SWOG S2302 Pragmatica-Lung trial did not achieve its primary endpoint of improved overall survival with the combination of ramucirumab and pembrolizumab compared with standard-of-care treatments for patients with stage IV or recurrent non–small cell lung cancer (NSCLC) who previously...
Jamie E. Chaft, MD, FASCO, of Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, reviews results of the NeoADAURA trial, which looked at neoadjuvant osimertinib with or without chemotherapy vs chemotherapy alone in patients with resectable EGFR-mutated non–small cell lung cancer (NSCLC) (Abstract 8001).
Bjorn Henning Gronberg, MD, PhD, of Norwegian University of Science and Technology (NTNU) and St. Olavs Hospital, presents phase II findings on the efficacy of atezolizumab after chemoradiotherapy (CRT) in limited-stage small cell lung cancer (SCLC) (LBA8005).
Neoadjuvant nivolumab plus chemotherapy significantly improved overall survival rates at 5 years compared with chemotherapy alone before surgery in patients with resectable non–small cell lung cancer (NSCLC), according to findings from the final analysis of the phase III CheckMate 816 trial. The...
Rami Manochakian, MD, FASCO, of Mayo Clinic Florida, offers his thoughts on findings from the primary analysis of the phase III DeLLphi-304 trial, which compared tarlatamab-dlle, a bispecific T-cell engager immunotherapy targeting delta-like ligand 3 and CD3, with chemotherapy as a second-line treatment of patients with small cell lung cancer (SCLC) (LBA8008).
Martin Reck, MD, PhD, of LungenClinic Grosshansdorf, Germany, discusses data from the phase III AEGEAN trial that studied perioperative durvalumab and neoadjuvant chemotherapy. Patients who were MRD-positive after surgery had significantly worse disease-free survival compared to MRD-negative patients. In addition, mutations in KEAP1 and KMT2C were associated with MRD positivity and reduced benefit from the regimen, identifying a small high-risk subgroup with poor prognosis (Abstract 8009).
Rami Manochakian, MD, FASCO, of Mayo Clinic Florida, offers his thoughts on findings from the primary analysis of the phase III DeLLphi-304 trial, which compared tarlatamab-dlle, a bispecific T-cell engager immunotherapy targeting delta-like ligand 3 and CD3, with chemotherapy as a second-line treatment of patients with small cell lung cancer (SCLC) (LBA8008).
Results from an international clinical trial demonstrated that DB-1310, a new antibody-drug conjugate, is showing early signs of effectiveness in patients with advanced solid tumors that have not responded to standard treatments, particularly those with EGFR-mutant non–small cell lung cancer...
David R. Spigel, MD, FASCO, Chief Scientific Officer of Sarah Cannon Research Institute, reviews data on the role of a 14-gene molecular assay in selecting patients with stage IA–IIA non–small cell lung cancer (NSCLC) as high risk (LBA8027).
David Allen Barbie, MD, of the Lowe Center for Thoracic Oncology at Dana-Farber Cancer Institute, reviews specific clinical and molecular features of early progressors and long-term progression-free survivors from the phase III ADRIATIC trial, which assessed consolidation durvalumab vs placebo after concurrent chemoradiotherapy for limited-stage small cell lung cancer (Abstract 8014).
Raffaele Califano, MD, of the Christie NHS Foundation Trust and the University of Manchester, discusses outcomes by osimertinib resistance mechanisms in MARIPOSA-2, a study that evaluated the efficacy of the bispecific antibody amivantamab-vmjw plus chemotherapy vs chemotherapy in patients with EGFR-mutant advanced NSCLC after disease progression on osimertinib (Abstract 8639).
Results from an international clinical trial show that a 14-gene molecular assay can help identify patients with early-stage nonsquamous non–small cell lung cancer (NSCLC) who could benefit from adjuvant chemotherapy after surgery. The research will be presented at the 2025 ASCO Annual Meeting...
Inhaling wildfire-related air pollution may reduce the likelihood of survival among patients with non–small cell lung cancer (NSCLC), according to new findings presented by Singhal et al at the 2025 ASCO Annual Meeting (Abstract 10520). Background Wildfire-related air pollution contains particulate ...
In a study reported in JAMA Oncology, Heyward et al examined the harm-benefit balance of immune checkpoint inhibitor use across lines of treatment in non–small cell lung cancer (NSCLC). Study Details The retrospective cohort study, conducted in 2024, involved 2013 to 2019 Surveillance,...
Although I have spent the past 2 decades of my medical career as a primary care physician, educator, and researcher in conditions that disproportionately affect people of Asian descent, including lung cancer, I was still unprepared to hear the words “You have stage IV non–small cell lung...
Zongertinib, an investigational oral, HER2-selective, EGFR-sparing tyrosine kinase inhibitor, elicited durable responses and demonstrated clinical benefit in patients with advanced, previously treated, HER2-mutant non–small cell lung cancer (NSCLC), according to data presented by John V. Heymach,...
Results from a global phase III clinical trial found that maintenance therapy with a combination of the alkylating agent lurbinectedin and the PD-L1 inhibitor atezolizumab improved survival in some patients with extensive-stage small cell lung cancer (SCLC) compared with maintenance therapy with...
On May 14, the U.S. Food and Drug Administration (FDA) granted accelerated approval to telisotuzumab vedotin-tllv (Emrelis), a c-Met–directed antibody and microtubule inhibitor conjugate, for adults with locally advanced or metastatic, nonsquamous, non–small cell lung cancer (NSCLC) with high c-Met ...
The National Comprehensive Cancer Network (NCCN) released its first set of Clinical Practice Guidelines in Oncology (NCCN Guidelines®) in 1996, covering eight tumor types. Today, guidelines are available for more than 60 tumor types, subtypes, and related topics. During the NCCN’s 30th Annual...
In an interim analysis of a Japanese trial (ACHILLES/TORG1834) reported in the Journal of Clinical Oncology, Miura et al found that afatinib prolonged progression-free survival vs platinum-based chemotherapy in patients who had treatment-naive nonsquamous non–small cell lung cancer (NSCLC) with...
Thousands of forward-looking research studies defined the 2025 American Association for Cancer Research (AACR) Annual Meeting. Here, aside from our fuller coverage of key presentations in The ASCO Post, we offer a snapshot of a few additional abstracts that may be of interest to cancer researchers...
In a study reported in The New England Journal of Medicine, Pich et al found that tumor-infiltrating clonal hematopoiesis (TI-CH) was associated with an increased risk of death or recurrence among patients with early-stage non–small cell lung cancer (NSCLC) and poorer overall survival among...
The phase III MARIPOSA trial was a head-to-head comparison of the EGFR tyrosine kinase inhibitor osimertinib and the combination of the bispecific EGF receptor–directed and MET receptor–directed monoclonal antibody amivantamab-vmjw and the EGFR tyrosine kinase inhibitor lazertinib in the first-line ...
Patients with human immunodeficiency virus (HIV) are less likely to receive potentially life-saving cancer treatment if they reside in communities with lower income levels and educational attainment, according to a recent study published by Islam et al in Cancer. Study Methods and Results...
In an analysis from the Scandinavian phase III NARLAL2 trial, reported in the Journal of Clinical Oncology, Schytte et al found that fluorodeoxyglucose (FDG)-PET–guided heterogeneously dose-escalated radiotherapy was not associated with greater 6-month toxicity vs standard radiotherapy in...
The novel HER2-targeted tyrosine kinase inhibitor zongertinib elicited durable responses in patients with advanced, previously treated non–small cell lung cancer (NSCLC) that harbored a HER2 mutation, according to the preliminary results of the early-phase Beamion LUNG-1 trial. These findings were...
The oral KRAS G12D inhibitor zoldonrasib could provide clinical benefit in patients with previously treated non–small cell lung cancer (NSCLC) whose tumors harbored a KRAS G12D mutation, according to new findings presented by Arbour et al at the 2025 American Association for Cancer Research (AACR)...
Nicolas Girard, MD, a thoracic oncologist at the Institut Curie, Paris, presented the results of an interim analysis of the open-label phase II COCOON study, at the European Lung Cancer Congress (ELCC) 2025.1 A readily available preventive regimen (the COCOON regimen) reduced moderate-to-severe...
Updates from several clinical trials of the EGFR tyrosine kinase inhibitor osimertinib across stages and settings of EGFR-mutated non–small cell lung cancer (NSCLC) were presented at the European Lung Cancer Congress (ELCC) 2025. The updated results from the phase III LAURA trial were presented by ...
There has been remarkable progress in treating EGFR-variant lung adenocarcinoma with tyrosine kinase inhibitors such as gefitinib, erlotinib, osimertinib, and afatinib. However, several important issues remain unresolved, including whether there remains a role for chemotherapy, who should receive a ...
Although immune checkpoint inhibitors (ICIs) have transformed the treatment landscape over the last decade for patients with non–small cell lung cancer (NSCLC), the agents can also stimulate uncontrolled immunity against normal tissues and organs, leading to a cascade of immune-related adverse...
In a pooled analysis of the phase II TRUST-I and TRUST-II trials reported in the Journal of Clinical Oncology, Pérol et al found that the oral, potent, CNS-active, selective, next-generation ROS1 tyrosine kinase inhibitor (TKI) taletrectinib was highly active in ROS1-positive advanced or metastatic ...
A recent study published by Hooda et al in The Annals of Thoracic Surgery suggests that Medicaid expansion under the Affordable Care Act has significantly improved access to timely treatment and high-volume hospitals for patients with early-stage non–small cell lung cancer (NSCLC). These findings...
Individuals who reported exclusive use of combustible cigarettes as well as those who reported dual use of both cigarettes and e-cigarettes showed similarly high toxicant exposure, according to the results of a study published in Nicotine & Tobacco Research. Both groups of smokers showed higher ...