Bo Wang MD. Executive Member, Lung Cancer Research at Sarah Cannon Research Institute. Hematology-Oncology Willamette Valley Cancer Institute. Views are my own.
My biggest takeaways for #WCLC25 plenary:
1) Flaura2 confirmed as a go to regimen for most classical EGFRmut NSCLC
2) Ivonesvimab + chemo shows benefit over chemotherapy alone in a western population post TKI (EGFRmut)
3) zidesamtinib for ROS1 promising, needs much more maturity
#ASCO26#ANVIL is in.
➡️Adjuvant nivolumab: negative.
DFS HR 0.97, p=0.78. N=935.
6 years of follow-up. PD-L1≥50%: HR 0.86, p=0.43.
But here's what makes this problematic; put it next to IMpower010 and KEYNOTE-091:
PD-L1≥50%:
• IMpower010 (atezo): HR 0.43 ✓
• KEYNOTE-091 (pembro): HR 0.82 ✗
• ANVIL (nivo): HR 0.86 ✗
PD-L1<1%:
• IMpower010: HR 0.97 ✗
• KEYNOTE-091: HR 0.75 ✓
• ANVIL: HR 0.97 ✗
Three drugs. Three assays. Completely inconsistent results by PD-L1 subgroup. No reproducible biomarker-efficacy relationship across trials.
I do not think this is a nivolumab problem. It's an adjuvant IO problem. We don't understand which patients benefit and after 3 phase IIIs, we still can't reliably select them. ctDNA-guided adjuvant therapy can't come fast enough.
@ASCO@LungCancerRx
We just published findings from the MARIPOSA trial :
Long-Term Impact of First-Line Amivantamab Plus Lazertinib Versus Osimertinib on Mechanisms of Acquired Resistance in MARIPOSA: A Brief Report.
https://t.co/eUqeHQyZqZ
Ph III PACIFIC2 trial of concurrent chemoRT + durvalumab v pbo in unresectable stage III NSCLC @JCO_ASCO:
- 328pts
- no diff in PFS (HR 0.85, p=0.247), OS (HR 1.03, p=0.823), ORR, or tox
Negative study, but important data @OncoAlert #LCSM https://t.co/uH4Lw09Tfg
For 2nd and 3rd year fellows who are thinking about first jobs - remember to apply to many job types! Do academic job talks, interview at community and hybrid hospital employed positions, and physician owned practices, and pharma companies. Take time & learn what’s out there 😀
My biggest takeaways for #WCLC25 plenary:
1) Flaura2 confirmed as a go to regimen for most classical EGFRmut NSCLC
2) Ivonesvimab + chemo shows benefit over chemotherapy alone in a western population post TKI (EGFRmut)
3) zidesamtinib for ROS1 promising, needs much more maturity
#WCLC25 : Professor Ahn presenting the much awaited results of Ifinatamab DXd ( iDXd) in pretreated pts with #SCLC :
✅ ORR=48.2% in ITT, 56.3% in 2L, 51% in CFTI<90d
✅ mPFS=4.9m, DoR=5.3m, OS=10.3m
✅ mOS=12m for 2L pts!
✅ ILD in 12.4%
Ph3 IDeate-Lung02 ongoing!
@IASLC@OncBrothers@OncoAlert@VJOncology
#WCLC2025 both taletrectinib and zidesamtinib are promising ROS1 targeting agents. TRUST and ARROS programs are both undergoing development. Taletrectenib already FDA approved and pending phase 3 study in China against crizotinib. I will keep my eyes peeled for both