Natalie Vokes

Asst professor @MDAndersonNews. Lung cancer and clinical computational oncology. Tweets are my own.

[OncoDaily Lung @OncodailyLung]

🫁 Never-smoker NSCLC is not one immunotherapy story, it is a biomarker story.

In a large retrospective analysis, Gariazzo, Elkrief, Concannon et al. evaluated 741 patients with metastatic NSCLC without actionable genomic alterations who had never used tobacco and received ICI-based regimens.

Overall outcomes were modest:

📌 ORR: 23.2%
📌 Median PFS: 4.5 months
📌 Median OS: 16.8 months

But the study identified important predictors of benefit:

🧬 PD-L1 ≥90%
🧬 TMB ≥90th percentile
🧫 High TIL density
🔥 Immune-enriched transcriptomic profiles
🛡️ Increased MHC class I/II antigen presentation and T-cell activity

Another key signal: PD-(L)1 + CTLA-4 combinations outperformed chemo-immunotherapy and PD-(L)1 monotherapy in median PFS and OS.

The takeaway is clear:

Never-smoker, AGA-negative NSCLC should not be viewed as uniformly resistant to immunotherapy. A selected subgroup with very high PD-L1, high TMB, and immune-rich tumors may derive meaningful benefit.

For clinical decision-making, this study supports moving beyond smoking history alone and toward deeper immune and molecular profiling.

https://t.co/9B4e4YK30U

@alessandra_dodi @DiFedericoMD @doctordegio @pecci_federica1 @mihaela_aldea @NarjustFlorezMD @JuliaRotow @XinAnnWang @ACortelliniMD @FedericoCappuz1 @DrMarkAwad @stescalera @giulio_metro @NIVokes @AdamJSchoenfeld @BRicciutiMD

[UT MD Anderson @UTMDAnderson]

Dr. Natalie Vokes shared the latest insights on novel frontline combinations with checkpoint inhibitors for metastatic non-small cell lung cancer at #ASCO26.

The session explored emerging strategies aimed at improving outcomes and expanding treatment options for patients with advanced lung cancer. @NIVokes #EndCancer

[Bruna Pellini, MD @BrunaPellini]

🫁 What’s next for 1L #NSCLC #without actionable genomic alterations?

Excellent, well-balanced discussion by Dr. @NIVokes , highlighting key advances and putting new data into clear clinical context.

A complex and rapidly evolving treatment landscape.

#NSCLC #LungCancer #ASCO26 #ThoracicOncology @UTMDAnderson @ASCO

[Natalie Vokes @NIVokes]

@drgandara Important to understand though if driven by MTAP or CDKN2A or other genes in the locus

[The Mark Foundation for Cancer Research @TheMarkFdn]

🌟Three of the 15 inaugural @AACR Trailblazer Award recipients are previous Mark Foundation early-career grantees. It’s a privilege to watch @efapostolou29, @TuomasTammela, and @NIVokes continue to grow their careers and tackle cancer’s most difficult questions.

[OncoDaily @oncodaily]

🟢 𝗔𝗔𝗖𝗥 𝗔𝗻𝗻𝗼𝘂𝗻𝗰𝗲𝘀 𝗥𝗲𝗰𝗶𝗽𝗶𝗲𝗻𝘁𝘀 𝗼𝗳 𝗔𝗔𝗖𝗥 𝗧𝗿𝗮𝗶𝗹𝗯𝗹𝗮𝘇𝗲𝗿 𝗖𝗮𝗻𝗰𝗲𝗿 𝗥𝗲𝘀𝗲𝗮𝗿𝗰𝗵 𝗚𝗿𝗮𝗻𝘁𝘀 𝟮𝟬𝟮𝟲

The latest initiative from American Association for Cancer Research highlights where the future of oncology is being built.

https://t.co/PcL3MDvjbl

@AACR @KarenODixon @JJMilnerLab @jontsai @NIVokes @YMerbl @TuomasTammela

#AACR #oncology #OncoDaily #cancer #grant

[UT MD Anderson @UTMDAnderson]

Congratulations to our Dr. Natalie Vokes on receiving an @AACR Trailblazer Cancer Research Grant, announced at this morning's #AACR26 opening ceremony.

This grant will support her research into CDKN2A/MTAP-deleted non-small cell lung cancer. #EndCancer

[Natalie Vokes @NIVokes]

@IDEOlogyHealth All of these time points would be valid times to check as we incorporate new biomarkers into practice

[Natalie Vokes @NIVokes]

@IDEOlogyHealth Good data from the cocoon trial supporting prophylaxis!

[Natalie Vokes @NIVokes]

@IDEOlogyHealth OS data supports combination, but have to consider patient-specific factors and goals

[Alessandro Di Federico @DiFedericoMD]

Biomarker complexity is rapidly increasing, yet the cost and accessibility of the technologies needed to implement them are not always keeping pace
In @JTOonline, our comprehensive study of the routinely-assessed TTF-1 expression in lung adenocarcinoma
https://t.co/xAXHcGzyej
1/7

[Natalie Vokes @NIVokes]

Special mention to @LeiDeng3 and Bolun Liu for their analysis of NCDB dataset, and the teams of @BRicciutiMD, @DiFedericoMD, @alissajcooper and @AdamJSchoenfeld for their collaboration. Hope that such studies can pave the way for better treatment options in these rare tumors!

[Natalie Vokes @NIVokes]

Delighted to share this multi-institutional collaboration dissecting outcomes in sarcomatoid lung cancer, a rare and hard to treat subtype. While chemotherapy may have limited efficacy, we found that many of these tumors are PDL1 high and responsive to immunotherapy.

[JTO & JTO CRR @JTOonline]

Outcomes to ICIs and genomic features in PSC remain underexplored compared with other NSCLC subtypes. Hong et al. present the findings from their multicenter retrospective study on clinicogenomic features and #immunotherapy associations in PSC. https://t.co/sUAWExySSp @NIvokes

[JTO & JTO CRR @JTOonline]

Outcomes to ICIs and genomic features in PSC remain underexplored compared with other NSCLC subtypes. Hong et al. present the findings from their multicenter retrospective study on clinicogenomic features and #immunotherapy associations in PSC. https://t.co/sUAWExySSp @NIvokes

[Journal for ImmunoTherapy of Cancer @jitcancer]

New #JITC article: Causal AI-based clinical and radiomic analysis for optimizing patient selection in combined immunotherapy and SABR in early-stage NSCLC: a secondary analysis of the phase II I-SABR trial https://t.co/sfXU3hdqhV
@StevenLin_MDPhD @liao_zhongxing @dave_qian @ca_chung @NIVokes @JiaWu_PhD @JoeChangMD @MDAndersonNews

[Biagio Ricciuti, MD, PhD @BRicciutiMD]

🚨 Excited to share our 2 new studies published today in @TheLancetOncol — one offering deeper insight into refining #ICI for PD-L1–negative & 🧬#STK11-mutant #NSCLC, and the other exploring #ICI vs 💊#BRAF/MEKi in #BRAF V600E #NSCLC. @O@OncoAlert @IASLC #LCSM. /W✨@DiFedericoMD✨

These studies aren’t full answers — but we hope they help sharpen strategies and spark further progress in tailoring immunotherapy for NSCLCs historically seen as resistant.

Heartfelt thanks to the co-authors, patients, collaborators & reviewers who made this possible.

@marinagarassino @MarceloCorassa @peters_solange
@pecci_federica1 @ACortelliniMD @dplanchard @RobertoFerrara_ @CoreyLangerMD @FawziAbuRous @mihaela_aldea @XinAnnWang @DanaFarber @DanaFarberNews @DrMarkAwad @NIVokes @StephenVLiu @NarjustFlorezMD @alessi_joao @DrJNaidoo @Alfdoc2

[Jose Fernando Moura, PhD @FernandoOnco]

NSCLC MTAP-del
BMS-986504 (MTA-coop PRMT5i) in pretreated pts:
ORR 29% · DOR 10.5m · DCR 80%
Active in EGFR/ALK/KRAS subgroups.
Well tolerated, low heme tox.

➡️ Next step: MountainTAP-9 & 29
#LungCancer #Oncology #TargetedTherapy #wclc25 @IASLC @OncoAlert

[Young Kwang Chae, MD, MPH, MBA @youngkwangchae]

Loving the poster vibes at #WCLC2025! 😎 Connecting with mentors & friends = best part. Always learning! 📚💡@drgandara @ChristineBestv1 @NIVokes

[Natalie Vokes @NIVokes]

Great to see so much data coming out in this space, with many clinical trials now available or coming for patients with MTAP deletions including at @MDAndersonNews and other centers

[Benjamin Besse @BenjaminBesseMD]

Be ready to screen MTAP loss in all pts with advanced NSCLC, regardless of driver.
@mihaela_aldea shows incidence, highest in ALK/RET/EGFR/ROS1.
AMG193 paved the way at #ESMO24.
BMS-986504 confirms druggability: 29% ORR + many durable SD (slide @CharuAggarwalMD). #WCLC25

[Bingnan Zhang @BZhangMD]

Important paper put out by stellar MDA colleagues! Congrats to all co- authors. @LaurenByersMD @NIVokes John Heymach @MDAndersonNews