Reflections on ASCO24 by Jill Feldman

Jill Feldman shared on X/Twitter:

“1. What an honor to meet Dr. Lynn Schuchter. I’m grateful for her inspiring vision. Highlighting the people behind data on BOTH sides of the curve and a reminder to comfort always is true leadership in humane, compassionate care. Thank you, we/advocates felt it.

2. Finally recognizing Stage III isn’t early-stage for most patients. Great presentations by Suresh S. Ramalingam and Lecia Sequist on promising data and honest panel discussion, Thank you both!

My main nonscientific takeaway:

• No PET required leaves many ?’s
• 81% crossover.
• Significant PFS, esp CNS, but PFS/OS = increased QOL.
• Ask if CRT benefit some stage IV, not just if stage III still needs it.
• This is NOT a cure and 13% discontinue due to AE… need biomarkers (MRD?) to stratify patients.
• Biomarker testing and prescription MUST be accessible and affordable to ALL.
• Please consider using ‘lowest effective dose’ instead of de-escalation!

Most importantly, patients/families need all the information to choose whether the benefit is worth the risk.

3. ADRIATIC trial of durvalumab after chemo/XRT in limited-stage small cell lung cancer.

Fantastic presentation of the impressive, impactful data by David R. Spigel followed by a brilliant, very balanced discussion by Lauren Averett Byers (thank you for emphasizing the importance of patient preferences!).

My takeaway: IMMEDIATE PRACTICE CHANGING
Remaining Questions:

• Why does IO work in LS and not ES?
• PCI or MRI surveillance?
• Does sequencing matter?

This is the first treatment advancement in MANY DECADES and brought me to tears. My mom died just 6 mths after she was diagnosed with SCLC. THIS is the hope that doctors, patients, and families desperately need.

Let’s celebrate this win, but not forget that we still have far to go.

4. Bottom line – Early integration of palliative care improves QOL AND SURVIVAL!

In my opinion this study is one of the most important studies ever! Dr. Joseph Greer and Dr. Jennifer Temel shared data from this simple but very meaningful study showing that telehealth is AS EFFECTIVE as in-person visits for delivering early palliative care to patients with advanced NSCLC.

My Takeaway:

• Telehealth can reduce barriers to access and reduce financial and TIME toxicity.
• Patients can get high-quality palliative care from their homes.
• We need to educate physicians and patients that palliative care is NOT hospice care.
• Every patient with advanced cancer should be referred early.

At the opening session, Dr. Lynn Schuchter reminded us of Hippocrates’s quote, ‘To cure sometimes, to relieve often, and to comfort always is all that may be reasonably expected of medicine’.

5. Lung cancer – A few oral abstracts (haven’t seen all yet).

• HARMONi-A – encouraging data and waiting to see CNS penetration, which is critical.
• NRG-LU002 – Disappointing, but I am wondering if it’s similar to the early gefitinib trial, where we need to find the right biomarker to stratify patients.
• CROWN – median OS is jaw-dropping, but AE’s can be brutal. Would Alectinib be considered 1st for some patients?
• PALOMA-3 – subcutaneous Avelumab has similar pharmacokinetics as IV, fewer IRR, less time in clinic and increased OS – no brainer!
• TRUST-1 – 90% ORR 87% intracranial, happy to see promising research in ROS1.
• ADC’s – I will remain cautiously optimistic.

Research is our lifeline and our future. The true value of research for patients and families is Hope – Hope to live longer AND better!

6. The ASCO Patient Advocate Lounge is the home base for advocates during the meeting. It’s where the magic happens—catching up with old friends, meeting new ones, and getting the best hugs in Chicago! A huge thank you to Jeannine Salamone for creating a safe, comfortable space for us and for making everyone feel welcome!”

Jill Feldman is a lung cancer patient and advocate. She is the Co-Founder EGFR Resisters, an advocacy group of EGFR positive lung cancer patients who are resistant to targeted treatment.

She is the Past President of the LUNGevity Foundation, Deputy Chair of IASLC’s patient advisory board and a member of The Chicago Institute of Translational Medicine’s patient advisory board.

Jill is committed to understanding and promoting patient-centered research as a member of the programmatic panel for the Department of Defense Lung Cancer Research Program, as a planning committee member on IASLC’s North America Conference on Lung cancer and as a member of the the ECOG-ACRIN Research Group’s patient advocate committee and thoracic committee.