This week in lung oncology highlights how clinical decision-making continues to evolve across surgery, biomarkers, immunotherapy, and survivorship, driven by both clinical trials and real-world insights shared by leading experts worldwide.
Louis Gros Swiss Oncologist/ Chef de Clinique CHUV Cancer Prevention & Screening/ Clinical Trials
Lung cancer can be curable, even in patients over 80. In our new study published in The Lancet Regional Health – Americas, we examined surgical outcomes and quality of life in octogenarians with early-stage lung cancer. In a prospective cohort of 884 patients, carefully selected patients aged ≥80 years achieved long-term survival and quality-of-life outcomes comparable to younger patients after surgery, despite slightly higher postoperative complication rates. These findings suggest that age alone should not exclude patients from potentially curative lung cancer surgery. Age is not the limit. How we age is what matters. Proud to contribute to this work with colleagues from Mount Sinai and the IELCART investigators.
Read About Study on OncoDaily Lung
Karim Abdelhamid- Attending Physician | Translational Researcher
“New paper out : Multidisciplinary international expert consensus on tissue acquisition in NSCLC. While a lot of attention is placed on new treatments in NSCLC, the quality of the initial tissue sample remains a fundamental – and sometimes overlooked – determinant of patient management. In this work, an international multidisciplinary group came together to provide practical recommendations on tissue acquisition, with a focus on real-world constraints and the growing demands of molecular testing. The goal is straightforward: improve sample adequacy so that advances in precision oncology can actually translate into clinical benefit. Very pleased to have contributed to this collaborative effort.”
Mihaela Aldea Medical Oncologist, Gustave Roussy, Villejuif, France
“MTAP loss is frequent in oncogene-driven #NSCLC, with highest rates in ALK+ (up to 45%), followed by RET+ (up to 36%) and EGFR-mutant tumors (up to 24%). IHC and NGS may be complementary for detection. #PRMT5i shows activity regardless of prior TKI exposure. PRMT5i + targeted therapy may outperform monotherapy in models with at least partial TKI sensitivity. RETpositive Alk Ros1 France Cancer Poumon EGFR Resisters Dana-Farber Cancer Institute Gustave Roussy Annals of Oncology.
Eric Lim Professor of Thoracic Surgery at The Royal Brompton Hospital
“Surgical access doesn’t just affect complications, it determines survival! A paradigm shift thanks to an international effort of trialists from Europe to China, published this week in The Lancet.”
Diego A. Díaz García Oncólogo Médico | Alta Especialidad en Oncología
“Small Cell Lung Cancer.
Small cell lung cancer (SCLC) is a high-grade neuroendocrine carcinoma strongly associated with tobacco exposure. Incidence in the US was 4.7 cases per 100,000 in 2021, with 5-year OS ranging from 12% to 30%.
Key clinical features:
• ~95% of patients have a smoking history
• 70% present with extensive-stage disease
• Brain metastases at diagnosis occur in ~15%
Treatment landscape:
Limited-stage SCLC (≈30%)
Concurrent platinum–etoposide chemoradiation remains the backbone. Recent data show median OS up to 55.9 months with consolidation durvalumab.
Extensive-stage SCLC (≈70%)
First line: platinum–etoposide plus PD-L1 inhibitor (durvalumab or atezolizumab) followed by maintenance immunotherapy. Median OS remains ~12–13 months despite response rates of 60%–70%.
Second line options include:
• Lurbinectedin: ORR 35%, median PFS 3.7 months
• Tarlatamab (DLL3 BiTE): ORR ~40%, median PFS 4.9 months.
Despite therapeutic advances, relapse remains common and outcomes remain limited, highlighting the need for more effective strategies in this aggressive disease.JAMA DOI 10.1001/jama.2025.0560.”
Hyun Koo Kim Korea University Guro Hospital Professor
“I am pleased to share our recent study comparing subcostal single-port (SP) robotic lobectomy with the conventional intercostal multi-port (MP) approach in patients with NSCLC, which was published in Int J Surg.
In this propensity score-matched analysis, the SP approach demonstrated shorter operative and console times, reduced chest tube drainage, and significantly lower postoperative pain, along with faster recovery of pulmonary function. Importantly, these benefits were achieved while maintaining comparable mid-term oncologic outcomes.
These findings suggest that the subcostal SP approach may represent a meaningful advancement in minimally invasive thoracic surgery, with potential benefits in patient recovery without compromising oncologic safety.”
Dr Risgabh Jain Medical oncologist (AIIMS, Delhi)
#ELCC26: 7 Thoracic Oncology Trials That Could Shift NSCLC Practice
Thoracic oncology is clearly moving toward ADCs, resistance biology, and smarter IO strategies. Here are the trials that matter
Beamion LUNG-1 (Zongertinib)
A serious T-DXd challenger in HER2-mutant NSCLC
→ Strong focus on CNS activity + durability signals
BL-B01D1-204-01 (Bispecific ADC)
EGFR/HER axis targeting beyond TKIs
→ Key strategy for post-TKI resistance
3082-CL-0101 (ADC platform)
Next-gen ADC sequencing question
→ Watch ILD signals + positioning in treatment flow
KEYNOTE-671 (Perioperative Pembrolizumab)
Already practice-influencing
→ OS maturity could firmly establish periop IO standard
TOP (Next-gen IO strategy)
Beyond chemo-IO plateau
→ Selection vs intensification dilemma
ASTEROID & BECOME
Resistance-focused trials
→ PD-L1 low + primary/secondary resistance solutions
Takeaway:
We are entering the post-chemo-IO era
→ ADCs + precision IO will define next-line standards
Save this for ELCC26 updates
Full insights + visuals coming soon
Eric Singhi Thoracic Medical Oncologist focused on patient education & young-onset lung cancer
“Must SAVE slide. Data to support the use of immune checkpoint blockade in early-stage resectable NSCLC!” #PrimOLung26
Alessandro Di Federico MD, Medical Oncologist | Research Fellow at MSKCC. PhD student at University of Bologna
“TTF-1 expression is negative in a non-negligible minority of lung adenocarcinomas. In this paper now fully published in JTO, we comprehensively characterized these tumors and evaluated their sensitivity to current treatments.”
Mario Occhipinti MD, PhD | Thoracic Oncologist, IstTumori/ AIOM Young Committee
“At Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, we are expanding access to innovative treatment options for patients with advanced ALK-rearranged non-small cell lung cancer.
We are currently offering treatment with neladalkib (NVL-655):
• In the first-line setting within the Phase III ALKAZAR clinical trial (NCT06765109)
• In later lines of therapy through an Expanded Access Program (NCT06834074)
ALK-positive NSCLC represents a distinct molecular subtype where targeted therapies can significantly impact outcomes. Providing access to next-generation ALK inhibitors remains a key priority, both through clinical trials and early access programs. We welcome referrals and are available to discuss potential eligibility for these opportunities. For further information, please feel free to reach out.”