Felipe Couñago
Felipe Couñago/genesiscare.com

Felipe Couñago: Key Clinical Trials in Lung and GU Cancers at ESMO 2025

Felipe Couñago, National Clinical Director of GenesisCare, Spain, shared a post on LinkedIn:

“Key Clinical Trials in Lung and GU Cancers at ESMO 2025: Insights from a Radiation Oncologist’s Perspective

Lung Cancer

  • LAURA – EGFR-mutant unresectable NSCLC post-CRT: MRD cleared in 84% with osimertinib vs 0% placebo. Great work by Dr. Arriola.
  • KEYNOTE-671 – Perioperative pembrolizumab in resectable NSCLC (5-year):
    OS 64.6% vs 53.6% (HR 0.74) | EFS 49.9% vs 26.5% (HR 0.58)
    A milestone toward curing more patients.
  • ELEVATE – Adjuvant ensartinib in resected ALK+ NSCLC: HR 0.20, 2y DFS 87.3% vs 57.2%. Strong new adjuvant option.
  • Alectinib adjuvant (5y data) – Outstanding curves; (Dr. Dziadziuszko).
  • LungMATE-013 – Neoadjuvant chemo-IO for unresectable IIIB/C → surgery vs RT:
    pCR 47%, HR 0.38 favoring surgery. Disruptive data.
  • NORTHSTAR – Osimertinib ± local therapy (68% RT): PFS 25.3 vs 17.5 mo (HR 0.66). Supports consolidative RT beyond oligometastatic disease.
  • MDT-BRIDGE – Borderline-resectable NSCLC; durvalumab + chemo → surgery/CRT: 82% conversion to resectability․

Genitourinary (GU) Tumours

  • LUNAR (PSMA + SBRT) – Improved PFS, no added toxicity.
  • PSMA Addition – rPFS benefit, trend to OS gain.
  • CAPItello-281 – PTEN-deficient mHSPC: rPFS improved.
  • ENZARAD – ADT + enzalutamide + RT: No MFS gain, ↑ toxicity. Maybe a role in N+ pts
  • PRESTO (AFT-19) – Short-course intensified ADT: PSA-PFS ↑, MFS neutral. NCCN 2026: ADT + apalutamide (2B).
  • EMBARK – High-risk BCR: ~40% ↓ risk of death vs ADT.
  • KEYNOTE-905 (EV-303) – Cisplatin-ineligible MIBC: pembro + EV improved EFS/OS/pCR.
  • STOPCAP (metaanalysis) – RT improves OS/PFS in low-volume de novo M1 PCa.”

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