Amol Akhade, Senior Consultant at Fortis Hospitals Mumbai, shared a post on LinkedIn:
“Top Lung Cancer Data from ESMO 2025 – My Key Takeaways
The ESMO 2025 programme delivered a wave of potentially practice-changing updates in lung cancer.
Here are the highlights that stood out to me:
- HARMONi-6 (LBA4) – Ivonescimab (PD-1/VEGF bispecific) + chemo vs tislelizumab + chemo in 1L squamous NSCLC. The first head-to-head of its kind; if OS/PFS hold, this could reset 1L standards in squamous.
- OptiTROP-Lung04 (LBA5) – Sacituzumab tirumotecan (TROP2 ADC) vs platinum chemo in EGFR-mutant NSCLC post-TKI. A potential chemo-sparing breakthrough in a difficult space.
- HER2-mutant NSCLC (LBAs 74 and 75) – Zongertinib in the 1L setting (BEAMION-1) and sevabertinib in pretreated patients (SOHO-01). The HER2 story is accelerating beyond trastuzumab-deruxtecan.
- Stage III disease (LBA69 – SKYSCRAPER-03) – Atezolizumab + tiragolumab vs durvalumab post-cCRT. A true ‘PACIFIC challenger’ that may decide the fate of TIGIT in NSCLC.
- Adjuvant ALK+ NSCLC (LBA66 – ELEVATE) – Ensartinib as an adjuvant strategy, expanding the precision paradigm beyond EGFR.
- EGFRm metastatic strategy (LBA72 – NorthStar) – Osimertinib ± local consolidative therapy. Could formalize LCT as part of standard care.
- Small Cell Lung Cancer (LBAs 100 and 101 – DeLLphi-304) – Tarlatamab (DLL3 T-cell engager) vs chemo in pretreated SCLC. Safety, CRS/neurologic events, and subgroup data are crucial — but momentum is building fast.
What this means:
- ADCs are moving firmly into EGFRm and HER2-mutant spaces.
- HER2 TKIs may challenge ADC dominance with intracranial efficacy and better tolerability.
- TIGIT combinations face a make-or-break moment.
- DLL3 T-cell engagers are giving us real hope in SCLC – a disease where we’ve seen little progress for decades.
Taken together, these data signal a paradigm shift in lung cancer across early-stage, locally advanced, and metastatic disease.
The challenge will be sequencing these new agents, managing overlapping toxicities (ILD, CRS, ICANS), and ensuring accessibility in LMICs.
I’ll be following the presentations closely at ESMO2 – stay tuned for deeper dives and real-world implications.”
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