Yago Garitaonaindia, Translational Research Fellow at CCIT-DK – National Center for Cancer Immune Therapy of Denmark, shared a post on LinkedIn:
“ASCO26 melanoma, lung orals, oh my!!! Early stages and cell therapy dominate the scene,
NSCLC
LORIN | neoadjuvant lorlatinib, stage III ALK+
pCR 46.9% | MPR 81.3% | ORR 83.7% | 75% conversion-to-surgery in unresectable
Before reading this as a 7-year cure story (CROWN): patients stop lorlatinib, and pCR under a TKI is not the EFS surrogate it is in IO (see melanoma targeted therapy). Strong results, need follow-up. Big point on conversion rates. Interesting TROP2 signal in residual disease + the DTPC analysis. Exactly what you ask of any trial now.
ANVIL / ALCHEMIST (EA5142) | adjuvant nivolumab, resected NSCLC
No DFS benefit: ITT HR 0.97, PD-L1 >=50% HR 0.86 | 935 pts | 72.6 mo follow-up
Alongside PEARLS, IMpower010 and BR.31, the adjuvant IO story stays inconsistent. We need selection and dynamic biomarkers. Beyond whether adjuvant after neoadjuvant adds anything, the real question is: if it does, for whom? Only the biology will tell us. Link in first comment
The discussion (and why discussants matter)
Standout moment: Mariano Provencio from Grupo Español de Cáncer de Pulmón in the NSCLC oral session.
On ALCHEMIST: can we even call it an adjuvant trial when treatment is separated from surgery by months? NADIM adjuvant is the missing piece.
On LORIN: it still has to beat ALINA’s EFS/OS. Does deeper pathological response translate into survival? And will N3 disease move into perioperative trials? This is exactly why we want great discussants.
Melanoma
Triplet IO (ipi + nivo-rela) | resectable stage III
pCR 63% | MPR 69% | 0 recurrences (mFU 9.8 mo) | 1 fatal myocarditis
Excellent pCR data, but a toxic death in a curative-intent setting is a real call for patient selection.
NeoReNi II | neoadjuvant nivo + rela, resectable stage II
pCR 60% | MPR 65% | No grade 4-5 TRAEs, SLN mapping preserved
Neoadjuvant IO is feasible in stage II. Phase 3 needs patient selection + response-adapted treatment, or we keep asking the same questions. Testing clinical decisions, not only testing drugs.
OBX-115 TIL(Agni-01) | advanced melanoma
ORR 67% | DCR 93% | mDoR not reached | n=15
mbIL15-engineered TILs replace high-dose IL-2. Low-dose lymphodepletion, CNB-enabled manufacturing. Small cohort, short follow-up, but if it holds in phase 2 it dismantles the main toxicity barrier of TIL therapy. Democratic TILs?
One line through all of it: we are getting very good at producing responses, and still not good at deciding who needs what.”
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