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.”
Title: Adjuvant Nivolumab vs Observation in Resected Non–Small Cell Lung Cancer
Authors: Jamie E. Chaft, Zhuoxin Sun, Charles M. Rudin, Onkar V. Khullar, Charles B. Simone II, Kurt Oettel, David Kozono, Rajitha Sunkara, Bryan Faller, James M. Isbell, Vladimir Hugec, Asheesh Shipstone, Eric C. McGary, Jeffrey M. Clarke, Ashita Talsania, Li Ding, Ramaswamy Govindan, Jacob M. Sands, John V. Heymach, Luis E. Raez, Shakun M. Malik, Thomas E. Stinchcombe, Sumithra J. Mandrekar, Jeffrey Bradley, David E. Gerber, Everett Vokes, David Gandara, Charles Staley, Suresh S. Ramalingam
Read the Full Article.
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