#ASCO24 is tomorrow! Lung Cancer Abstracts not to missed👇 My Top 5 Targeted Therapy abstracts, with key data where available Get your thinking caps on for tomorrow ASCO ESMO - Eur. Oncology IASLC #ASCOLDP22 #ESMOCorrespondents Annals of Oncology #IrishLungCancerCommunity EGFR Resisters KRASKickers

#ASCO24 is tomorrow! Lung Cancer Abstracts not to missed, installment 2 👇 My Top 5 Immunotherapy abstracts below, aside from the plenaries See you tomorrow! ASCO ESMO - Eur. Oncology IASLC #ASCOLDP22 #ESMOCorrespondents Annals of Oncology #IrishLungCancerCommunity #IrishLungCancerAlliance

CROWN study: 5 yr FU of Ph3 Lorlatinib vs crizotinib in 1L ALK+ mNSCLC 5 year PFS not reached PFS 60% (vs 8%) at 5 yrs with HR at 0.19 4/114 developed brain mets on lorlatinib Good IC control. Longest PFS across all ALK. Surely this underlines 1L use over sequential? #ASCO24

5yr CROWN update of Lorlatinib ✅ Clearly the most effective 1L ALK TKI ✅ PFS = extraordinary ✅ Dose reduction does not impact efficacy ✅ v3 ALK subtypes do not do worse ✅ No new ALK resistance mutations ❗️TP53 co-mut still do less well ❗️Toxicity main issue #ASCO24 #LCSM

Dr. Tony Mok at #ASCO24 with primary analysis of phase III KRYSTAL 12: adagrasib vs docetaxel (2:1) in previously treated #KRAS G12C NSCLC. 453pts with 9.4m median f/u. Adagrasib received accelerated approval for #KRAS G12C NSCLC Dec 12, 2022 based on KRYSTAL-1.

CB101 soto+carbo/pem cohort. 1stline ORR 65% l, mPFS 10.8mo. mPFS 11.9mo in PDL1neg. 8.3mo mPFS 2L+. TRAEs mostly heme. V low rates of G3+ ALT rise if IO non-exposed. >>v encouraging efficacy with low AE rate. Ongoing CB202 ph3 trial testing this further #ASCO24

Treatment naive atypical EGFR mutation? (All mut except DelEx19, L858R, Ex20 Ins) 🤔 Amivantamab + Lazertinib? ✅ Longest mPFS recorded = 19.5m ❗️Usual (significant) toxicities ❗️Small numbers Likely to be more effective than Afatinib or Osimertinib if tolerated #ASCO24 #LCSM

#ASCO24 Many expanding options after chemo-IO failure in 2L #NSCLC ☑️ Pattern of IO resistance matters! ☑️ NGS testing imperative for all- rebiopsy! ☑️ TKIs, ADCs (HER2, cMET) ☑️ Biomarker-driven platform trials needed! ☑️ Mind the algorithm! #some #LCSM ASCO ESMO - Eur. Oncology IASLC

LAURA: great presentation by Suresh S. Ramalingam, MD, FASCO: 2:1 randomisation; x over allowed. Stark disposition slide differences. PFS HR 0.16! #ASCO24

ADRIATIC: Ph3 Durva (q4w for 4#) vs Placebo as consolidation if not progressing post cCRT for locally advanced SCLC Median OS 55.9 vs 33.4 mo (HR 0.73 0.57-0.93) 36 mo survival: 56.6 vs 47.6% PFS: 16.6 vs 9.2 mo HR 0.76 Toxicity tolerable Exciting data and new SOC! #ASCO24

ADAURA MRD presentation; detects molecular relapse pre radiological; sequential ctDNA sampling and scans outlined in first slide. 8% were baseline mrd+ and had poor outcomes. MRD detects relapse 4.7 months earlier. Nice presentation by A/Prof Tom John #ASCO24

CheckMate-77T update ❓Is neo-adj chemoIO appropriate with N2 (poorer prog) St3 ✅ EFS maintained HR 0.60 (N2) v 0.60 (non-N2) ✅ 67% w N2 had nodal downstaging ✅ N2 w/o pCR = ⬆️EFS w Niv HR 0.48 🤔 If resectable, N2 not a reason per se to avoid neo-adj chemoIO #ASCO24 #LCSM

Neoadjuvant nivolumab plus ipilimumab results in a substantial pathological response in most patients with mismatch repair–deficient colon cancer and appears to be safe. Read the full NICHE-2 phase 2 study results: nej.md/3Ku4X0H

PALOMA-3 results Journal of Clinical Oncology after #ASCO24 oral presentation. Subcutaneous vs intravenous amivantamab (with lazertinib) in previously treated #EGFR NSCLC (n=418). Primary PK endpoint shows non-inferiority. Subcutaneous with much better safety profile. ascopubs.org/doi/10.1200/JC…

Superb work from Charles Swanton & team, helping us to better understand who may need an “Osi+” frontline approach &why. But, many UK labs don’t test TP53 & many do but won’t report it (!) EGFR status is best interpreted knowing TP53 and RB1 status at baseline.

Are you interested in a career in Medical Oncology? Join us on Tues 17th Sept, 6pm (BST) to hear about our exciting and rapidly growing specialty! Register now: eur03.safelinks.protection.outlook.com/?url=https%3A%… RT ESMO - Eur. Oncology Royal College of Physicians JRCPTB Royal College of Physicians & Surgeons of Glasgow RCPEdin The Royal College of Radiologists BONUS