Podcasts about nsclc

In this episode, we will discuss the FDA approval of telisotuzumab vedotin, an antibody drug conjugate, for NSCLC with high c-MET expression. To help review the data and offer perspective on this new agent, I am joined by two expert thoracic oncologists. I want to welcome Dr. Mor Moskovitz, Head of the Thoracic Medical Oncology Service at Davidoff Cancer Center at the Rabin Medical Center in Petah Tikva, Israel.

Welcome to the Oncology Brothers podcast! In this episode, hosts Drs. Rahul and Rohit Gosain are joined by Dr. Gilberto Lopes, a thoracic medical oncologist from the Sylvester Cancer Center. Together, they dived into the latest updates on anti-EGFR drugs used in non-small cell lung cancer (NSCLC) with EGFR mutations. In this informative discussion, they covered: •⁠  ⁠The evolution of EGFR inhibitors, including Afatinib, Osimertinib, Amivantamab, and Lazertinib. •⁠  ⁠Common side effects associated with these treatments, such as diarrhea, skin toxicity, and infusion-related reactions. •⁠  ⁠Strategies for managing these side effects to improve patient quality of life and treatment adherence. •⁠  ⁠Insights from recent studies, including the SKIPirr trial and the MARIPOSA study, highlighting the benefits of new combinations and treatment approaches. Youtube: https://youtu.be/v6fb6nx0YY4 Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ Join us as we explore how proactive management of side effects can maximize the effectiveness of these therapies and enhance patient outcomes. Don't forget to check out our other ToxCheck discussions, treatment algorithms, and conference highlights!

Featuring perspectives from Dr Ramaswamy Govindan and Dr Stephen V Liu, including the following topics: Introduction (0:00) Management of Nonmetastatic Non-Small Cell Lung Cancer (NSCLC) without a Targetable Mutation — Dr Govindan (4:04) First- and Later-Line Therapy for Metastatic NSCLC without a Targetable Mutation — Dr Liu (26:59) CME information and select publications

Clinical investigators discuss available data guiding the management of non-small cell lung cancer with immunotherapy and other nontargeted approaches.  CME information and select publications here.

“A lot of other disease sites, they have some targeted therapies, they have some immunotherapies [IO]. In lung cancer, we have it all. We have chemo. We have IO. We have targeted therapies. We have bispecific T-cell engagers. We have orals, IVs. I think it's just so important now that, particularly for lung cancer, you have to be well versed on all of these,” ONS member Beth Sandy, MSN, CRNP, thoracic medical oncology nurse practitioner at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about lung cancer treatment. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by May 16, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to lung cancer treatments. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episode: Episode 359: Lung Cancer Screening, Early Detection, and Disparities ONS Voice articles: Non-Small Cell Lung Cancer Prevention, Screening, Diagnosis, Treatment, Side Effects, and Survivorship Oncology Drug Reference Sheet: Amivantamab-Vmjw Oncology Drug Reference Sheet: Cisplatin Oncology Drug Reference Sheet: Lazertinib Oncology Drug Reference Sheet: Nivolumab and Hyaluronidase-Nvhy Oncology Drug Reference Sheet: Fam-Trastuzumab Deruxtecan-Nxki Optimize Your Testing Strategy and Improve Patient Outcomes With NeoGenomics' Neo Comprehensive™–Solid Tumor Assay Clinical Journal of Oncology Nursing article: Oncogenic-Directed Therapy for Advanced Non-Small Cell Lung Cancer: Implications for the Advanced Practice Nurse ONS Biomarker Database ONS video: What is the role of the KRAS biomarker in NSCLC? Biomarker Testing in Non-Small Cell Lung Cancer Discussion Tool ONS Huddle Cards: Checkpoint inhibitors External beam radiation Monoclonal antibodies Proton therapy To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “Unfortunately, because lung cancer is pretty aggressive, we'll see lung cancer mostly in stage IV. So about 50%–55% of all cases are not caught until they are already metastatic, or stage IV. And then about another 25%–30% of cases are caught in stage III, which means they're locally advanced and often not resectable, but we do still treat that with curative intent with concurrent chemoradiation. And then 10%–20% of cases are found in the early stage, and that's stage I and II, where we can do surgical approaches.” TS 2:53 “The majority of radiation that you're going to see is for patients with stage III disease that's inoperable. At my institution, a lot of stage III is inoperable. Now, neoadjuvant immunotherapy has changed that a little bit. But if you have several big, bulky, mediastinal lymph nodes that makes you stage III, surgery is probably not going to be a great option. So we give curative-intent chemoradiation to these patients.” TS 10:51 “Oligoprogression would mean they have metastases but only to one site. And sometimes we will be aggressive with that. Particularly, there's good data, if the only site of progression is in the brain, we can do stereotactic radiation to the brain and then treat the chest with concurrent chemoradiation as a more definitive approach. But outside of that, the majority of stage IV lung cancer is going to be treated with systemic therapy.” TS 15:00 “It's important for nurses to know that there's a lot of different options now for treatment. Probably one of the most important things is making sure patients are aware of what their biomarker status is, what their PD-L1 expression level is, and make sure those tests have been done. … It's good that the patients understand that there's a myriad of options. And a lot of that depends on what we know about their cancer, and then that guides our treatment.” TS 31:05

Join us in this episode of the Oncology Brothers podcast as we dive deep into the rapidly evolving treatment landscape for metastatic non-small cell lung cancer (NSCLC) with actionable mutations in frontline therapy. Hosted by community oncologists Drs. Rahul and Rohit Gosain, we are thrilled to welcome Dr. Susan Scott, a thoracic medical oncologist from the Johns Hopkins Hospital. In this episode, we covered: •⁠  ⁠Common EGFR mutations and the latest treatment options, including osimertinib, amivantamab, and chemotherapy combinations. •⁠  ⁠The importance of comprehensive NGS testing and the need for retesting at progression. •⁠  ⁠Insights into managing side effects associated with various therapies, including the proactive management of cutaneous toxicities. •⁠  ⁠Treatment strategies for less common mutations such as ALK, ROS1, BRAF, and RET, along with their respective targeted therapies. •⁠  ⁠The role of immunotherapy in specific mutations and the importance of patient choice and preferences in treatment decisions. Whether you're a practicing oncologist or simply interested in the latest advancements in cancer treatment, this episode is packed with valuable information to help guide your practice. YouTube: https://youtu.be/LMYDAjZcn5w Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ Don't forget to like, subscribe, and hit the notification bell for more updates from the Oncology Brothers!

This week on The Beat, CTSNet Editor-in-Chief Joel Dunning speaks with Dr. Dibin Mohammed, a consultant at Government Medical College, Kozhikode, Kerala, India, about his WhatsApp group, Young CVTS Surgeons Kerala. Chapters 00:00 Intro 01:22 CTSNet Updates 03:44 Dr. Mohammed Guest 05:20 Allogeneic Mitral Valve Transplant 08:45 Multiple vs Single Arterial Grafting 11:50 AI & Machine Learning in CT Surgery 17:57 3-Port vs 4-Port Robotic Lobectomy 21:28 Redo Pulm Valve Replacement w RAA 24:32 Mitral Ann Disjunction Presentation 27:09 How-To LVOTE & CABG 29:22 Dr. Mohammed, Academic Group Chat 42:30 Upcoming Events 43:43 Closing They discuss the group's goal and the topics its covers, such as recent academic papers and innovative surgical solutions, as well as the reasons Dr. Mohammed created it. Dr. Mohammed also shares insights into working in India and the training systems for residents in the country.   Joel also highlights recent JANS articles on allogeneic mitral valve transplants, survival outcomes after multiple vs single arterial grafting among patients with reduced ejection fraction, artificial intelligence and machine learning in cardiothoracic surgery, and a comparative study of three-port vs. four-port robotic-assisted lobectomy for NSCLC.   In addition, Joel explores redo pulmonary valve replacement with right atrial appendage, how to perform a left ventricular outflow tract enlargement and CABG, and reviews a presentation from the Society for Cardiothoracic Surgery in Great Britain and Ireland Annual Meeting on mitral annular disjunction and mitral valve repair.   JANS Items Mentioned  1.) Allogeneic Mitral Valve Transplant: Historical Precedent, Current Considerations, and Future Implementation  2.) Survival Outcomes After Multiple vs Single Arterial Grafting Among Patients With Reduced Ejection Fraction  3.) Artificial Intelligence and Machine Learning in Cardiothoracic Surgery: Future Prospects and Ethical Issues  4.) Optimizing Surgical Precision: A Comparative Study of Three-Port vs. Four-Port Robotic-Assisted Lobectomy for NSCLC  CTSNET Content Mentioned  1.) Redo Pulmonary Valve Replacement With Right Atrial Appendage  2.) SCTS 2025 | Mitral Annular Disjunction and Mitral Valve Repair   3.) How to Perform a Left Ventricular Outflow Tract Enlargement and CABG  Other Items Mentioned  1.) Aortic Valve Replacement Series   2.) Career Center   3.) CTSNet Events Calendar  Disclaimer The information and views presented on CTSNet.org represent the views of the authors and contributors of the material and not of CTSNet. Please review our full disclaimer page here.

Welcome to the Oncology Brothers podcast! In this episode, Drs. Rahul and Rohit Gosain are joined by Dr. Mark Awad, a world-renowned thoracic medical oncologist from Memorial Sloan Kettering. Together, they dived deep into the treatment landscape for metastatic non-small cell lung cancer (NSCLC) without actionable mutations in frontline settings. Episode Highlights: •⁠  ⁠The importance of next-generation sequencing (NGS) and PD-L1 levels in treatment decision-making. •⁠  ⁠Current treatment options for patients with high PD-L1 scores, including single-agent immunotherapy. •⁠  ⁠Strategies for patients with low or intermediate PD-L1 scores, including chemotherapy combined with immunotherapy. •⁠  ⁠Discussed KRAS G12C and HER2 positive disease in second-line settings, including the latest approved therapies. •⁠  ⁠Insights into the potential side effects and considerations when transitioning from immunotherapy to targeted therapies. Join us as we explored the complexities of treating metastatic NSCLC and the ongoing need for clinical trials and biomarker discovery. Don't forget to check out our other episodes for more insights on treatment algorithms and recent FDA approvals! Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ Don't forget to like, subscribe, and hit the notification bell for more updates from the Oncology Brothers!

In today's episode, supported by Revolution Medicines, we spoke with Kathryn C. Arbour, MD, a thoracic medical oncologist at Memorial Sloan Kettering Cancer Center in New York, New York, about 2 important abstracts presented at the 2024 AACR Annual Meeting that explore novel RAS-targeted approaches in non–small cell lung cancer (NSCLC). Our discussion focused on early clinical findings with zoldonrasib (RMC-9805) and daraxonrasib (RMC-6236), both of which are RAS(ON) inhibitors under investigation for the treatment of patients with RAS-mutant NSCLC. Zoldonrasib, a KRAS G12D-selective tri-complex inhibitor, was evaluated in a phase 1 trial (NCT06040541) in patients with previously treated, advanced KRAS G12D–mutated solid tumors, including NSCLC. Daraxonrasib, a multi-selective RAS(ON) inhibitor, was highlighted in another phase 1 trial (NCT05379985) in patients with advanced RAS-mutant tumors, including previously treated NSCLC; notably, this AACR presentation focused on the association between early on-treatment circulating tumor DNA level reduction and clinical response with the agent. In this episode, Dr Arbour shared insights into the mechanisms of action behind these therapies, their respective clinical trial designs, and the potential implications that early data with the agents may have for the evolving RAS-mutant NSCLC treatment paradigm.

Discussing:Association between risk-reducing surgeries and survival in young BRCA carriers with #BreastCancer DESTINY-Breast11 Update from IndustryPALMIRA in Breast #Cancer (Palbo rechallenge)PEACE V STORM in #Prostate CancerMAGNITUDE :Niraparib and Abiraterone Acetate plus Prednisone in Met CR Prostate CancerOS EGFR-mutant AdvancedNon-Small Cell #LungCancer Treated with 1L Osimertinib Cemiplimab monotherapy as 1L treatment of patients with brain metastases from advanced #NSCLC with  PDL1 ≥50%Beyond fluorodeoxyglucose: Molecular imaging of cancer in precision medicine and more

This episode features the Beamion LUNG-1 trial, where zongertinib showed a 71% response rate in previously treated HER2-mutant NSCLC patients. The EAGLE-1 trial found gepotidacin non-inferior to standard treatment for urogenital gonorrhoea, with a 92.6% success rate. The U.S. Department of Health and Human Services and NIH launched the Generation Gold Standard initiative, a universal vaccine platform targeting pandemic-prone viruses, with trials ongoing for H5N1 avian influenza and coronaviruses.

Lorlatinib is reshaping first-line treatment for ALK-positive NSCLC—but its distinct side effect profile demands proactive, personalized management. In this episode,  Stefanie Houseknecht, PharmD, BCOP (Johns Hopkins Medicine) and Monica Chintapenta, PharmD, BCOP (Parkland Health)share how they're navigating real-world use of lorlatinib, from interpreting long-term data to counseling patients through CNS effects, weight gain, and metabolic challenges.Highlights:Why lorlatinib is gaining traction in first-line ALK+ NSCLCWhat the long-term CROWN data really means for patient outcomesHow to handle tricky side effects like cognitive changes, weight gain, and hyperlipidemiaReal-world tips for patient counseling and supporting adherenceThe importance of catching drug interactions and staying ahead on labsHow pharmacists are shaping care across the oncology teamBonus: Hear how our guests find balance beyond the clinic, whether in the garden or on the Boston marathon course. About Our Guests:Monica completed her Doctor of Pharmacy at Texas Tech University Health Sciences Center and went on to complete PGY-1 and PGY-2 residencies at Tufts Medical Center and Froedtert & the Medical College of Wisconsin, respectively. At Parkland, she supports outpatient hematology/oncology care and leads quality initiatives.   Stefanie earned her PharmD from the University of the Pacific, followed by PGY-1 and PGY-2 residencies at Palomar Medical Center and the University of California-San Diego. Her work focuses on thoracic malignancies, access to oral targeted therapies, and patient outcomes. She is active in the International Association for the Study of Lung Cancer and serves as a preceptor to pharmacy trainees across the Mid-Atlantic.  

Do you know the best strategies for genomic testing in NSCLC? Credit available for this activity expires: 4/30/2026 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/1002496?ecd=bdc_podcast_libsyn_mscpedu

Clinical investigators discuss available data guiding the management of EGFR mutation-positive non-small cell lung cancer.  CME information and select publications here.

This is the second episode of a two-part series on the HER2 diagnostic and treatment landscape in non-small cell lung cancer (NSCLC), hosted by the Oncology Brothers, Drs Rohit and Rahul Gosain.      In this episode, Dr Isabel Preeshagul and Dr Eric Singhi provide the benefit of their experience when discussing how to approach different treatment scenarios in HER2-mutant NSCLC.   The conversation unfolds to cover: • Ways to distinguish HER2 alterations from other alterations on biomarker reports  • The latest efficacy and safety data of currently approved and emerging treatments for HER2-altered NSCLC   • The potential CNS activity of these treatments in patients with HER2-mutated NSCLC  • How the treatment pathway may look in the near future      Clinical takeaways • In NSCLC, HER2-positivity includes mutations, amplifications and overexpression. It's important to distinguish HER2 alterations from EGFR mutations, particularly exon 20 insertions, when interpreting next-generation sequencing (NGS) results  • Trastuzumab Deruxtecan (T-DXd) is currently the only approved targeted agent for HER2-altered NSCLC in the 2nd-line setting. It shows promising efficacy, especially in HER2-mutant cases, but has limited brain penetration and is associated with notable side effects, including pneumonitis, which requires close monitoring  • Emerging TKIs, such as zongertinib, BAY 2927088 (sevabertinib), and NVL-330, target HER2-mutations and have shown high response rates and CNS activity in early studies, without ILD/pneumonitis. These treatments come with unique side effects like diarrhoea and rash, which can be managed with supportive care  • CNS metastases are common, with up to 30% of HER2-altered NSCLC patients presenting with or quickly developing CNS metastases. Current large molecule therapies (like T-DXd) have limited brain penetration, making small-molecule TKIs, like zongertinib, BAY 2927088 (sevabertinib), and NVL-330, promising for their potential CNS activity • Current standard 1st-line care for HER2-mutant NSCLC remains platinum-based chemotherapy ± immunotherapy. Targeted agents (like T-DXd) are generally reserved for 2nd-line use, but ongoing trials are evaluating the move toward frontline therapy Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ Don't forget to subscribe for the next episode

In this episode of Lung Cancer Considered, host Dr. Narjust Florez leads a discussion live from the Texas Lung Cancer Conference with Dr. Mihaela Aldea about the key information about RET-positive NSCLC, from diagnostic challenges to treatment selection. Join us in this lively discussion.

Immunotherapy continues to produce impressive outcomes in NSCLC and in this podcast we discuss some of the latest advances in this evolving area. Key publications and important considerations for patient care are discussed by Helen Westman, Lung Cancer Nurse Consultant at Royal North Shore Hospital Sydney, Dr Margie McGrath, Medical Oncologist at the Princess Alexandra Hospital and Greenslopes Private Hospital in Brisbane and Julie Teraci, Clinical Nurse Consultant in Melanoma from the Cancer Network in WA. This is a member-only episode. Access the full podcast by entering your log in details here - https://www.cnsa.org.au/resource/episode-15-advances-in-lung-cancer-treatment-with-immunotherapy-the-nursing-perspective.html https://www.cnsa.org.au/learn/podcast.html

Join us for an insightful episode of the Oncology Brothers podcast as we dive into the fast-evolving landscape of HER2-positive non-small cell lung cancer (NSCLC). In this first part of the two-part series, Drs. Rahul and Rohit Gosain were joined by Dr. Devika Das, a thoracic medical oncologist, and Dr. Fernando Lopez-Rios, a pathologist, to discuss the critical importance of testing and identifying HER2 alterations in lung cancer patients. In this episode, we covered: •⁠  ⁠The significance of HER2 alterations in NSCLC and how they differ from breast and gastric cancers. •⁠  ⁠The complexities of biomarker testing, including NGS, IHC, and FISH amplification. •⁠  ⁠Patient characteristics and phenotypes associated with HER2-positive disease. •⁠  ⁠The current testing workflows in clinical practice and the role of liquid biopsies. •⁠  ⁠Insights into the treatment landscape for HER2-positive NSCLC, including recent FDA approvals and ongoing clinical trials. Whether you're a healthcare professional or simply interested in the latest advancements in oncology, this episode provides valuable information on the integration of precision medicine in lung cancer treatment. YouTube: https://youtu.be/gMi-sflQyQo Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ Don't forget to subscribe for the next episode, where we will explore treatment options for HER2-positive non-small cell lung cancer in greater detail!

The last few years have seen “a remarkable change in both our approach and management of EGFR lung cancer,” says Shirish M. Gadgeel, MD, division head for hematology/oncology and associate director of Patient Experience and Clinical Care at the Henry Ford Cancer Institute in Detroit. He discusses key considerations for managing EGFR-mutated non-small cell lung cancer with Robert A. Figlin, MD, the interim director and Steven Spielberg Family Chair in Hematology-Oncology at Cedars-Sinai Cancer Center in Los Angeles. Dr. Gadgeel describes considerations for leptomeningeal metastases, important treatment toxicities, and exciting advances on the horizon. Dr. Gadgeel reported various financial relationships. Dr. Figlin reported various financial relationships.

Featuring perspectives from Dr Jonathan Goldman and Dr Natasha B Leighl, including the following topics: Introduction (0:00) Current Management of Nonmetastatic and Metastatic EGFR Mutation-Positive Non-Small Cell Lung Cancer (NSCLC) — Prof Leighl (1:42) Promising Novel Agents in Clinical Development; EGFR Exon 20 Mutation-Positive NSCLC — Dr Goldman (37:25) CME information and select publications

This PER® Spectives™ featured podcast reviews the 22nd Annual Winter Lung Cancer Conference® held in January/February 2025. Multiple successive generations of ALK inhibitors have provided increasing benefits as first-line treatment for the thousands of patients with non-small cell lung cancer (NSCLC) that harbors rearrangements or mutations in the ALK gene. This program focuses on the practical aspects of managing patients with ALK-positive advanced or metastatic NSCLC, putting recent clinical trial data into clinical context. The program is designed for those who did not attend the live meeting and to help reinforce learnings for those who did.

Welcome back to the Oncology Brothers podcast! In this episode, Drs. Rahul and Rohit Gosain are joined by Dr. Joshua Sabari, a thoracic medical oncologist from NYU, to discuss the latest findings from the European Lung Cancer Conference (ELCC) 2025. We dived into several key studies that are shaping the future of lung cancer treatment, including: • KEYNOTE-799: Exploring the combination of concurrent chemotherapy and radiation with the PD-1 inhibitor pembrolizumab for unresectable non-small cell lung cancer (NSCLC). • LAURA: The impact of osimertinib in patients with EGFR mutations post-chemoradiation therapy. • MARIPOSA: The promising results of amivantamab and lisertinib in the metastatic setting for EGFR-mutated NSCLC. • KRYSTAL-7: Investigating the use of KRAS G12C inhibitors in frontline therapy. Join us as we discuss the implications of these studies, the importance of next-generation sequencing (NGS), and how to manage side effects associated with these new therapies. YouTube: https://youtu.be/akoXXAUEl_8 Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ Don't forget to like, subscribe, and hit the notification bell for more updates on the latest in oncology! #Oncology #LungCancer #ELCC2025 #EGFR #KRAS #CancerResearch #Podcast

Oncology here & nowIn this interview Dr. Biagio Ricciuti of Dana Farber Cancer Institute (USA) talks to Dr. Marcelo Corassa of beneficência Portuguesa de São Paulo (Brazil) as they discuss Treatments in EGFR mutant Non Small Cell Lung Cancer. The discussion centers around the results of FLAURA, MARIPOSA and FLAURA2, future directions and much more.Join Us

“It's been known for quite a while that [KRAS] is a mutation that leads to cancer development, but for really over four decades, researchers couldn't figure out a way to target it. And so, it was often considered something that was undruggable. But all of this changed recently. So about four years ago, in 2021, we had the approval of the first KRAS inhibitor. So it's specifically a KRAS G12C inhibitor known as sotorasib,” Danielle Roman, PharmD, BCOP, manager of clinical pharmacy services at the Allegheny Health Network Cancer Institute in Pittsburgh, PA, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about the KRAS inhibitor drug class. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by April 11, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to KRAS inhibitors used for cancer treatment. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Pharmacology 101 series Cancer Symptom Management Basics series Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs ONS Voice articles: First KRAS-Targeted Therapy Receives FDA Approval for Lung Cancer Oncology Drug Reference Sheet: Adagrasib Oncology Drug Reference Sheet: Sotorasib ONS books: Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition) Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) Safe Handling of Hazardous Drugs (fourth edition) ONS course: Safe Handling Basics ONS video: What is the role of the KRAS biomarker in NSCLC? ONS Targeted Therapy Huddle Card ONS Oral Anticancer Medication Learning Library ONS Oral Anticancer Medication Toolkit ONS and NCODA Oral Anticancer Medication Compass Oral Chemotherapy Education Sheets Lumakras® (sotorasib) manufacturer website Krazati® (adagrasib) manufacturer website UpToDate Lexidrug (formerly Lexicomp) To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “If we look at specifically non-small cell lung cancer, this KRAS mutation is one of the most frequently detected cancer drivers or driver mutations. It's thought that about a quarter of cases of non-small cell lung cancer have this KRAS mutation, and it's usually a specific amino acid substitution that we see in non-small cell lung cancer, so what's known as KRAS G12C mutation.” TS 2:31 “Both of these agents, sotorasib and adagrasib, have the same mechanism of action. They bind to a pocket, very specifically on the KRAS G12C protein, and they lock it in an inactive state so that it can't cause that downstream uncontrolled signaling to happen. So they're kind of shutting down the signaling, and therefore you don't get that uncontrolled cell growth and proliferation.” TS 4:27 “Another big difference to point out, and one that is often used in clinical practice to differentiate when to use these agents, is specifically adagrasib is known to have activity in patients with metastatic non-small cell lung cancer that have active brain metastases. In the clinical trial, they included patients with active brain metastases, and they found that this drug has great [central nervous system] penetration. And so it may be considered the agent of choice in patients with brain metastases.” TS 7:19 “Other considerations—I think one of the big ones—is that there are a lot of drug interactions. Just specifically calling one out that I think is pretty impactful, is sotorasib has an interaction with acid-suppressing medications. So there is the recommendation to avoid [proton pump inhibitors] and H2 antagonists in patients receiving sotorasib. They can take antacids, but you would need to space those out from their dose of sotorasib.” TS 14:14 “This needs to be a collaborative endeavor to make sure these patients are monitored appropriately. We are putting a lot of responsibility on the patients with all of this. So, again, completely administered generally in the home setting, a lot of monitoring, a lot of adverse effects, need for reporting and management—so there's a lot happening here. And it takes a team to accomplish this and to do it right. And I firmly believe that this is often a collaborative effort between our pharmacy and oncology nursing teams to make this happen. Working together to ensure outreach to patients—I think that patients are often more successful with these medications with early identification of toxicities when we're doing scheduled outreach.” TS 19:44

Drs. Sabari and Yu discuss the molecular landscape of HER2-mutant lung cancer, including its genomic characteristics, common co-mutations, and differences between HER2 mutations and HER2 amplification. This discussion also explores the prevalence and clinical patterns of HER2 mutations, their oncogenic mechanisms, their impact on tumor behavior and metastases, and potential environmental or genetic contributors to their development.

How much do you know about HER2 alterations in patients with non-small cell lung cancer (NSCLC)? Credit available for this activity expires: 3/31/2026 Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/1002375?ecd=bdc_podcast_libsyn_mscpedu

In a conversation with CancerNetwork®, Leticia Nogueira, PhD, MPH, highlighted the findings and implications of a study she published that evaluated how exposure to wildfires affected post-operative length of stay (LOS) among patients who were recovering from surgery for non–small cell lung cancer (NSCLC). Data from this study showed that patients who underwent curative-intent surgery at facilities exposed to a wildfire disaster experienced a longer LOS compared with similar patients who received treatment during times when no disasters occurred. According to data published in Journal of the National Cancer Institute, the LOS was 7.45 days (SE, 0.22) for patients treated at facilities without wildfire exposure vs 9.42 days (SE, 0.25) among those who underwent surgery at facilities with exposure (P

In this episode of Thinking Thoracic, co-host Dr. Jeff Yang welcomes Dr. Gavitt Woodard and Dr. Christopher Seder to discuss their recent research on lobectomy versus sublobar resection for early-stage non-small cell lung cancer. Their studies, leveraging data from The STS General Thoracic Surgery Database, provide valuable insights into the long-term survival outcomes of these surgical approaches. Hear from Dr. Woodard on how her study, recognized as the Richard E. Clark Memorial Paper, aimed to evaluate patient populations that were not well represented in prior randomized trials, such as older adults and those with poorer pulmonary function. Dr. Seder explains how his research took a complementary approach, examining over 32,000 patients from 2012 to 2022, with a focus on distinguishing the survival outcomes between lobectomy, segmentectomy, and wedge resection.   

Are you up to date on the most optimal management of patients with early-stage ALK-positive non-small cell lung cancer (NSCLC)? Credit available for this activity expires: 3/24/26 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/preeclampsia-biomarker-screening-every-trimester-2025a100065r?ecd=bdc_podcast_libsyn_mscpedu

In today's episode, supported by Summit Therapeutics, we had the pleasure of speaking with Xiuning Le, MD, PhD, about the use of ivonescimab (SMT112) in patients with PD-L1–positive non–small cell lung cancer (NSCLC). Dr Le is an associate professor in the Department of Thoracic/Head and Neck Medical Oncology in the Division of Internal Medicine at The University of Texas MD Anderson Cancer Center in Houston. The phase 3 HARMONi-2 trial (NCT05499390) investigated ivonescimab vs pembrolizumab (Keytruda) in patients with locally advanced or metastatic, PD-L1–positive NSCLC without sensitizing EGFR mutations or ALK translocations. At the preplanned interim analysis, at a median follow-up of 8.7 months (IQR, 7.1-10.3), the median progression-free survival was significantly longer in the ivonescimab arm (n = 198) vs the pembrolizumab arm (n = 200), at 11.1 months (95% CI, 7.3-not estimable) vs 5.8 months (95% CI, 5.0-8.2), respectively (stratified HR, 0.51; 95% CI, 0.38-0.69; 1-sided P < .0001). The objective response rates were 50% (95% CI, 43%-57%) and 39% (95% CI, 32%-46%) in these respective arms. In our exclusive interview, Dr Le discussed the rationale for the HARMONi-2 trial, key findings from the study, and where these findings position the potential role of ivonescimab in the PD-L1–positive NSCLC treatment paradigm.

LCC in Mandarin: Virtual Tumor Board - EGFR NSCLC by IASLC

LCC in Italian: Virtual Tumor Board - Resectable NSCLC by IASLC

Medical, surgical, radiation, and interventional oncology all play vital roles in delivering care to patients battling liver cancer. How do we optimize outcomes when so many specialties have something to offer the same patient? The answer is collaborative oncology. Dr. Robert Martin (Director of Surgical Oncology, University of Louisville) and pioneer in liver-directed therapies, joins host Dr. Sabeen Dhand to discuss a collaborative approach to oncology and recent advances in locoregional therapy. --- This podcast is supported by: RADPAD® Radiation Protection https://www.radpad.com/ --- SYNPOSIS Dr. Martin discusses the importance of a growth mindset in advancing medical techniques and fostering collaborations between specialists. He then shares insights into minimally invasive procedures, such as microwave ablation and irreversible electroporation (IRE). The doctors also touch on the evolution of liver cancer treatments, emphasizing the significance of clinical trials on the horizon. To conclude, Dr. Martin encourages young professionals in surgery and interventional radiology to stay open-minded, be life-long learners, and find synergistic ways to integrate new technologies into patient care. --- TIMESTAMPS 00:00 - Introduction 02:31 - Dr. Martin's Background and Career Path 06:18 - Evolution of Liver Directed Therapies 10:12 - Collaboration Between Specialties 18:34 - Clinical Trials and Emerging Therapies 36:08 - Advice for Young Professionals 39:15 - Conclusion --- RESOURCES Radioembolization Oncology Trial Utilizing Transarterial Eye90 (ROUTE 90) for the Treatment of HCC: https://clinicaltrials.gov/study/NCT05953337?term=NCT05953337&rank=1 Intratumoral Injection of IP-001 Following Thermal Ablation in Patients With CRC, NSCLC, and STS (INJECTABL-1): https://clinicaltrials.gov/study/NCT05688280 Immunophotonics, CIRSE, and Next Research Announce Innovative Phase 2/3 Clinical Trial: INJECTABL-3: https://immunophotonics.com/news/immunophotonics-cirse-and-next-research-announce-innovative-phase-2-3-clinical-trial-injectabl-3/

What if a cancer treatment worked—until it suddenly didn't? A new case report, “Acquired RUFY1-RET rearrangement as a mechanism of resistance to lorlatinib in a patient with CD74-ROS1 rearranged non-small cell lung cancer: A case report,” published in Oncotarget, reveals how a non-small cell lung cancer (NSCLC) patient developed drug resistance through a rare genetic alteration, allowing the cancer to evade therapy. This unexpected finding highlights the importance of advanced genetic testing and personalized cancer treatments. Non-Small Cell Lung Cancer, Targeted Therapy and Drug Resistance Non-Small Cell Lung Cancer is the most common type of lung cancer, accounting for nearly 85% of all cases. Some patients with NSCLC have genetic mutations, such as ROS1 gene fusions, that drive tumor growth. These patients often respond well to targeted therapies like lorlatinib, a ROS1 inhibitor that blocks cancer growth. However, cancer is constantly evolving. Over time, it can develop resistance to targeted therapies, leading to treatment failure. Understanding these resistance mechanisms is crucial for precision oncology, the approach of tailoring cancer treatment based on a patient's unique genetic profile. Full. blog - https://www.oncotarget.org/2025/03/12/a-rare-genetic-shift-that-helped-lung-cancer-evade-treatment/ DOI - https://doi.org/10.18632/oncotarget.28682 Correspondence to - Wade T. Iams - wade.t.iams@vumc.org Video short - https://www.youtube.com/watch?v=HE_qSkcRZho About Oncotarget Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. Oncotarget is indexed and archived by PubMed/Medline, PubMed Central, Scopus, EMBASE, META (Chan Zuckerberg Initiative) (2018-2022), and Dimensions (Digital Science). To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

Virtual Tumor Board: Stage III ALK+ NSCLC by IASLC

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/KRC865. CME credit will be available until February 26, 2026.Modern Practice Principles in Lung Cancer—First Find the Targets, Then Treat With Precision: A Concise Guide for Biomarker Testing and EGFR-Targeted Therapy in NSCLC In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC. Both are Johnson & Johnson companies.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/KRC865. CME credit will be available until February 26, 2026.Modern Practice Principles in Lung Cancer—First Find the Targets, Then Treat With Precision: A Concise Guide for Biomarker Testing and EGFR-Targeted Therapy in NSCLC In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC. Both are Johnson & Johnson companies.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/KRC865. CME credit will be available until February 26, 2026.Modern Practice Principles in Lung Cancer—First Find the Targets, Then Treat With Precision: A Concise Guide for Biomarker Testing and EGFR-Targeted Therapy in NSCLC In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC. Both are Johnson & Johnson companies.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME information, and to apply for credit, please visit us at PeerView.com/KRC865. CME credit will be available until February 26, 2026.Modern Practice Principles in Lung Cancer—First Find the Targets, Then Treat With Precision: A Concise Guide for Biomarker Testing and EGFR-Targeted Therapy in NSCLC In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an educational grant from Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC. Both are Johnson & Johnson companies.Disclosure information is available at the beginning of the video presentation.

Live from TTLC25: Targeted Therapy in Early Stage NSCLC Debate by IASLC

Dr. Jyoti Patel is back on the podcast to discuss the updates to the living guideline on therapy for stage IV NSCLC with driver alterations. She shares updated recommendations in the first- and second-line settings for patients with stage IV NSCLC and classical EGFR mutations, and the impact of these updates for clinicians and patients. We also look to the future to discuss ongoing developments in the field. Read the full living guideline update “Therapy for Stage IV Non-Small Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, Version 2024.3” at www.asco.org/living-guidelines. TRANSCRIPT This guideline, clinical tools, and resources are available at http://www.asco.org/living-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO-24-02785     Brittany Harvey: Welcome to the ASCO Guidelines Podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges and advances in oncology. You can find all the shows including this one at asco.org/podcasts.   My name is Brittany Harvey and today I'm interviewing Dr. Jyoti Patel from Northwestern University, co-chair on “Therapy for Stage IV Non-Small Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, Version 2024.3.” It's great to have you back on the show today, Dr. Patel. Dr. Jyoti Patel: Thanks so much. Happy to be here. Brittany Harvey: And then before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Patel, who has joined us here today, are available online with the publication of the guideline and in the Journal of Clinical Oncology, which is linked in the show notes. So then, to dive into the content of this update, Dr. Patel, this clinical practice guideline for systemic therapy for patients with stage IV non small cell lung cancer with driver alterations is living, meaning that it's continuously reviewed and updated. So what data prompted this latest change to the recommendations? Dr. Jyoti Patel: Thanks so much. So it's really been an exciting time in the treatment of EGFR lung cancer, particularly this past year has required us to rethink approaches to front- and second-line therapy. In this particular update, we examined what patients in the front-line setting may be offered by their clinicians. And so we're talking about the population of classical EGFR mutations, so exon 19 and exon 21 L858R substitution. And so certainly for this population, osimertinib has a high level of evidence and should be offered to all patients at the time of diagnosis when they present with advanced disease. Our last update included a recommendation that patients could also get platinum doublet chemotherapy with osimertinib or osimertinib alone. This current recommendation also introduces another alternative therapy and that's the combination of amivantamab plus lazertinib. And so now, clinicians are faced with three really good options for their patients with EGFR exon19 deletion or L858R. Brittany Harvey: It's great to hear that there's this advance in the space, particularly for patients with these classical EGFR mutations that you mentioned. So what should clinicians know as they implement these new first-line recommendations? Dr. Jyoti Patel:  I think it's become more complex than ever. Certainly, we know again that patients should get osimertinib in the frontline setting. But we've been kind of stuck at progression-free survival that's between a year and a half and two years. And so we've really been looking at opportunities to intensify therapy. So one could certainly be with chemotherapy or switching over to amivantamab, the bispecific antibody that targets EGFR and MET plus lazertinib, an oral TKI that's very similar in structure to osimertinib. And when you're talking to a patient, it's really a conversation about balancing efficacy with toxicity. Unfortunately, as we know, there aren't that many free lunches. And so if we think about what a patient is hoping for in their therapy and how we can further personalize treatment options, really is important to look at some of the analyses for this study. So in the study of amivantamab plus lazertinib, we know that there were increased toxicities with a combination of both therapies. In fact, up to 75% of patients had over grade 3 toxicities, versus about 43% of patients with osimertinib monotherapy. And we know if we look back at FLAURA2, almost two thirds of patients with osimertinib and chemotherapy had grade 3 toxicities, compared to 27% of patients with osimertinib alone. So we certainly see an increase in toxicities. Then we have to ask ourselves, are those paper toxicities or ones that really impact patients? And we know that amivantamab, for example, causes significant cutaneous toxicities. With both of these therapies, whether it's chemotherapy or adding amivantamab, there's the burden of infusional visits and increased time in the doctor's office. Certainly with chemotherapy, there can be an increased incidence of myelosuppression. And so when we're thinking about advising our patients, certainly we need to talk about the toxicities. But one thing that we've been able to do is to look at the patients that were included in this trial. And what we really find is that in higher risk cohorts, particularly those that we know historically have done less well with standard osimertinib, so patients, for example, with CNS metastasis, for those patients with co-mutations, it may be that that additive benefit is significant. And so one example I think would be from the MARIPOSA study, again, the study of amivantamab and lazertinib versus chemotherapy. What we can say is that patients who had co-mutations, so patients with EGFR mutations as well as TP53, lazertinib and amivantamab led to a hazard ratio of 0.65 compared to osimertinib alone. So that was 18.2 months versus 12.9 months. And so this may be really important to patients. And we also see conversely that patients with wild type TP53, so those patients who didn't have the mutation, probably had equivalent survival regardless of therapy. So certainly, we need to prospectively study some of these high-risk cohorts. We've only seen progression-free survival in these studies. And so at this juncture, we can advise our patients about toxicity, the improvements in certain categories of progression-free survival, but we really still don't know how this pans out in overall survival. In many of these studies, all patients do not necessarily cross over to the study arm and so they may have lost the benefit of subsequent therapy. Brittany Harvey: Absolutely. It's very important to talk about that balance of benefits and risks and particularly those toxicities that you discussed. So I appreciate reviewing that recommendation and the considerations for clinicians for first-line therapy. This update also included a second-line treatment update. What is that update for patients with EGFR alterations? Dr. Jyoti Patel: So this is where it gets super tricky because we have a frontline option with amivantamab and now we've had an update in the second line option. So what we said is that for patients who have progressed on an EGFR TKI, and in the United States, certainly that's predominantly osimertinib, or those in other parts of the world that may have gotten an earlier generation TKI, but do not have evidence of T790M or other targetable mutations, we can offer patients chemotherapy with or without amivantamab. And so certainly we have seen that this again leads to improved survival. There have also been a number of studies looking at incorporation of PD-L1 and anti-VEGF therapies. And what we can say, I think pretty clearly is that multiple phase 3 trials have really shown no benefit of the addition of PD-1 to platinum chemotherapy. But there are some emerging bispecific antibodies that may target PD-1 as well as VEGF, or combinations of antibodies that target both of those pathways that may improve outcome. At this juncture, I think we feel that the evidence surrounding chemotherapy plus amivantamab is strongest, but there is certainly work in this space that will be of interest. Now, what happens if your patient received amivantamab and lazertinib in the frontline setting and then has progression? And so we're trying to understand resistance mechanisms and opportunities for treatment. What the panel decided to recommend, based on the available evidence, was that certainly those patients should get platinum-based chemotherapy, but there may also be a role for antivascular endothelial growth factor targeting therapy such as bevacizumab in patients in whom it would be safe. Brittany Harvey: Great. I appreciate you detailing those recommendations when it gets complicated in the second-line setting. So what should clinicians know as they implement these second-line recommendations too? Dr. Jyoti Patel: So certainly the frontline setting matters significantly. So if a patient gets osimertinib in the frontline setting, we generally suggest that patients undergo repeat testing to see if they have another targetable mutation. If they don't, then I think preferred therapy would be chemotherapy with or without amivantamab. And amivantamab leads to a significant improvement in progression-free survival and response rate at the cost of increased risk of toxicity. For patients who get FLAURA2 in the frontline setting, chemotherapy plus osimertinib, it's a little bit of an unclear space. Those patients most likely would get docetaxel with or without ramucirumab. But there are other agents that we hope to have available to our patients in the near future. For patients who receive amivantamab and osimertinib, we recommend that those patients get chemotherapy probably with anti-VEGF as demonstrated by multiple trials that have shown the improved progression-free survival with introduction of an anti-VEGF agent. And we've seen evidence of amivantamab in the third line setting, so it is likely that this question about sequencing really takes center stage in our next set of trials. When you're talking to a patient, I think again, it's absolutely important to discuss: What are their goals? How symptomatic or how fast is their progression? Are there ways in which patients may benefit from spot treatment oligoprogression such as radiation? When is the right time for introduction of amivantamab and when do we think patients need chemotherapy? Is it up front or predominantly in the second-line setting? Brittany Harvey: Definitely. And then you've just touched on the goals of treatment for individual patients. So in your view, what does this update mean for patients with stage IV non-small cell lung cancer and an EGFR alteration? Dr. Jyoti Patel: For patients, this is a time in which shared decision making really needs to take center stage. So our best patients are those patients that are best informed not only about their disease but also have a good understanding about what is important to them and their families in terms of care. And so bringing that shared understanding to the table again helps us think about this particular cancer as more of a journey rather than just a one off treatment. Therapy will hopefully be prolonged, and so it's absolutely important that we address toxicities, make therapies more tolerable, again, with the shared goal of living long and living well. Brittany Harvey: Absolutely. Those are key points to making sure that patients are living both longer and have a good quality of life during that time as well. So then, before you mentioned the possibility of future sequencing trials and other ongoing developments. What additional studies or future directions is the panel examining for future updates to this living guideline? Dr. Jyoti Patel: So certainly we're thinking about trials that look at, for example, cfDNA clearance. So are there patients that do well and can we detect that early on without having to intensify therapy on day 1 so it may be that we add chemotherapy a little bit later. I think really exciting are some of the new bispecific. The HARMONi-A trial was a trial in China of a novel bispecific, ivonescimab. And this drug targets both PD-1 and VEGF and it was combined with chemotherapy. And this trial found almost a doubling of progression-free survival with this drug in combination chemotherapy in an EGFR patient population. That study is being planned and being run in the United States to see if we have similar outcomes with a more diverse population. So certainly that's exciting. There are a number of antibody drug conjugates that are being studied in the post-chemotherapy setting as well. And I think we'll likely soon see a better understanding of what co-mutations and burden of disease really mean when we're thinking about assigning treatment. So which patients, again, need intensification of therapy and which patients may do really well on just an oral agent that they're taking at home with more tolerable toxicity than dual treatment. Brittany Harvey: Yes, we'll look forward to continued developments in these fields and seeing some of those studies come to fruition. So with that, I want to thank you for your work to rapidly and continuously update this guideline, and thank you for your time today, Dr. Patel. Dr. Jyoti Patel: Thanks so much, Brittany. It's really an exciting time for lung cancer and we hope that these updates really help physicians decide the best treatments for their patients. Again, it's a rapidly evolving landscape which is fantastic, but it does become more cumbersome to stay ahead of the literature. Brittany Harvey: Definitely. And so we appreciate your time and the panel's time spent reviewing this literature and providing this much needed information to clinicians everywhere. So finally, thank you to all of our listeners for tuning into the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/living-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in the  Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

Dr. Lyudmila Bazhenova joins us again to share the newest changes to the living guideline on therapy for stage IV NSCLC without driver alterations. She discusses new evidence reviewed by the panel and changes to second-line recommendations for patients with good performance status and HER2 overexpression, and what these updates mean in practice. We discuss ongoing evidence generation as we await further updates to these living guidelines. Read the full living guideline update “Therapy for Stage IV Non-Small Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline, Version 2024.3” at www.asco.org/living-guidelines. TRANSCRIPT This guideline, clinical tools, and resources are available at http://www.asco.org/living-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO-24-02786     Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts. My name is Brittany Harvey and today I'm interviewing Dr. Lyudmila Bazhenova from University of California San Diego Moores Cancer Center, co-chair on “Therapy for Stage IV Non–Small Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline, Version 2024.3.” It's great to have you back on the show today, Dr. Bazhenova. Dr. Lyudmila Bazhenova: It's my pleasure to be here as always. Brittany Harvey: Great. Then before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the entire guideline panel, including Dr. Bazhenova, who has joined us here today, are available online with the publication of the guide in the Journal of Clinical Oncology, which is linked in the show notes. So then to dive into the content here, first, this living clinical practice guideline for systemic therapy for patients with stage IV non-small cell lung cancer without driver alterations has frequent updates to the recommendations. What prompted this latest update? Dr. Lyudmila Bazhenova: Living ASCO guidelines are created to keep up with rapidly changing evidence which affect treatment of our patients with lung cancer. As a committee, we review published literature on a specific topic at the regular intervals and determine if it alters any recommendations. This time, upon our literature review, we felt that there are new data that requires an update in the guidelines and therefore the guidelines were updated. Brittany Harvey: Great. Thank you for that updated information. So then it looks like the panel updated recommendations for second line and subsequent treatment options for patients with good performance status and HER2 overexpression. What is that updated recommendation from the panel? Dr. Lyudmila Bazhenova: Yes, this is correct. We now added an extra recommendation for patients with stage IV non-small cell lung cancer who have overexpression of the protein called HER2. HER2 overexpression with 2+/3+ level via immunohistochemistry is seen in approximately 8% to 20% of patients with lung cancer. And the data behind our recommendation comes from the DESTINY-Lung01 trial where patients with HER2 overexpression were treated with trastuzumab deruxtecan. And we saw that if patients with stage IV non-small cell lung cancer had a HER2 IHC score of 3+, overall response rate was seen at 53% and median duration of response was 6.9 months and, therefore, that in our opinion qualified for updated recommendation. We are still waiting for additional results that will be released later on another clinical trial where we see preliminary data presented at the World Conference of Lung Cancer in 2024. They looked at 36 patients also with HER2 overexpression and saw the overall response rate of almost 45%. It is important to highlight in this smaller study that a majority of the patients in the study were actually having EGFR mutation and the response rate in those patients who had an EGFR mutation was higher than the response rate in patients without EGFR mutations who just had a HER2 overexpression. So for now this is updated in the guidelines, but we will wait for additional data or formal publication of a World Lung Conference presentation and see if those recommendations need to be changed. Brittany Harvey: Understood, and I appreciate you providing the context of some of those ongoing developments as well. So then what should clinicians know as they implement this updated recommendation? Dr. Lyudmila Bazhenova: Number one, we should all start from remembering to test for HER2 via immunohistochemistry. There is a slight difference in what considers HER2 positive in lung versus breast. In lung, we use what's called the gastric scoring and the difference is the circumferential versus non circumferential staining of the membrane. And number two, immunohistochemistry is not always included in next generation sequencing panels. So when you order your next generation sequencing, I think it's important to know if your company that you're using is testing for HER2 via immunohistochemistry. And if it's not, make sure that you find a company that does or work with your local pathology department to make sure that this testing is offered. It is also important to know the difference between HER2 overexpression and HER2 exon 20 insertion mutation even though the treatment for those two abnormalities is the same, which is trastuzumab deruxtecan. But the benefit that you can cite your patients and the rigor of the literature supporting the usage of trastuzumab deruxtecan in mutation versus overexpression is different. Brittany Harvey: Yes. And as you mentioned, it's essential that, in the first place, patients are actually receiving the testing so that we know if they're eligible for these treatment options. So what additionally does this change mean for patients with stage IV non-small cell lung cancer and HER2 overexpression? Dr. Lyudmila Bazhenova: So for patients, it adds another treatment modality which is now FDA approved. So if there are patients listening to me, make sure that your physician has tested your tumor for HER2 overexpression. So I think proactive asking of your physician would be very appropriate in this situation. Brittany Harvey: Absolutely. And then earlier you mentioned an ongoing trial that the panel was looking to for the future. But what other additional trials did the panel review during this guideline update and what is the panel examining for future updates to this living guideline? Dr. Lyudmila Bazhenova: So at this point we reviewed three additional studies. The results of those studies did not make it into a change in guidelines. So we reviewed the HARMONi-2 trial.  HARMONi-2 trial so far does not have an official publication and, as per our strategy on how we come up with ASCO guidelines, we need to wait for an official publication. So this is one thing we're going to be expecting in the future. Once this is published, we will review it and decide if we need to make an additional change in recommendations. For those of you who are not aware, HARMONi-2 trial used bispecific monoclonal antibody against VEGF and PD-1 and was a phase III randomized trial comparing their investigational product which is called ivonescimab over pembrolizumab for patients with PD-L1 more than 50. And again, we are waiting for the final publication to make our recommendation. The second trial we reviewed was a LUNAR trial and the LUNAR trial looked at addition of tumor treating fields to chemotherapy or immunotherapy in patients whose cancer progressed with platinum doublet. The key point about this study is that immunotherapy was not required to be administered in a first line setting which is a current standard of care in the United States. And even though the study met their primary endpoint of overall survival, there were more benefits in patients who were immunotherapy naive in the second line. And we felt that given the potential lifestyle implication of wearing a device for 18 hours per day, and the lack of evidence in immunotherapy-pretreated population, and the absence of data in the first-line setting where we currently using immunotherapy in the United States, we felt that there is insufficient data to definitely recommend addition of tumor treating fields to systemic chemotherapy for most patients. And we are waiting for additional trials that are ongoing in this setting to formalize or change our recommendations. And we also reviewed- the final study that we reviewed was TROPION-Lung01. TROPION-Lung01 study was a phase III study in post platinum doublet setting which compared efficacy of Dato-DXd and docetaxel and trials showed improvement in progression free survival but not in overall survival. And progression free survival benefit was more pronounced in non-squamous carcinoma histology subgroup and we felt that the results do appear promising, but the strength of evidence which was based on unplanned subgroup analysis was not sufficient enough to make a change in treatment recommendation at this time. Brittany Harvey: I appreciate your transparency on why some of that data did not prompt a change to recommendations at this time. And additionally, we'll look forward to those future published results and potential incorporation of new data into future versions of this living guideline. So, I want to thank you so much for your work to rapidly and continuously update this guideline and for your time today, Dr. Bazhenova. Dr. Lyudmila Bazhenova: It is my pleasure. Thank you so much. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines Podcast. To read the full guideline, go to www.asco.org/living-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in the  Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement.  

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/CC/AAPA information, and to apply for credit, please visit us at PeerView.com/RDK865. CME/MOC/CC/AAPA credit will be available until February 25, 2026.Targeting Higher Standards in Resectable NSCLC: The Surgery-Oncology Coalition for Tailoring Care in EGFR & ALK TKI Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through independent educational grants from AstraZeneca and Genentech, a member of the Roche Group.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/CC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/JUZ865. CME/MOC/CC/AAPA/IPCE credit will be available until February 25, 2026.Mastering the Integration of Immunotherapy in Resectable NSCLC: Practical Considerations for Real-World Practice In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through independent educational grants from AstraZeneca, Bristol Myers Squibb, and Merck & Co., Inc., Rahway, NJ, USA.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/CC/AAPA information, and to apply for credit, please visit us at PeerView.com/RDK865. CME/MOC/CC/AAPA credit will be available until February 25, 2026.Targeting Higher Standards in Resectable NSCLC: The Surgery-Oncology Coalition for Tailoring Care in EGFR & ALK TKI Therapy In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through independent educational grants from AstraZeneca and Genentech, a member of the Roche Group.Disclosure information is available at the beginning of the video presentation.

This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/MOC/CC/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/JUZ865. CME/MOC/CC/AAPA/IPCE credit will be available until February 25, 2026.Mastering the Integration of Immunotherapy in Resectable NSCLC: Practical Considerations for Real-World Practice In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported through independent educational grants from AstraZeneca, Bristol Myers Squibb, and Merck & Co., Inc., Rahway, NJ, USA.Disclosure information is available at the beginning of the video presentation.

Descriptions: As part of the IASLC's ongoing series of podcasts in world languages, Dr. Nagla Abdel Karim moderates a discussion in Arabic with Dr. Bashir Abu Aqeel and Dr. Fawzi Abu Rous. The group discusses chemoimmunotherapy in metastatic non-small cell lung cancer.

In this episode of Lung Cancer Considered, host Dr. Stephen Liu moderates a Virtual Tumor Board case involving drug resistance in EGFR mutant NSCLC. This discussion takes the listener through the treatment of EGFR mutant NSCLC after acquired resistance to osimertinib. Guest: Dr. Yasushi Goto from National Cancer Center, Japan in Tokyo Guest: Dr. Rachel Sanborn, the Earle A. Chiles Research Institute of the Providence Cancer Institute in Portland, Oregon

BUFFALO, NY - February 6, 2025 – A new #casereport was #published in Volume 16 of Oncotarget on February 5, 2025, titled “Acquired RUFY1-RET rearrangement as a mechanism of resistance to lorlatinib in a patient with CD74-ROS1 rearranged non-small cell lung cancer: A case report." In this case report, Jenny L. Wu from Vanderbilt University School of Medicine and Wade T. Iams from Vanderbilt-Ingram Cancer Center describe a rare case of drug resistance in a patient with advanced non-small cell lung cancer (NSCLC). The patient, a 42-year-old man who had never smoked, initially responded well to lorlatinib, a targeted therapy designed to treat cancer driven by specific genetic alterations. However, after six months, his cancer began to grow again. Clinicians discovered that this was due to a new genetic change, known as the RUFY1-RET fusion. This finding highlights how cancers can adapt to treatment and the importance of ongoing genetic testing to guide therapy decisions. NSCLC is the most common type of lung cancer, and in some cases, it is driven by genetic changes that can be targeted with specific drugs. The patient's cancer originally had a ROS1 gene rearrangement, which made it responsive to lorlatinib. But as time went on, the cancer started to grow again, and tests revealed a new genetic alteration called RUFY1-RET fusion, which likely caused resistance to lorlatinib. This new genetic change was identified using RNA next-generation sequencing (RNA NGS), an advanced test that can find mutations that standard genetic tests might miss. After discovering the RUFY1-RET gene fusion, the patient was treated with a combination of lorlatinib and pralsetinib, a drug that specifically targets RET gene alterations. While this combination helped control the cancer for about four months, the patient's condition unfortunately worsened after four months. “This is the first reported case of a RET fusion as a potential mechanism of resistance to lorlatinib, it identifies a novel RET fusion partner, and it emphasizes the importance of testing for acquired resistance mutations with both DNA and RNA at the time of progression in patients with targetable oncogenic drivers.” Understanding cases like this can help clinicians and researchers develop more effective treatment strategies, including combination therapies that target multiple genetic changes to combat drug resistance. While the combined therapy in this case provided only temporary benefits, it offers important insights for future research and patient care, particularly for cancers that no longer respond to standard treatments. DOI: https://doi.org/10.18632/oncotarget.28682 Correspondence to: Wade T. Iams, wade.t.iams@vumc.org Keywords: cancer, ROS1 rearrangement, RET rearrangement, non-small cell lung cancer, targeted therapy, case report Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ About Oncotarget Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. Oncotarget is indexed and archived by PubMed/Medline, PubMed Central, Scopus, EMBASE, META (Chan Zuckerberg Initiative) (2018-2022), and Dimensions (Digital Science). To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

In today's episode, we had the pleasure of speaking with David Gerber, MD, a professor in the Department of Internal Medicine at the University of Texas Southwestern Medical Center, a member of its Division of Hematology/Oncology, and co-director of Education and Training for the Harold C. Simmons Comprehensive Cancer Center in Dallas. In our exclusive interview, Dr Gerber discussed the evolving role of antibody-drug conjugates (ADCs) in non–small cell lung cancer (NSCLC), focusing on findings from key clinical trials. He highlighted results from the phase 3 TROPION-Lung01 trial (NCT04656652), which demonstrated a modest improvement in progression-free survival with datopotamab deruxtecan-dlnk (Datroway), a TROP2-directed ADC, compared with docetaxel in patients with previously treated advanced NSCLC. He also emphasized the toxicity profile of TROP2-directed ADCs, particularly gastrointestinal toxicities and myelosuppression. Dr Gerber also reviewed the phase 2 HERTHENA-Lung01 trial (NCT04619004) evaluating patritumab deruxtecan in patients with EGFR-mutant NSCLC and the phase 2 DESTINY-Lung02 trial (NCT04644237) assessing fam-trastuzumab deruxtecan-nxki (Enhertu) in those with HER2-mutant NSCLC. Dr Gerber reflected on the shared DXd payload of these ADCs, highlighting its implications for toxicity and efficacy, as well as open questions regarding treatment sequencing and resistance mechanisms.