Podcasts about thoracic oncology

In today's episode, we had the pleasure of speaking with Balazs Halmos, MD, MS, about the phase 2 VISION trial (NCT02864992) evaluating tepotinib (Tepmetko) in patients with MET exon 14 skipping mutation–positive non–small cell lung cancer (NSCLC). Dr Halmos is a professor in the Department of Oncology (Medical Oncology) and the Department of Medicine (Oncology and Hematology), director of Thoracic Oncology, and associate director of Clinical Science at Montefiore Einstein Comprehensive Cancer Center in Bronx, New York. In our exclusive interview, Halmos discussed the rationale and design of the VISION trial, the significance of MET exon 14 skipping mutations as a distinct oncogenic driver, and the clinical utility of tepotinib, which is a selective MET TKI. He reviewed the trial's efficacy results, which demonstrated consistent response rates across lines of therapy and diagnostic methods, as well as tolerability findings that highlighted the importance of monitoring and managing MET-related adverse effects. Dr Halmos also reflected on subgroup analyses from the trial, noting the agent's activity across treatment settings, particularly in older patients and those with central nervous system involvement. Additionally, Halmos underscored the critical role of comprehensive biomarker testing in NSCLC, highlighting how parallel tissue- and circulating tumor DNA–based testing can optimize timely identification of actionable alterations and ensure patients receive the most effective frontline therapy. He also discussed practical considerations for dose selection and modifications with tepotinib, offering insights into strategies for maximizing treatment benefit and maintaining patient quality of life.

n this episode of Conversations in Lung Cancer Research, A/Prof Tim Clay discusses the multidisciplinary management of CNS metastases in the context of thoracic cancers. Joined by Dr. Keryn Davidson, a consultant neurosurgeon, and A/Prof Fiona Hegi Johnson, a radiation oncologist, the discussion focuses on the nuances of treating patients with non-small cell lung cancer presenting with brain metastases. Key topics include the role of neurosurgery, decision-making for radiation therapy, evolving approaches for oncogene-driven cancer patients, management of radiation necrosis, and the complexities of treating small cell lung cancer and leptomeningeal disease.  This episode is sponsored by Pfizer.(00:00) Introduction and Acknowledgements(00:35) Meet the Experts(01:44) Neurosurgery in CNS Metastases(07:00) Radiation Therapy Insights(13:59) Oncogene-Driven Lung Cancer(25:14) Challenges in Small Cell Lung Cancer(29:56) Advanced Treatment Strategies(32:23) Future Directions and Conclusion

In this JCO Article Insights episode, Dr. Joseph Matthew interviews authors Dr. Yang Zhang and Dr. Haiquan Chen about their recently published JCO article, "Phase III Study of Mediastinal Lymph Node Dissection for Ground Glass Opacity–Dominant Lung Adenocarcinoma" TRANSCRIPT Joseph Mathew: Welcome to the Journal of Clinical Oncology Article Insights episode for the August issue of the JCO. This is Joseph Mathew, editorial fellow for JCO, and today, it is my pleasure to have with us Dr. Haiquan Chen and Dr. Yang Zhang, authors of the recently published manuscript, "Phase 3 Study of Mediastinal Lymph Node Dissection for Ground-Glass Opacity-Dominant Lung Adenocarcinoma," which we will be discussing today. Dr. Chen is the Director of the Institute of Thoracic Oncology at Fudan University and the Chief of Thoracic Surgery at Fudan University Shanghai Cancer Center, where he is also the Head of Thoracic Oncology MDT and the Director of the Lung Cancer Center. Dr. Chen is a surgeon-scientist and a pioneer in developing individualized surgical strategies for early-stage non-small cell lung cancer. Dr. Zhang is a surgical oncologist and a member of the team which Dr. Chen leads at the Fudan University Shanghai Cancer Center. Welcome Dr. Chen and Dr. Zhang. Thank you very much for accepting our invitation and joining us today as part of this podcast episode. To summarize the salient points, this study presented the interim analysis of a multi-center, open-label, non-inferiority, randomized controlled trial investigating the necessity of systematic mediastinal lymph node dissection at the time of segmentectomy or lobectomy in patients with clinical stage T1N0M0 ground-glass opacity-dominant invasive lung adenocarcinoma, as defined by a consolidation-to-tumor ratio of 0.5 or less on thin-section computed tomography and a maximum tumor diameter of 3 cm or less. Eligible participants with intraoperatively confirmed invasive adenocarcinoma on frozen section analysis were randomized to either the systematic mediastinal lymph node dissection arm or to no mediastinal lymph node dissection. In the latter experimental group, mediastinal lymph nodes comprising the N2 nodal stations were not dissected, and the hilar nodes were variably addressed at the discretion of the operating surgeon. The primary endpoint of the trial was disease-free survival at 3 years. Secondary endpoints included perioperative outcomes, the status of lymph node metastasis in the systemic lymph node dissection arm, and 3-year overall survival. Before the trial reached its accrual target, a pre-planned interim safety analysis set for the time point when enrollment reached 300 patients was performed. It was noted that while none of the patients in either arm had nodal metastasis on postoperative pathological evaluation, lymph node dissection-related intraoperative and postoperative complications were more commonly observed in the systematic lymph node dissection arm, including one life-threatening episode of massive bleeding. Since this met the predefined criteria for trial termination, and in accordance with the principle of non-maleficence, further recruitment was stopped and the trial terminated. Although the 3-year disease-free survival and the overall survival for the enrolled patients were comparable, operative outcomes, including the duration of surgery, blood loss, chest tube duration, length of postoperative stay, and the rate of clinically significant complications, were significantly lower in the experimental arm compared with the systematic lymph node dissection group. The authors concluded that for well-selected patients, mediastinal nodal dissection could be omitted without adversely affecting oncological outcomes, representing a significant shift in current surgical practice, given that guidelines the world over recommend systematic lymph node dissection or sampling for all invasive lung cancers. In summary, this study addressed a clinically relevant question with regard to the extent of nodal dissection, especially in the light of recent evidence recommending less extensive parenchymal dissections for early-stage non-small cell lung cancer, with the findings suggesting that invasive lung adenocarcinoma associated with ground-glass opacities of consolidation-to-tumor ratio up to 0.5 was an excellent predictor of tumor biology, and in clinical T1N0M0 lesions, a reliable predictor of negative mediastinal lymph node involvement. So Dr. Chen and Dr. Zhang, could you tell us some more about what led you to do this research and the challenges which you faced while recruiting patients for this trial? Dr. Yang Zhang: Dr. Mathew, thank you for your summary. The current clinical guidelines recommend systematic lymph node dissection or sampling for every patient with early-stage lung cancer, regardless of their lymph node status. And in our clinical practice, we observe that this procedure causes a lot of surgical complications including chylothorax and recurrent laryngeal nerve injury. Furthermore, dissecting the tumor-draining lymph nodes actually may potentially damage the body's anti-tumor immunity. So, Dr. Chen proposed the concept of selective lymph node dissection, which we aimed to dissect the metastatic lymph nodes, while at the same time we try to preserve as many uninvolved lymph nodes as possible. So previously, we have conducted a series of retrospective studies to identify reliable predictors of nodal negative status in certain mediastinal zones, and we have performed a prospective observational phase 2 clinical trial to validate that the six criteria we proposed are 100% in predicting node-negative status. And this forms the basis for our phase 3 clinical trial. Dr. Haiquan Chen: This trial is only one of the series of trials. The meaning of this trial you already said. And for a long time, from the surgeon's point of view, we considered minimally invasive surgery. It minimizes the size of the incision and minimizes the number of the holes we made. So, the true and the high-impact of minimally invasive, we make a concept of minimal dissection, that means organ-level minimally invasive. So we proposed the concept of minimally invasive 3.0, that means minimal incision, minimal dissection (that means organ-level minimal), and systemic minimally invasive. So at first, we judged from the point of minimally invasive surgery. As long as immunotherapy is widely used in the clinical practice, we know immunotherapy, that means you use drugs to stimulate and activate the lymph node site. If we dissect all the metastatic lymph nodes, cut them out, how can we restimulate that lymph node site? So, from minimally invasive trauma and second, from the functional aspect, to try to save as many uninvolved lymph nodes as possible. Joseph Mathew: Thank you, Dr. Chen. That's a very interesting concept that you alluded to even in the discussion of this paper, as to the potential role of the non-metastatic lymph nodes as immune reservoirs. So, coming back to this paper, were there any challenges which you faced while recruiting patients for this trial? Dr. Haiquan Chen: The criteria is very clear. That means invasive adenocarcinoma, that means most of the centimeter is 3.0 centimeter and also CTR ratio less than 0.5. And we can see that, you know, we did study about that. Even the invasive component of the subsolid nodule, it's bigger than the solid part. That means even the pure GGO, we can find out that there's still some invasive component. From this point of view, pure GGO and subsolid GGO, from this part of invasive carcinoma, that means it's a special clinical subtype that we, from retrospective study and also prospective study, we find out this group of patients, there are no mediastinal lymph node metastasis. So I think it's very important for this kind of group that we can avoid doing the mediastinal lymph node dissection. And we can do organ-level minimally invasive surgery. And also, we try to keep the patient's immune function as normal as possible. Dr. Yang Zhang: Well, Dr. Mathew, we believe that the biggest challenge when we are enrolling these patients is that there needs to be a paradigm shift in the mind because systematic lymph node dissection has long been the standard of care. And some patients may misunderstand. Before the enrollment, we have to give them informed consent, but if the patient hears that they may be enrolled in the no-lymph-node-dissection group, they may feel that they do not receive radical, curative-intent surgery. So we believe, as Dr. Chen has said, after the release of our results, the no-lymph-node dissection may be incorporated in the future guideline for those patients without lymph node involvement, we can just omit the lymph node dissection. Joseph Mathew: The study described two pre-planned interim points during the course of subject enrollment when the data was analyzed. So Dr. Chen and Dr. Zhang, could you please explain a little more about these two interim points of analysis that were planned and the rationale behind it? Dr. Yang Zhang: When conducting this trial, we have two concerns. One is if there is any lymph node metastasis, there may be omission of metastatic lymph nodes not dissected in the no-lymph-node-dissection group. And there is another concern is that if all these lymph nodes are uninvolved, then dissecting these lymph nodes may cause life-threatening complications. So, we set the 150 interim analysis to ensure that there is no lymph node involvement in this group. And the other early termination criteria is set because if there is no lymph node involvement found in both groups, then a severe complication which is life-threatening is unacceptable because it threatens the patient's safety. Joseph Mathew: So, although you did briefly allude to in the paper, what was the basis for selecting DFS as the primary endpoint when the objective of this trial was to assess nodal involvement in this subset of tumors? Dr. Yang Zhang: Well, previously, we have done a series of retrospective studies and one prospective phase 2 trial. And in these studies, we have identified that GGO-dominant lung adenocarcinoma, even if it's invasive, it has no lymph node involvement. So this phase 3 trial was primarily designed to compare the survival outcomes. But as the trial went on, as Dr. Chen has concerns that if the patients have no lymph node metastasis at all, it may be unfair to dissect the lymph nodes for patients enrolled in the systematic lymph node dissection group. So there is one life-threatening complication that happens due to dissecting the lymph nodes and injury to the superior vena cava, which leads to massive bleeding. It is at this point that we decided to terminate this trial for patient safety concerns. Joseph Mathew: Yeah, that's a very fair point. So you made sure that the ethical considerations were kept intact. So another point was, there was a mention in the study of the historical data from your institution suggesting a 3-year disease-free survival of 96.6% for patients with clinical T1N0M0 ground-glass opacity-dominant invasive lung adenocarcinoma. So could you please elaborate on the patterns of recurrence which you noted for this group of patients who had developed a recurrence? Dr. Haiquan Chen: Yeah, I think over 90% 3-year DFS, that's the least. From our retrospective data for this kind of group of patients, their DFS is so good. To the best of my knowledge, almost 100%. So this is very conservative, 94, 90% is very conservative. I think the trial eventually would have been positive. It's a special clinical subtype, even for invasive adenocarcinoma, their prognosis is much better than the other type of invasive adenocarcinoma. Joseph Mathew: So this question may be slightly outside the purview of this study, but in your clinical practice, would you advocate either segmentectomy or lobectomy for all patients meeting the trial criteria, that is, lesions measuring 3 cm or less with a CTR of up to 0.5? Or is there a subgroup of patients you would recommend a wedge dissection for? Dr. Haiquan Chen: I think CTR ratio is one parameter and also the location is another very important parameter. So we put it together to make a decision, the patient should do a lobectomy or segmentectomy. Even for an ongoing trial, for even the patient, invasive adenocarcinoma, we can do in the right location, even wedge, it can achieve enough negative margin in the ongoing trial to verify the comparable result for the patient, we can do the wedge dissection. So not just the CTR ratio, that's not the only parameter to make a decision on what kind of procedure we'll do. Joseph Mathew: Yeah, great point, Dr. Chen. So from my perspective, this study was a well-designed, randomized control trial based on a relevant and clinically valid research question. So what, in your opinion, are the main strong points of this study? Dr. Yang Zhang: We believe that this study represents the first randomized clinical trial published, yet, regarding the topic of selective lymph node dissection. It basically offers the highest level of evidence. We believe our results should be incorporated in the future clinical guideline. Joseph Mathew: Given the increasing incidence of these lesions, I think it was- a randomized control trial in this arena was much awaited. And the other point is that GGO-dominant lung adenocarcinomas, the specific clinical guidelines are not very clear. So I think your study brought out that lymph node dissection for these tumors which satisfy the eligibility criteria could be omitted safely. Important consideration here is that the conclusions of the trial were based on an interim analysis, and this analysis was not planned for an early assessment of the primary endpoint. In other words, the study was not adequately powered to detect a significant difference in DFS at 3 years. So Dr. Chen and Dr. Zhang, what do you perceive are the most important limitations of this study which you feel should be addressed in future research? Dr. Haiquan Chen: So the surgery now is more individualized. I think the surgery from the last two decades, from the maximum tolerable intervention to minimum effective treatment, there's a big shift. So I think that the consensus, we can preserve normal lung parenchyma as much as possible. For the lymph nodes, I think that the big shift, we should shift it to keep as many as uninvolved lymph nodes as possible. So that's very important, not just to reduce the intraoperative trauma, but also to keep the immune environment as normal as possible. Joseph Mathew: Another point was the limited long-term follow-up data to determine the actual impact of omitting lymph node dissection on local-regional disease control. So is any future follow-up planned to assess the long-term survival outcomes for the 302 patients which were enrolled in this trial? Dr. Haiquan Chen: Yeah, I think that's very important for us. This trial we terminated just because if we keep the trial going, it's unfair for the mediastinal lymph node dissection group. We tried to just stop here, and we shifted to the single-arm trial. So, 2 or 3 years, this trial and another trial, they will give our final result to demonstrate more if selective mediastinal lymph nodes have a better result than ever before. And we will support the mediastinal lymph node dissection. That's one way. And the American College just asked me, how can we put this policy into clinical practice in the United States? Because most of the patients they meet have solid tumors. So we have another trial, try to figure out how we can make sure before and intraoperative the lymph node status is negative or positive, and then we can solve that problem and put this policy into clinical practice in the Western society. Joseph Mathew: Great. So that would be something we should all be looking forward to. So, this brings me to the final point of discussion on future research in this field. Dr. Chen, you commented in the paper that future studies should focus on improving the reproducibility of CTR evaluation. What are your thoughts on this subject? Dr. Haiquan Chen: The CTR ratio, the concept from the JCOG 0201, just a concept from that prospective study, the phase 2 study, only subgroup analysis they give the concept of CTR ratio and the diameter. How can we reproduce? In our group and also I believe in Japan and in China, in Korea, and in our daily practice, I think CTR ratio is not a big issue. There are two very important things. One, you make sure the CTR ratio, not in a common CAT scan, but in a high-resolution CAT scan. So the imaging, that's the first thing. And the second, not from the single section and a two or three section, you make sure that your calculation is accurate. That's not just the single section, you make sure that you got the conclusion, the CTR ratio is the same number. We make sure that totally we, from the top to the bottom of the whole lesion, we make sure that the CTR ratio is accurate. Joseph Mathew: Thank you, Dr. Chen. I think that would involve training our radiologists also to be aware of the CTR ratio and how it should be interpreted. So another very interesting concept which you had alluded to in the discussion was the potential role of non-metastatic lymph nodes as immune reservoirs. So how do you think we could preserve these nodes and do you think sentinel node biopsies would play a role in future? Dr. Yang Zhang: Actually, Dr. Chen has also led some basic research on this topic. We are investigating the immunological role of the tumor-draining lymph nodes. And our preliminary results have already shown that the tumor-draining lymph nodes of lung cancer, especially those uninvolved lymph nodes, have a vital role in the anti-tumor immunity and also effective response to the current anti-PD-1 immunotherapy. In the future, we believe that by incorporating our clinical evidence and those findings from our basic research, we will be able to provide very strong rationale to support selective lymph node dissection. Joseph Mathew: So lastly, what are the questions that still remain to be answered and what do you perceive as the next step in this field? Dr. Haiquan Chen: I think for the lung cancer surgery, especially for the cT1N0M0, they are more individualized. We can, based on the patient, the location, the CTR ratio, we can do wedge dissection, or segmentectomy, or lobectomy. For the lymph node dissection, we can do no mediastinal lymph node dissection or selective, only to dissect the positive one, or we have to do the systemic mediastinal lymph node dissection. So we can see there are too many combinations. So in the near future, for the surgery perspective, we have it more individualized. In the future, we just try to make sure we do not cut as many as possible. We just make sure that we can avoid over-diagnosis or overtreatment or over-dissected. I think that in the near future, that goal will come true. Joseph Mathew: That's a great point, Dr. Chen. So that would be something also for the thoracic oncology community to work towards. This wraps up today's episode of JCO Article Insights. Dr. Chen and Dr. Zhang, thank you very much for taking the time to join us today in what has been a very insightful session. Dr. Haiquan Chen: Thank you. Dr. Yang Zhang: Thanks. Joseph Mathew: To our audience, thank you for listening. Please stay tuned for more interviews and articles, summaries, and be sure to leave us your comments and ratings. For more podcasts and episodes from ASCO, please visit asco.org/podcasts. 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.

Welcome to the Oncology Brothers podcast! In this episode, we kick off a three-part CME series focused on small cell lung cancer (SCLC). Joined by Dr. Hossein Borghaei, Chief of Thoracic Oncology at the Fox Chase Cancer Center. Together they dived into the evolving treatment landscape for SCLC, highlighting recent advancements and data from ASCO 2025. Episode Highlights: •⁠  ⁠Overview of the current standard of care for limited and extensive-stage SCLC. •⁠  ⁠Discussion on the role of concurrent chemoradiation therapy and the new standard of care involving immunotherapy. •⁠  ⁠Insights into the use of lurbinectedin in maintenance therapy and its impact on overall survival. •⁠  ⁠Exploration of the promising results from the DeLLphi study on tarlatamab, a bispecific antibody, and its implications for treatment. •⁠  ⁠The importance of patient selection and managing side effects in treatment decisions. Join us as we navigate the complexities of SCLC treatment and look forward to future advancements that may improve patient outcomes. Accreditation/Credit Designation Physicians' Education Resource®, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Physicians' Education Resource®, LLC designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Acknowledgment of Commercial Support This activity is supported by an educational grant from Jazz Pharmaceuticals, Inc. Link to gain CME credits from this activity: https://www.gotoper.com/courses/breaking-down-the-latest-clinical-data-for-first-line-maintenance-and-rr-sclc  Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ #OncologyBrothers #SmallCellLungCancer #CME #ASCO2025 #LungCancer #Immunotherapy #CancerTreatment

Host: Gerard A. Silvestri MD, MS, Master FCCP Guest: Fabien Maldonado, MD, FCCP Guest: Adam H. Fox, MD, MSc Cutting-edge biopsy methods and streamlined biomarker testing are transforming early-stage non-small cell lung cancer (NSCLC) care. Hear from Drs. Gerard Silvestri, Fabien Maldonado, and Adam Fox as they discuss the evolution of bronchoscopic techniques, insights from landmark trials, and the role of pragmatic clinical research in refining biopsy approaches. Dr. Silvestri is a pulmonologist and the Hillenbrand Professor of Thoracic Oncology at the Medical University of South Carolina; Dr. Maldonado is a Professor of Medicine and Thoracic Surgery, the Pierre Massion Director in Lung Cancer Research, and the Director of Interventional Pulmonology Research at Vanderbilt University; and Dr. Fox is a pulmonologist and Assistant Professor of Medicine at the Medical University of South Carolina. This program is produced in partnership with the American College of Chest Physicians and is sponsored by AstraZeneca.

Host: Gerard A. Silvestri MD, MS, Master FCCP Guest: Jeffrey B. Velotta, MD, FACS Guest: Anne Gonzalez, MD, M.Sc. For patients with non-small cell lung cancer, staging accuracy is critical in guiding treatment decisions that can significantly affect outcomes. In this expert-led discussion, Dr. Gerard Silvestri sits down with Drs. Anne Gonzalez and Jeffrey Velotta break down what clinicians need to know, including how to perform thorough EBUS staging, why PET scans alone aren't enough, and what the updated TNM classification means for surgical planning. Dr. Silvestri is a pulmonologist and the Hillenbrand Professor of Thoracic Oncology at the Medical University of South Carolina; Dr. Gonzalez is a pulmonary and critical care physician, a researcher in the Translational Research and Respiratory Diseases Program, and an Associate Professor in the Department of Medicine at McGill University in Montreal; and Dr. Velotta is a leading thoracic surgeon specializing in complex cancers, a Clinical Professor in the Department of Clinical Science at the Kaiser Permanente Bernard J. Tyson School of Medicine, and a Clinical Assistant Professor in the Department of Surgery at UCSF School of Medicine in California. This program is produced in partnership with the American College of Chest Physicians and is sponsored by AstraZeneca.

In this episode of 'Conversations in Lung Cancer Research,' A/Prof Mel Moore sits down with A/Prof Fiona Hegi Johnson, a radiation oncologist at the Peter McCallum Cancer Center and senior research fellow at the University of Melbourne. Fiona shares her journey into radiation oncology, highlighting her career progression, the impact of serendipity, and the importance of mentors. They discuss technological advancements in the field, the role of multidisciplinary teams, changes in lung cancer treatments, and clinical challenges. Fiona offers insights into balancing clinical work with research and provides advice for early-career professionals in the field.(00:00) Introduction and Acknowledgements(00:32) Guest Introduction: Associate Professor Fiona Hegi Johnson(01:33) Fiona's Career Journey and Early Challenges(04:08) Choosing Radiation Oncology(06:04) Balancing Clinical and Academic Roles(09:46) Challenges in Radiation Oncology Research(13:45) Technological Advances in Lung Cancer Treatment(17:22) Multidisciplinary Team Dynamics(23:03) Fiona's Role in TROG and Mentorship(28:32) Advice for Early Career Professionals(30:02) Conclusion and Final Thoughts

As part of IASLC's ongoing series of podcasts in world languages, Dr. Nagla Abdel Karim moderates a discussion in Arabic with Dr. Asrar AlAhmadi and Dr. Maya Khalil. The group discusses the journey and career development of Arabic women in the field of thoracic oncology.

i3 Health recently launched an exciting new online educational activity, “What's New with HER2: Charting New Paths in NSCLC Care.” This two-part series dives deep into the evolving role of HER2 in non–small cell lung cancer (NSCLC). In a special interview, Dr. Julia Kathleen Rotow—Clinical Director of the Lowe Center for Thoracic Oncology at Dana-Farber Cancer Institute and Assistant Professor of Medicine at Harvard Medical School—shares the latest breakthroughs in treating HER2-mutated NSCLC. She highlights why ongoing medical education is crucial in this fast-changing field and offers her insights on where HER2-targeted therapies are headed next. Stay tuned after the interview to listen to Module 1 of this accredited activity! Click below to complete the claim your CE credit: Module 1: https://bit.ly/49NCaQu Click below to complete the next Module in this series, Current and Emerging Treatments for HER2-Mutated NSCLC Module 2: https://bit.ly/405xEJO

i3 Health recently launched an exciting new online educational activity, “What's New with HER2: Charting New Paths in NSCLC Care.” This two-part series dives deep into the evolving role of HER2 in non–small cell lung cancer (NSCLC). In a special interview, Dr. Julia Kathleen Rotow—Clinical Director of the Lowe Center for Thoracic Oncology at Dana-Farber Cancer Institute and Assistant Professor of Medicine at Harvard Medical School—shares the latest breakthroughs in treating HER2-mutated NSCLC. She highlights why ongoing medical education is crucial in this fast-changing field and offers her insights on where HER2-targeted therapies are headed next. Stay tuned after the interview to listen to Module 1 of this accredited activity! Click below to complete the claim your CE credit: Module 2: https://bit.ly/405xEJO Click below to complete the Module 1 from this series, HER2 in NSCLC: Actionable Insights and Testing Recommendations Module 1: https://bit.ly/49NCaQu

In this episode of TOGA's Conversations in Lung Cancer Research, A/Prof Mel Moore speaks with Prof Shankar Siva about his groundbreaking work in radiation oncology, particularly focusing on the PRIME Lung study. They discuss the journey from concept to large clinical trials, the challenges of grant applications, the importance of controversial ideas in research, and the role of industry funding. Shankar also shares insights into his interest in genitourinary cancers and the future of radiation therapy, emphasising the significance of mentorship and practical advice for junior radiation oncologists.00:00 Welcome and Introduction00:33 Meet Professor Shankar Siva01:26 Prime Lung Study Overview02:32 Building on Previous Research04:00 From Concept to Large Trial06:11 International Collaborations07:16 Tips for Clinician Researchers12:11 Industry Funding in Radiation Oncology14:33 Interest in Genitourinary Cancers19:34 The Role of Mentorship25:09 Advice for Junior Colleagues28:25 Conclusion and Final Thoughts

In the wake of the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, CancerNetwork® put together an X Spaces discussion hosted by Stephen Liu, MD, and Joshua Sabari, MD, to highlight the most intriguing and practice-changing lung cancer abstracts. Discussed topics ranged from long-term follow-up with commonplace therapies to an analysis of what time of day is the best to administer immunochemotherapy.  Liu, an associate professor of Medicine at Georgetown University, and the director of Thoracic Oncology and head of Developmental Therapeutics at the Georgetown Lombardi Comprehensive Cancer Center, and Sabari, an assistant professor in the Department of Medicine at the NYU Grossman School of Medicine, and the director of High Reliability Organization Initiatives at the Perlmutter Cancer Center, shared expert insights on the latest non–small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) breakthroughs. Trials of note that they discussed included: The phase 3 DeLLphi-304 trial (NCT05740566) - Tarlatamab (Imdelltra) versus chemotherapy (CTx) as second-line (2L) treatment for small cell lung cancer (SCLC): primary analysis of Ph3 DeLLphi-304.1 The phase 3 IMforte trial (NCT05091567) - Lurbinectedin (Zepzelca; lurbi) + atezolizumab (Tecentriq; atezo) as first-line (1L) maintenance treatment (tx) in patients (pts) with extensive-stage small cell lung cancer (ES-SCLC): primary results of the phase 3 IMforte trial.2 The phase 3 CheckMate 816 trial (NCT02998528) - Overall survival with neoadjuvant nivolumab (Opdivo; NIVO) + chemotherapy (chemo) in patients with resectable NSCLC in CheckMate 816.3 The phase 3 PACIFIC15 trial (NCT05549037) - Randomized trial of relevance of time-of-day of immunochemotherapy for progression-free and overall survival in patients with non–small cell lung cancer.4 The phase 3 Beamion LUNG-1 trial (NCT04886804) - Patient-reported outcomes (PRO) evaluating physical functioning and symptoms in patients with pretreated HER2-mutant advanced non–small cell lung cancer (NSCLC): results from the Beamion LUNG-1 trial.5 The phase 3 ARTEMIA trial (NCT06472245) - Phase 3 trial of the therapeutic cancer vaccine OSE2101 versus docetaxel in patients with metastatic non–small cell lung cancer and secondary resistance to immunotherapy. References Rudin C, Mountzios G, Sun L, et al. Tarlatamab versus chemotherapy (CTx) as second-line (2L) treatment for small cell lung cancer (SCLC): primary analysis of Ph3 DeLLphi-304. J Clin Oncol. 2025;43(suppl 17):LBA8008. doi:10.1200/JCO.2025.43.17_suppl.LBA8008 Paz-Ares L, Borghaei H, Liu SV, et al. Lurbinectedin (lurbi) + atezolizumab (atezo) as first-line (1L) maintenance treatment (tx) in patients (pts) with extensive-stage small cell lung cancer (ES-SCLC): primary results of the phase 3 IMforte trial. J Clin Oncol. 2025;43(suppl 16):8006. doi:10.1200/JCO.2025.43.16_suppl.8006 Forde PM, Spicer JD, Provencio M, et al. Overall survival with neoadjuvant nivolumab + chemotherapy in patients with resectable NSCLC in CheckMate 816. J Clin Oncol. 2025;43(suppl 17):LBA8000. doi:10.1200/JCO.2025.43.17_suppl.LBA8000 Zhang Y, Huang Z, Zeng L, et al. Randomized trial of relevance of time-of-day of immunochemotherapy for progression-free and overall survival in patients with non-small cell lung cancer. J Clin Oncol. 2025;43(suppl 16):8516. doi:10.1200/JCO.2025.43.16_suppl.8516 Sabari JK, Nadal E, Hendriks L, et al. Patient-reported outcomes (PRO) evaluating physical functioning and symptoms in patients with pretreated HER2-mutant advanced non-small cell lung cancer (NSCLC): results from the Beamion LUNG-1 trial. J Clin Oncol. 2025;43(suppl 16):8620. doi:10.1200/JCO.2025.43.16_suppl.8620 Liu SV, Guibert C, Tostivint EP, et al. Phase 3 trial of the therapeutic cancer vaccine OSE2101 versus docetaxel in patients with metastatic non-small cell lung cancer and secondary resistance to immunotherapy. J Clin Oncol. 2025;43(suppl 16):TPS8651. doi:10.1200/JCO.2025.43.16_suppl.TPS8651

In the third edition of a special podcast series, CancerNetwork® spoke with Daniel Morgensztern, MD; Mary Ellen Flanagan, NP; and Janelle Mann, PharmD, BCOP, about optimal strategies for incorporating different therapeutic agents into lung cancer care. As part of the latest discussion, the group highlighted the relevant efficacy data, administration protocols, and toxicity management considerations associated with TROP2-directed antibody-drug conjugates (ADCs) in patients with non–small cell lung cancer (NSCLC). Morgensztern is a professor of Medicine and the clinical director of Thoracic Oncology in the Division of Oncology at Washington University School of Medicine in St. Louis. Flanagan is a nurse practitioner in the Division of Thoracic Oncology at Washington University. Mann is a clinical oncology pharmacist at Siteman Cancer Center of Washington University School of Medicine and manager of Clinical Pharmacy Services at Barnes-Jewish Hospital. Morgensztern opened the discussion by highlighting the characteristics of prominent TROP2-targeting ADCs in NSCLC management, which included sacituzumab govitecan-hziy (Trodelvy), datopotamab deruxtecan-dlnk (Datroway), and sacituzumab tirumotecan (sac-TMT). Additionally, he reviewed data from clinical trials assessing these ADCs across different NSCLC populations, including the phase 3 EVOKE-01 trial (NCT05089734) showing a numerical overall survival (OS) improvement with sacituzumab govitecan vs docetaxel. Regarding the safety profiles of these ADCs, Flanagan described the unique toxicities associated with the agents' payloads as well as potential off-target effects. On top of myelosuppression, fatigue, and diarrhea, she stated that these therapies may cause more visceral organ toxicities like keratitis of the eye and interstitial lung disease. According to Flanagan, some prophylactic measures in the event of certain toxicities include frequent salt and baking soda mouth rinses as well as oral dexamethasone.  Mann then outlined the dosing variability considerations and supportive care measures surrounding the use of agents like sacituzumab govitecan. She emphasized continuously re-educating patients about expected toxicities and supportive care strategies as they undergo these infusion-based therapies to help avoid surprise instances of ocular toxicity, diarrhea, and other adverse effects. Reference Paz-Ares LG, Juan-Vidal O, Mountzios GS, et al. Sacituzumab govitecan versus docetaxel for previously treated advanced or metastatic non-small cell lung cancer: the randomized, open-label phase III EVOKE-01 study. J Clin Oncol. 2024;42(24):2860-2872. doi:10.1200/JCO.24.00733

In today's episode, we spoke with Jonathan W. Goldman, MD, about the phase 2 LUMINOSITY study (NCT03539536) evaluating telisotuzumab vedotin-tllv (Teliso-V; Emrelis) in patients with c-MET protein–overexpressing, nonsquamous, EGFR wild-type advanced non–small cell lung cancer (NSCLC). Dr Goldman is a professor of medicine in the Division of Hematology/Oncology at UCLA, as well as director of Clinical Trials in Thoracic Oncology, associate director of Early Drug Development, and chair of the University of California Lung Cancer Consortium.

In this episode of Conversations in Lung Cancer Research, we welcome A/Prof Bryan Chan, a senior Medical Oncologist and this years TOGA ASM Convener. Bryan, affiliated with multiple institutions including Adam Crosby Cancer Center and Griffith University, discusses his comprehensive career journey from fellowship at the Princess Margaret Cancer Center in Toronto to his current roles in Australia. The discussion highlights the benefits of overseas fellowships, the development of clinical trials, and his leadership in thoracic oncology at the Sunshine Coast University Hospital. Bryan also touches upon the challenges and rewards of balancing private and public practice and pioneering quality improvement initiatives. The episode concludes with an exciting preview of the upcoming TOGA Annual Scientific Meeting, which Bryan is convening. Medical professionals and anyone interested in the latest in lung cancer research and practice will find valuable insights in this conversation with Bryan. (00:00) Welcome and Introduction(00:41) Guest Introduction: Associate Professor Brian Chan(02:12) Brian's Fellowship Experience at Princess Margaret Cancer Center(03:44) Benefits of Overseas Fellowships(06:58) Transitioning Back to Australia(08:29) Balancing Public and Private Practice(10:08) Establishing a Quality Committee(15:02) Building a Clinical Trials Unit(18:15) Advice for Junior Consultants(21:19) TOGA Annual Scientific Meeting Preview(25:39) Conclusion and Farewell 

Host: Jacob Sands, MD Guest: Elaine Shum, MD Guest: Estelamari Rodriguez, MD, MPH There was a recent pooled analysis of the TROPION-Lung01 and TROPION-Lung05 studies, which focused on the efficacy and safety of datopotamab deruxtecan (Dato-DXd) in patients with previously treated EGFR-mutated advanced non-small cell lung cancer (NSCLC). According to the results, Dato-DXd demonstrated an overall response rate of 43 percent, with durable responses and a manageable safety profile. Joining Dr. Jacob Sands to talk more about these findings and their implications are Drs. Elaine Shum and Estelamari Rodriguez. Dr. Shum is an Assistant Professor in the Department of Medicine at NYU Grossman School of Medicine, and Dr. Rodriguez is an Associate Director of Community Outreach, Thoracic Oncology at Sylvester Comprehensive Cancer Center at the University of Miami Health System.

In this episode, Jonathan Sackier kicks off a special miniseries on lung cancer with Haval Balata, Consultant Respiratory Physician at Manchester University NHS Foundation Trust. From the Manchester Lung Health Check to robotic bronchoscopy, Balata shares insights into pioneering early detection efforts, the challenge of public misconceptions, and innovations reshaping lung cancer screening and diagnosis. Timestamps: 03:12 – Inspiration to specialise 04:09 – Early diagnosis barriers 08:02 – Manchester Lung Health Check 14:10 – Robot-assisted bronchoscopy 19:24 – Public misconceptions 28:57 – Risk stratification & follow-up 34:24 – Innovations in early detection 37:10 – Hopes for the future 41:22 – Three healthcare wishes

Host: Gerard A. Silvestri MD, MS, Master FCCP Guest: Anurag Singh, MD Guest: Adam H. Fox, MD, MSc Guest: Mariam Alexander, MD, PhD Despite the typically poor prognosis of extensive-stage small cell lung cancer, recent advancements are reshaping clinical perspectives on treatment. New and emerging options show promise for prolonged survival and improved quality of life. Join Drs. Gerard Silvestri, Adam Fox, Mariam Alexander, and Anurag Singh as they discuss how the therapeutic landscape is evolving for these patients. Silvestri is a pulmonologist and the Hillenbrand Professor of Thoracic Oncology at the Medical University of South Carolina. Dr. Fox is a pulmonologist and Assistant Professor of Medicine at the Medical University of South Carolina. Dr. Alexander is a medical oncologist and Assistant Professor of Medicine at the Medical University of South Carolina. Dr. Singh is a Professor of Radiation Oncology and the Director of Radiation Research at the Roswell Park Cancer Center in New York. This program is produced in partnership with the American College of Chest Physicians and is sponsored by AstraZeneca.

Host: Gerard A. Silvestri MD, MS, Master FCCP Guest: Anurag Singh, MD Guest: Adam H. Fox, MD, MSc Guest: Mariam Alexander, MD, PhD Recent therapeutic advances are reshaping our approach to limited-stage small cell lung cancer. In this multidisciplinary discussion, Dr. Gerard Silvestri sits down with Drs. Adam Fox, Mariam Alexander, and Anurag Singh to explore the evolving standard of care and practical considerations for timely and effective care. Dr. Silvestri is a pulmonologist and the Hillenbrand Professor of Thoracic Oncology at the Medical University of South Carolina. Dr. Fox is a pulmonologist and Assistant Professor of Medicine at the Medical University of South Carolina. Dr. Alexander is a medical oncologist and Assistant Professor of Medicine at the Medical University of South Carolina. Dr. Singh is a Professor of Radiation Oncology and the Director of Radiation Research at the Roswell Park Cancer Center in New York. This program is produced in partnership with the American College of Chest Physicians and is sponsored by AstraZeneca.

In this episode of Conversations in Lung Cancer Research, A/Prof Mel Moore speaks with Prof Wendy Cooper, a leading pathologist in cancer research. They discuss Wendy's journey into pathology, the evolution of lung cancer diagnostics, the impact of AI and liquid biopsies, and the importance of international collaboration in research. Wendy shares insights on the challenges of equitable access to cancer diagnostics and the pressures faced by pathologists in multidisciplinary meetings. The conversation concludes with advice for junior clinicians on career development and involvement in professional organisations.(00:00) Introduction and Acknowledgements(00:36) Introducing Prof Wendy Cooper(01:32) Wendy's Path to Pathology(04:42) The Evolution of Lung Cancer Pathology(08:18) The Role of AI in Pathology(10:30) Translational Research and International Collaboration(14:09) Molecular Testing Guidelines in Australia(18:05) Challenges and Future Directions in Pathology(26:52) The Impact of Lung Cancer Screening Programs(29:08) Final Thoughts and Advice 

In this episode of 'Conversations in Lung Cancer Research,' Professor Tom John from the Peter MacCallum Cancer Centre in Melbourne discusses the significant progress and excitement surrounding cancer vaccines, particularly their emerging role in lung cancer treatment.He is joined by Professor Ken O'Byrne, a medical oncologist and clinical scientist at the Princess Alexandra Hospital and Queensland University of Technology, and Professor Georgina Long AO, the medical director of the Melanoma Institute of Australia and co-recipient of the 2024 Australian of the Year.The experts delve into technological advances spurred by COVID-19 vaccine development, promising results from recent melanoma and lung cancer vaccine trials, and the potential for personalised neoantigen mRNA vaccines. They also discuss historical challenges in vaccine efficacy and the promising future of immunotherapy and cancer vaccines, including patient perspectives and the logistics of rapid vaccine production and distribution.00:00 Introduction03:15 Historical Context of Cancer Vaccines05:13 Technological Advances in Vaccine Development06:53 The Promise of mRNA Technology14:03 Personalised vs. Off-the-Shelf Vaccines18:02 Identifying Neoantigens for Vaccines21:13 Caution and Optimism in Vaccine Development23:18 Exploring Tumour Mutation Burden and Vaccine Bias29:35 Challenges and Opportunities in Metastatic Disease33:53 Immunotherapy and Vaccine Hesitancy37:52 Future of Cancer Vaccines and Rapid Innovation42:14 Conclusion and Final Thoughts

Guest: Dr. Corey Langer is the Director of Thoracic Oncology and Professor of Medicine at the Hospital of the University of Pennsylvania

In the second edition of a special podcast series, CancerNetwork® spoke with Daniel Morgensztern, MD; Mary Ellen Flanagan, NP; and Janelle Mann, PharmD, BCOP, about the best practices for incorporating recently approved bispecific antibodies into cancer care. This discussion focused on clinical trial results, administration protocols, and adverse effect (AE) management strategies related to the use of tarlatamab-dlle (Imdelltra) for patients with small cell lung cancer (SCLC). Morgensztern is a professor of Medicine and the clinical director of Thoracic Oncology in the Division of Oncology at Washington University School of Medicine in St. Louis. Flanagan is a nurse practitioner in the Division of Thoracic Oncology at Washington University. Mann is a clinical oncology pharmacist at Siteman Cancer Center of Washington University School of Medicine and manager of Clinical Pharmacy Services at Barnes-Jewish Hospital. The conversation opened with Morgensztern highlighting tarlatamab's mechanism of action as an agent that targets DLL3. He then reviewed prior efficacy data that the therapy demonstrated in the phase 1 DeLLphi-300 trial (NCT03319940) and the phase 2 DeLLphi-301 trial (NCT05060016). Of note, the FDA approved tarlatamab as the first available T-cell engager immunotherapy for patients with extensive-stage SCLC who have progressed on prior platinum-containing chemotherapy in May 2024 based on data from the DeLLphi-301 trial. Additionally, Flanagan detailed strategies for monitoring and mitigating the most common AEs associated with tarlatamab in this patient population, which include cytokine release syndrome and immune effector cell–associated neurotoxicity syndrome. Mann then outlined considerations for properly dosing and administering the agent, highlighting factors that clinicians should keep in mind when continuing treatment in an inpatient or outpatient setting. The group also spoke about clinical decision-making related to patients who have brain metastases, which included processes for adjusting the dose of tarlatamab and sequencing the bispecific agent with radiotherapy. Reference FDA grants accelerated approval to tarlatamab-dlle for extensive stage small cell lung cancer. News release. FDA. May 16, 2024. Accessed March 14, 2025. https://tinyurl.com/48k34rw5

In this episode of Conversations in Lung Cancer Research, Dr. Malinda Itchins, Dr. Annie Wong, and A/Prof Stephen Kao discuss the concept of liquid biopsy, its advantages and limitations, and its clinical applications in lung cancer treatment. They explore how liquid biopsy can provide faster diagnosis and treatment options, especially for patients who cannot undergo traditional tissue biopsies. However, they also address the challenges of sensitivity and the need for further research to integrate liquid biopsy into routine clinical practice.This episode is sponsored by: AstraZeneca  Daiichi Sankyo Australia  SOPHiA Genetics  Thermo Fisher Scientific(00:00) Introduction and Acknowledgements(01:16) Meet the Experts(02:10) Understanding Liquid Biopsy(03:01) Advantages of Liquid Biopsy(06:21) Limitations of Liquid Biopsy(09:15) Clinical Scenarios for Liquid Biopsy(13:15) Barriers and Future Directions(19:39) Conclusion and Thank You

As part of IASLC's ongoing series of podcasts in world languages, Dr. Balazs Halmos moderates a discussion in Hungarian with Dr. Krisztina Bogos, Dr. Ferenc Rényi-Vámos and Dr. Zsolt Megyesfalvi. The podcast reviews recent advances in lung cancer screening, diagnosis and management with a particular focus on implementation in Hungary. Highlights of the discussion include novel staging and diagnostic tools, state-of-the-art biomarker testing, perioperative therapy and clinical trials access. Host: Balazs Halmos, MD, Director, Thoracic Oncology & Clinical Cancer Genomics, Montefiore Medical Park at Eastchester, Bronx, New York Guest: Ferenc Rényi-Vámos, MD, PhD, Thoracic Surgery, Semmelweis University and National Institute of Oncology, Budapest, Hungary Guest: Krisztina Bogos, MD, Thoracic Oncology National Koranyi Institute of Pulmonology, Budapest, Hungary Lung Cancer Research and Pathology Guest: Zsolt Megyesfalvi, MD, PhD, Semmelweis University and National Institute of Oncology, Budapest, Hungary and National Koranyi Institute of Pulmonology, Budapest, Hungary

In the first edition of a special 3-part podcast series, CancerNetwork® spoke with Daniel Morgensztern, MD; Mary Ellen Flanagan, NP; and Janelle Mann, PharmD, BCOP, about best practices for implementing recently approved bispecific antibodies into cancer care. Their initial discussion focused on the clinical trial results, administration protocols, and toxicity management strategies related to the use of amivantamab-vmjw (Rybrevant) for patients with EGFR-mutated non–small cell lung cancer (NSCLC). Morgensztern is a professor of Medicine and clinical director of Thoracic Oncology in the Division of Oncology at Washington University School of Medicine in St. Louis. Flanagan is a nurse practitioner in the Division of Thoracic Oncology at Washington University in St. Louis. Mann is a clinical oncology pharmacist at Siteman Cancer Center of Washington University School of Medicine in St. Louis and manager of Clinical Pharmacy Services at Barnes-Jewish Hospital. Morgensztern began by giving an overview of amivantamab's mechanism of action and highlighting supporting data for the agent when administered alone or in combination with other agents.  The FDA initially approved amivantamab monotherapy for patients with EGFR exon 20 insertion–mutant NSCLC in May 2021 based on data from the phase 1 CHRYSALIS trial (NCT02609776). Furthermore, the agency approved amivantamab/chemotherapy as frontline treatment for patients with NSCLC harboring EGFR exon 20 insertion mutations in March 2024 based on data from the phase 3 PAPILLON trial (NCT04538664). Findings from the phase 3 MARIPOSA trial (NCT04487080) also supported the FDA approval of amivantamab plus lazertinib (Lazcluze) for those with EGFR-mutant NSCLC in August 2024. Additionally, Mann reviewed key dosing considerations as patients receive amivantamab via intravenous infusion. She detailed the use of premedication such as diphenhydramine (Benadryl) to supplement amivantamab while monitoring for toxicities during the initial infusion period, which may necessitate additional dosing adjustments. Flanagan added to the conversation surrounding infusion-related reactions by describing strategies for mitigating the risk of venous thromboembolism, cutaneous toxicities, and other adverse effects. References 1. RYBREVANTTM (amivantamab-vmjw) receives FDA approval as the first targeted treatment for patients with non-small cell lung cancer with EGFR exon 20 insertion mutations. News release. The Janssen Pharmaceutical Companies of Johnson & Johnson. May 21, 2021. Accessed January 29, 2025. https://tinyurl.com/3d8wtu4m 2. FDA approves amivantamab-vmjw for EGFR exon 20 insertion-mutated non-small cell lung cancer indications. News release. FDA. March 1, 2024. Accessed January 29, 2025. https://tinyurl.com/msw4u5yk 3. RYBREVANT® (amivantamab-vmjw) plus LAZCLUZE™ (lazertinib) approved in the U.S. as a first-line chemotherapy-free treatment for patients with EGFR-mutated advanced lung cancer. News release. Johnson & Johnson. August 20, 2024. Accessed January 29, 2025. https://tinyurl.com/yxc8u8t4

In this episode of Conversations in Lung Cancer Research, A/Prof Mel Moore interviews Prof Michael Boyer, AM about his extensive career in medical oncology and his current role as CEO of Chris O'Brien Lifehouse. They discuss his early interest in oncology, the influential mentors in his career, and the evolution of lung cancer treatment and research. Michael shares his perspectives on leadership in medical and research roles, the importance of building relationships, and the balance between industry-sponsored and cooperative group research. They also touch upon professional challenges, emotional resilience in oncology, and Michael's vision for the future of his career and the field of oncology. (00:00) Welcome and Introduction(01:04 )Guest Introduction: Professor Michael Boyer(02:25) Michael Boyer's Early Career and Mentorship(07:27) Leadership Roles and Challenges(11:33) Involvement in Clinical Research(21:03) Emotional Aspects of Oncology(29:38) Future of Oncology and Career Advice(33:06) Conclusion and FarewellResources and Links:International Association for the Study of Lung Cancer https://www.iaslc.org/Chris O'Brien Lifehouse https://www.mylifehouse.org.au/Schwartz Rounds https://www.theschwartzcenter.org/programs/schwartz-rounds/

In this introductory episode, Associate Professor Mel Moore, medical oncologist and education chair at TOGA, announces the evolution of TOGA podcasts to 'Conversations in Lung Cancer Research.' The podcast will continue to deliver the latest breakthroughs in lung cancer research while expanding to include deeper dives and engaging discussions with experts in thoracic oncology. Listeners can look forward to unique insights from researchers, clinicians, and key thought leaders shaping the future of lung cancer care.

This week's episode will be focusing on additional details for Extensive Stage Small Cell Lung Cancer (SCLC), options for relapsed/refractory disease & advice for trainees. We are so excited to welcome back Dr. Stephen Liu international expert for lung cancer, Director of Thoracic Oncology & Developmental Therapeutics at Georgetown Lombardi Cancer Center and Co-Host of the IASLC Podcast.

Description: As part of IASLC's commitment to communicating in all world languages, this episode of Lung Cancer Considered is recorded in German and is part of our Virtual Tumor Board series. Host Professor Alessandra Curioni-Fontecedro moderates a discussion with two colleagues, who will discuss the dynamic topic of managing resectable stage III NSCLC. Host: Prof Alessandra Curioni-Fontecedro, MD, Head of Oncology, Cantonal Hospital Fribourg, Chair of Medical Oncology, University of Fribourg Guest: Prof. Isabelle Opitz, Professor of Thoracic Surgery and Director of the Department of Thoracic Surgery at University Hospital of Zurich, Chair of the Lung Cancer Center of Zurich, and the past President of the European Society of Thoracic Surgery. She received the IASLC Robert J Ginsberg Lectureship Award for Surgery at the 2022 World Conference on Lung Cancer Guest: Prof. Michael Thomas, Chefarzt of Dept of Thoracic Oncology at the Thoraxklinik Heidelberg, Germany.

This week's episode will be focusing on Small Cell Lung Cancer (SCLC). We will go all the important details on risk factors, diagnostic work-up, staging and treatment of both locoregional and metastatic SCLC. We are so excited to welcome Dr. Stephen Liu international expert for lung cancer, Director of Thoracic Oncology & Developmental Therapeutics at Georgetown Lombardi Cancer Center and Co-Host of the IASLC Podcast.

Stay ahead in NSCLC management with this accredited podcast! HER2 alterations, including gene mutations and protein overexpression, are key therapeutic targets, but their complexity can challenge treatment decisions. In Module 1 of this podcast, Dr. Julia Kathleen Rotow, Clinical Director of the Lowe Center for Thoracic Oncology at Dana-Farber Cancer Institute and Assistant Professor of Medicine at Harvard Medical School, provides essential insights and testing recommendations to optimize patient care. Listen now! Click here to claim CME/NCPD credit: https://bit.ly/49NCaQu

Stay ahead in NSCLC management with our accredited podccast! HER2 alterations, including gene amplifications, mutations, and protein overexpression, are critical therapeutic targets, but their heterogeneity can complicate treatment strategies. In Module 2, Dr. Julia Kathleen Rotow, Clinical Director of the Lowe Center for Thoracic Oncology at Dana-Farber Cancer Institute and Assistant Professor of Medicine at Harvard Medical School, explores advanced testing methodologies and strategies to navigate HER2 complexities and optimize patient outcomes. Listen now! Click here to claim CME/NCPD credit: https://bit.ly/405xEJO

In this episode of Lung Cancer Considered, host Dr. Stephen Liu moderates a discussion about the management of relapsed SCLC, which remains a very challenging cancer to treat, despite recent progress. Guest: Dr. Malinda Itchins is a Medical Oncologist at Royal North Shore Hospital, Visiting Medical Officer for Thoracic Cancers at Chris O'Brien Lifehouse, and Faculty at the University of Sydney. She is the Board Director and Lung Cancer Chair for the Clinical Oncology Society of Australia (COSA) and the Scientific Committee Advanced NSCLC Group Co-Chair for the Thoracic Oncology Group of Australasia (TOGA). Guest: Dr. Jacob Sands is an Assistant Professor at Harvard Medical School and Thoracic Medical Oncologist at the Lowe Center for Thoracic Oncology at the Dana Farber Cancer Institute, where he leads the Clinical Research Program in SCLC. Jacob is also Co-founder and President of the Rescue Lung Society, a 501(c)3 society focused on advancing lung cancer screening.

Welcome to the Oncology Brothers podcast! In this episode, hosts Drs. Rahul and Rohit Gosain are joined by Dr. Stephen Liu, Associate Professor and Director of Thoracic Oncology at the Georgetown Lombardi Comprehensive Cancer Center. Together, they dive into the latest findings from ESMO 2024, focusing on key studies in lung cancer that every community oncologist should be aware of. Episode Highlights: •⁠  ⁠LAURA Trial: Discussing the role of osimertinib in locally advanced unresectable EGFR-mutant lung cancer post-chemoradiation and its impact on CNS progression-free survival. •⁠  ⁠MARIPOSA and MARIPOSA-2 Studies: Exploring the importance of amivantamab in metastatic non-small cell lung cancer, including insights on resistance patterns and treatment sequencing. •⁠  ⁠ADRIATIC Study: Analyzing the use of durvalumab as consolidation therapy in limited-stage small cell lung cancer and its implications for practice, including updates on prophylactic cranial irradiation (PCI). Join us as we unpack these pivotal studies that are shaping the future of lung cancer treatment. Don't forget to check out our highlights on GI, GU, and breast cancer from ESMO 2024! Subscribe for more insights and updates in oncology! Website: http://www.oncbrothers.com/ X/Twitter: https://twitter.com/oncbrothers Contact us at info@oncbrothers.com    

Description: The FDA approved amivantamab therapy for EGFR mutant NSCLC after progression on osimertinib. This approval is based on the phase III MARIPOSA-2 trial, with data first shared at ESMO 2023 in Madrid with a simultaneous publication in the Annals of Oncology. Lung Cancer Considered host Dr. Stephen Liu talks with two leading oncologists to learn more about how this therapy will be used by clinicians Guest: Dr. Karen Reckamp, Professor of Medicine, Director of the Division of Medical Oncology, and Associate Director of Clinical Research at Cedars-Sinai Medical Center Guest: Dr. William Nassib William, National Leader of Thoracic Oncology at Oncolinicas, Sao Paulo, Brazil

The 2024 World Conference on Lung Cancer brings together leading experts, researchers, and oncologists to showcase the latest advancements in lung cancer research and celebrate IASLC's 50th anniversary. To reach a global audience, IASLC has recorded podcast episodes on WCLC 2024 in world languages. In this episode, host Dr. Clarissa Mathias moderates a discussion in Portuguese about highlights from the conference with Dr. Isabella Favato Barcelos and Dr. William Nassib William. Guests: Dr. Clarissa Mathias Medical Oncologist at Oncoclinicas Bahia and Hospital Santa Izabel Dr. Isabella Favato Barcelos Medical Oncologist, Oncoclinicas&Co/MedSir, Brazil Dr. William Nassib William National Leader of Thoracic Oncology at Oncolinicas, Sao Paulo, Brazil

In this special WCLC 2024 episode of Lung Cancer Considered, hosts Dr. Narjust Florez and Dr. Stephen Liu recap the conference and discuss the meeting's most impactful research. Dr. Jacob Sands discusses overall survival updates from TROPION-Lung01 with datopotamab deruxtecan and DeLLphi-301 with tarlatamab. Dr. Hidehito Horinouchi reports results from the LUMINOSITY study of telisotuzumab vedotin, and Dr. Noemi Reguart gives some perspective on TRUST-II with talectrectinib. The group discusses the biggest stories from WCLC 2024, their favorite moments, and a preview of WCLC 2025 in Barcelona, Spain. Guests: Dr. Hidehito Horinouchi Assistant Chief, Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo General Secretary, Japan Clinical Oncology Group Dr. Noemi Reguart Clinical Professor at the University of Barcelona Coordinator of the Thoracic Oncology Unit, Hospital Clínic Barcelona, Spain WCLC 2025 Co-Chair Dr. Jacob Sands Assistant Professor of Medicine, Harvard Medical School Lowe Cancer Center for Thoracic Oncology Dana Farber Cancer Institute

In this special WCLC 2024 episode of Lung Cancer Considered, host Dr. Narjust Florez discusses daily highlights from the conference. Dr. Xiuning Le reports updated results of BAY 292708, and Dr. Gerrina Ruiter summarizes the Beamion LUNG-1 study, both of which evaluate the efficacy of therapies for patients with HER2-Mutant NSCLC. Dr. Fiona Hegi-Johnson adds her perspective as a discussant of the POLESTAR trial evaluating EGFR therapy after chemoradiation in stage III unresectable NSCLC. Guests: Dr. Fiona Hegi-Johnson Radiation Oncologist at the Peter MacCallum Cancer Centre Senior Research Fellow at the University of Melbourne Dr. Xiuning Le, M.D., Ph.D. Assistant Professor in the Department of Thoracic/Head and Neck Medical Oncology University of Texas M.D. Anderson Cancer Center Dr. Gerrina Ruiter, M.D., Ph.D. Pulmonologist Specialized in Thoracic Oncology at the Netherlands Cancer Institute Amsterdam, The Netherlands

In 1972, in response to the overwhelming need for collaboration and a growing concern for public health, Drs. David T. Carr, Oleg S. Selawry, Lawrence Broder, Clifton Mountain and George Higgins began building an international, multidisciplinary organization. In 1974, the group launched the International Association for the Study of Lung Cancer (IASLC) at their first formal meeting in Florence, Italy, having recruited more than 250 founding members from across the globe and with different perspectives. In today's episode, host Dr. Narjust Florez talks with two of those early members who played influential roles in IASLC's early growth and success: Dr. Paul Bunn and Dr. Fred Hirsch. Guest: Dr. Paul Bunn is a Distinguished Professor of Medicine and James Dudley Chair in Cancer Research, Division of Medical Oncology at the University of Colorado School of Medicine. Dr Bunn was President of the ASCO and he served as president and as CEO, of the International Association for the Study of Lung Cancer. Guest: Dr. Hirsch is the Executive Director at the Center for Thoracic Oncology in The Tisch Cancer Institute at Mount Sinai (TCI) and the Joe Lowe and Louis Price Professor of Medicine (Hematology and Medical Oncology) at the Icahn School of Medicine at Mount Sinai. Dr. Hirsch served as Chief Executive Officer of IASLC for five years.

Dr. James Fanale worked in healthcare for nearly five decades, but never reallyknew what it meant to be a patient until he was told he had cancer - Stage 4 lungcancer. James was president and CEO of Care New England, retiring in 2022, shortly after being diagnosed. Jim typically ran the Falmouth Road Race and insists on being able to continuerunning. Since his cancer diagnosis, Jim has focused on his personal life. He's retired and planning trips with his wife, Deb. Jim is in the middle of writing a book called “Onward,” which focuses on the empathy in medicine and the emotional weight of the journey of patients and their caregivers. All the proceeds will be donated to a new “caregivers fund” at the Dana-Farber. Dr. Barbie is the Director of the Lowe Center for Thoracic Oncology atDana-Farber Cancer Institute and an Associate Professor of Medicine at HarvardMedical School. He is also Associate Director of the Belfer Center for Applied Cancer Science and an Associate Member of the Broad Institute. According to the American Cancer Society, there will be an estimated 234,580 new cases of lung cancer in the United States for 2024. Lung cancer is by far the leading cause of cancer death in the U.S., accounting for about 1 in 5 of all cancer deaths. Each year, more people die of lung cancer than of colon, breast, and prostate cancers combined. On a positive note, the number of new lung cancer cases continues to decrease, partly because more people are quitting smoking (or not starting). The number of lung cancer deaths continue to drop as well due to fewer people smoking and advances in early detection and treatment, according to the American Cancer Society.

Description: Host Dr. Narjust Florez and two esteemed international clinicians discuss the unique characteristics of CNS metastases in patients with non-small cell lung cancer and small cell lung cancer. Guest: Dr. Sarah Goldberg is an Associate Professor of Medicine in the section of Medical Oncology at the Yale School of Medicine. She is the Division Chief of Thoracic Oncology, the Research Director for the Center for Thoracic Cancers, and the Associate Program Director for the Medical Oncology-Hematology Fellowship Program at Yale Guest: Dr. Ernest Nadal is a medical oncologist and the director of Thoracic Tumors Section at the Catalan Institute of Oncology, an Associate Professor at the University of Barcelona, a vital member of the Spanish Lung Cancer Group and an expert in clinical trial development and interest in response and use of immune checkpoint inhibitors for the management of CNS metastases.

In this episode of Lung Cancer Considered, host Dr. Stephen Liu discusses the recently approved bispecific T-cell engager, tarlatamab, for small cell lung cancer. Guest: Dr. Anne-Marie Dingemans is a pulmonologist and Professor of Thoracic Oncology at Erasmus Medical Center in Rotterdam, the Netherlands. Guest: Dr.Ryan Gentzler is an Associate Professor and Director of the Thoracic Oncology Clinical Research Program at the University of Virginia

In this episode of Medical Affairs Unscripted, Peg Crowley-Nowick, PhD, MBA, President of Medical Affairs Consulting at Lumanity, and Jodi Smith, PhD, the Global Medical Strategy Lead in Thoracic Oncology at Pfizer, discuss the value of Medical Affairs. While they agree that there's a cost associated with bringing Medical Affairs into the early development of a drug, they see a clear and measurable benefit, from accelerated enrollment to having a solid foundation for commercialization. Through their many years in different roles within Medical Affairs, they know that to achieve these benefits, organizations need to have the right team members in the right roles with the agility to work in an ever-changing landscape as well as provide strategic thinking, a diversity of audience, and continuity throughout the product lifecycle - from clinical development through commercialization and beyond.

JCO PO author Dr. Christian Rolfo shares insights into his JCO PO article, “Liquid Biopsy of Lung Cancer Before Pathological Diagnosis Is Associated With Shorter Time to Treatment.” Host Dr. Rafeh Naqash and Dr. Rolfo discuss how early liquid biopsy in aNSCLC in parallel with path dx is associated with shorter time to treatment. TRANSCRIPT  Dr. Rafeh Naqash: Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCOPO articles. I'm your host, Dr. Rafeh Naqash, Social Media Editor for JCO Precision Oncology and Assistant Professor at the Stephenson Cancer Center, University of Oklahoma.   Today we are thrilled to be joined by Dr. Christian Rolfo, Associate Director of Clinical Research at the Center of Thoracic Oncology at the Tisch Cancer Institute at Mount Sinai Health System. He is also the lead author of the JCO Precision Oncology article entitled "Liquid Biopsy of Lung Cancer Before Pathological Diagnosis is Associated with Shorter Time to Treatment."  Our guest's disclosures will be linked in the transcript.  Christian, it's great to have you here. Welcome to our podcast and we are excited to learn about some of the interesting results from your study.  Dr. Christian Rolfo: Thank you very much, Rafeh. It's a pleasure to be here and discuss about liquid biopsy. Dr. Rafeh Naqash: You have a very important role in different liquid biopsy consortiums. This is an initiative that you have been leading and spearheading for quite a while, and it's nice to see that it is becoming something of a phenomenon now on a global scale where liquid biopsies are being implemented more and more in earlier stages, especially. For the sake of our audience, which revolves around academic oncologists, community oncologists, trainees, and patient advocates or patients themselves, could you tell us a little bit about the background of what liquid biopsies are? And currently, how do we utilize them in the management of lung cancer or cancers in general? Dr. Christian Rolfo: Liquid biopsy has been gaining importance over the years. We started to talk about liquid biopsy in 2009 when we started to see some correlations with EGFR mutations. In practicality, what we are doing is the most common or most applicable indication is to go for liquid biopsies from the blood, peripheral blood. So we are doing a blood draw and from there, what we are capturing is the DNA or fragments of DNA that are still in circulation. But the liquid biopsy definition is a little bit more broad and we can apply the concept of a minimally invasive approach to different fluids of the body, including pleural effusion, urine, and including CSF that is another indication, there, we are going to be a little bit more invasive than peripheral blood, but it is also an emerging tool that we will have to find specific indicators. In cancer, we started the history of liquid biopsy in advanced disease with the identification of biomarkers, and then from there, we are moving to other scenarios, including, nowadays, monitoring minimal residual disease and early detection. And that is applicable also for other tumors. Dr. Rafeh Naqash: Thank you, Christian, for that summary. Now, as you've rightly pointed out, we have come to implement liquid biopsies more and more, both in the academic setting and the community setting. And this has definitely led to faster turnaround time in some ways compared to tissue. In this study that you have authored with the help of many other collaborators and Foundation Medicine Flatiron Health data, the goal here, from what I understand, was to look at liquid biopsies that were done before, resulted before the pathological diagnosis. Could you tell us a little bit more about the premise of this study, why you thought about this question and how did you try to implement that idea to get to some of the interesting results that you see here? Dr. Christian Rolfo: Yeah, so what we are seeing generally in lung cancer and also in people with other tumors is that patients are having a journey and that they start seeing different doctors until they get a diagnosis. Generally, after the pathological diagnosis, if you don't have an in-house technology that is doing reflex testing, generally, oncologists need to request for testing and that is taking time. So if we are looking for comprehensive days until a patients are able to get a molecular profiling before we start the treatment is sometimes very long. We are talking, in some cases, about months. So, how we can speed the process, that was the main question. We tried to include liquid biopsy in the staging procedures that we generally were doing when we have a clinical diagnosis of lung cancer. It's either images that we are used to do, PET scans, MRIs, and other assessments, we want to include liquid biopsy there before the biopsy. And that's what we did. We were searching for this specific aim using the Flatiron Health Foundation Medicine electronic health records from 280 centers across the United States. We included a big number of patients in this analysis, more than 1000 patients for the first analysis. Dr. Rafeh Naqash: That's phenomenal that you had real-world data from 200+ centers across the US. Of course, when you have patients on a clinical trial versus patients in the real-world, we all know that there are differences in terms of approaching, overseeing, and managing these individuals. So this data set is an extension of what we could see in the real-world setting.  Could you tell us a little bit about the number of patients that you eventually identified that had liquid biopsies done before pathological diagnosis? I think you have different cohorts here, a group that was before and a group that was after, and you compared several important metrics treatment-wise from what I see. Could you highlight those for our listeners? Dr. Christian Rolfo: Yeah. So we were looking for patients who had a liquid biopsy CGP, comprehensive genomic profiling, ordered within 30 days pre diagnosis and post diagnosis. We focused on 5.2% of patients, which corresponded to 56 patients who ordered a liquid biopsy before diagnosis. The median time was eight days between the order and diagnosis and the range was between 1 to 28 days. And that was compared with 1020 patients who ordered a liquid biopsy after diagnosis. It is important to be clear that both cohorts had a similar stage and ctDNA tumor fraction. We can explain later what tumor fraction is, because it was done in addition with a paper that we just published last week. Liquid biopsy patients were consulted to have this CGP median one day after diagnosis, versus 25 days after for patients who had their diagnosis and their liquid biopsy later on. So, from these patients, the majority of the patients, 43% of LBx-Dx were positive for an National Comprehensive Cancer Network driver, and 32% had ctDNA TF >1% but were driver negative, so that is what we call presumed true negative. From here, maybe I can explain what is tumor fraction and, in general, how we use it.  Dr. Rafeh Naqash: I think that would be great for our listeners. We see this often in more and more liquid biopsy results nowadays, and I've tried to explain it to some of my fellows also. So, it would be nice if you explain for the sake of our listeners what tumor fraction is, what does it mean clinically, can you use it in a certain way, what biological relevance does it have. Dr. Christian Rolfo: So we are analyzing another paper that came out this week in cancer research on the concept of tumor fraction and it's a new definition. So what we are doing with tumor fraction is an algorithmic calculation or mathematical calculation on the amount of DNA of the cells also taking into consideration the math, the quantity of DNA present in the sample. So we are going very low in the sensitivity of this analysis and capturing there the real informative results of the ctDNA of the liquid biopsy. So in practicality, when you see a report that says the threshold that was established in this study was more than 1% or less than 1%, so patients who have a tumor fraction of more than 1%, we can really consider this liquid biopsy informative. And also in this next publication, we compared with tissue. In patients with a tumor fraction of more than 1%, were completely 100% correspondent with what we found in the reflected tumor tissue, the NGS. But what happened in patients with a tumor fraction of less than 1%, we can say that these patients are not informative. So we need to wait for the tissue biopsy result to come in because we were able to recuperate several patients that the liquid biopsy was negative with the tissue biopsy positive. This is an important concept because we are distinguishing not only the informativeness of liquid biopsy, but also we can distinguish between patients who are considered not shedder based on what is considered a shedder. And that was a problem until this kind of introduction was a problem before with the technology because the technology wasn't very fast to distinguish the sensitivity or high sensitivity. Now, the sensitivity is no longer a problem. Maybe, there is really value of information in what we have in liquid biopsy, and using this mathematical help, we can get these patients distinguished and help more people. So that would be really interesting. Dr. Rafeh Naqash: You touched on a few important concepts here, and one question I have, and I think there's no better person to answer this question. You're the right person to answer this question for our audience. Do you think when you have a liquid biopsy tumor fraction of less than 1%, and you have a tissue that is pending with an NGS, where tissue NGS has not resulted yet, but liquid biopsy results come in and tumor fraction is less than 1%. But let's say you have a non-smoker with a typical driver mutation and clinical characteristic positive individual in the clinic, and the tumor fraction is less than 1%. How much can you trust that liquid biopsy when the tumor fraction is less than 1%. Because do you think some of these driver mutations, like you mentioned, could be low shedders and you could miss a potentially actionable mutation on a liquid biopsy if the tumor fraction is less than 1%? Is that something that you've looked at or correlated or understood what would be the clinical meaning of that? Dr. Christian Rolfo: Absolutely. So there are two concepts here. A liquid biopsy could be non-informative, and that is what we saw in this paper. So you have patients that have a liquid biopsy negative, and that we see in the clinic, a liquid biopsy negative tissue biopsy positive. That could be because the liquid biopsy is not informative, but it could be also that the patient, for some biological reason, and we don't have an answer about that, they are not shedding the ctDNA in the bloodstream, ctDNA that we can capture. What we saw in different studies, including one of the papers that we presented also in ASCO last year with a MET amplification and  METex14, for example. In the study that was the VISION study using tepotinib, you see that patients who have a liquid biopsy negative are doing a better outcome compared to a patient who have a liquid biopsy positive. So I believe that we still have patients who are not shedders for some biological reason, that could be put in together with patients who have more bone metastasis than organ metastasis, or patients who have more in location, for example in the brain. These patients are difficult to capture in ctDNA due to some biological reasons. But also you have patients who are non-shedders. For the technicality of the parts of this tumor fraction analysis, it is really important to distinguish that and we will hear more and more. So, as you say, we have already some reports in some companies like Foundation are doing, but some others like to incorporate this tumor fraction. And several in-house technologies allow also to have this kind of mathematical calculation. So that is what we are facing now, to really understand better the power of liquid biopsy. Dr. Rafeh Naqash: Now, some of the other things that your project or paper that you published with JCO PO does not necessarily cover is the payer aspect of this. Now, we've had more and more discussions, obviously, and more and more information has been highlighted with the payers that this is an important test and needs to be reimbursed, even though if you do tissue NGS, liquid biopsies are complementary to tissue. So taking both together is probably a better view of the overall tumor or the mutational status of the tumor. But one of the biggest holes in this whole process, and this is my personal experience, I want to know what you think, is that we can't order these tests when the patient is admitted to the hospital, and 50% or more patients end up getting diagnosed in the hospital during an inpatient stay. The average hospitalization for someone with lung cancer is five to seven days on average, and then another one to two weeks to get into the clinic to see an oncologist. So what would your thoughts be there? How can we improve things there in terms of, can we try to do something different so that the payers agree that, yes, you can send a liquid biopsy when the patient is admitted, because there's that 14-day Medicare rule? Has your team, or have you in particular, tried to navigate some of those issues, and what are your thoughts on how we can try to improve some of those conversations?  Dr. Christian Rolfo: Yeah, that's a really good question, because here we are talking about inequities in access to the technology and the results and it's crucial. Several of our patients, specifically in lung cancer, they are coming to our consultations or to the emergency with a very bad situation so they need to be admitted immediately. And as you say, they can be there for one month waiting for results or for recovery or for stabilization of their general condition before we can start. Several of these patients will have some biomarkers that we can target with treatment. So in other words, I will say that this is a stupid rule because we cannot have in 2024 these kinds of limitations to access to treatment when we have on one side, the FDA is doing a terrific job to get drugs approved in a very short time, and on the other side we have payers who are not understanding the concept of molecular or precision oncology.  So what we are trying to do in these cases, to be honest, is to navigate with the vendors and try to get this done. I generally send the samples because I consider that personally that it is a very crucial information. And in several cases, we have started targeted therapies while the patient is still admitted. So I think it's something that we need to put in a better effort, because already we are not doing enough for our patients, if you look at the data of the MYLUNG Consortium that was presented in ASCO some years ago on the testing performance in the community practice, 50% of the patients with lung cancer were tested there were only some in minority groups, African Americans, 39%. So I think we need to do better in education, but also from the payer side, it's really crucial that they understand this concept.  Advocacy groups have a lot of say here. They are also doing an important job on that. We are now launching with ISLC, ISLB, Lung Cancer Europe, and Longevity in a survey that is to make also the patients aware what is the importance of molecular profiling, tissue or liquid biopsy, it's very important that you get something to treat the patient and select the right treatment. And even to say, there'll be a whole other work in your case so that is really important.  Dr. Rafeh Naqash: Absolutely, I completely agree. We have made a lot of strides, but there is still a lot of room for improvement in terms of equity, access, and reimbursement.   Now, one of the things that I noticed in your paper, and you could tell me a little bit more about this, when you looked at the pre-diagnosed liquid biopsies, meaning before tissue diagnosis, 56 individuals there suspected to have lung cancer, community-based testing was identified in 53 individuals versus academic being three. This is very encouraging when you see something like this happening in the community. Did you look at that? Did you try to understand why or how that was the case? Because in a general community setting, I would think that community practices have a more complicated system of reimbursement because they are dependent on direct reimbursement, whereas in bigger academic centers, there's some leeway here and there. So did you try to understand how they were able to order this before tissue, could you give us some insights there? Dr. Christian Rolfo: Yes, I think it was not big in this specific question, but it's a very interesting topic. Because we, generally, in academia, will believe that we are doing the things in advance and we are more, compared with the practical and the general practitioners or the general colleagues in the community practice, we have more resources. But sometimes, and it's true, obviously, we have more resources in terms of research and more opportunities in terms of clinical trials in some cases. But I think we understood with this minimal example that there is an important interest among general oncologists in the community practice to get this done. And this is something we need to emphasize, because sometimes we are putting the blame on our colleagues that are outside the academic centers on this lack of testing, and it's not really true sometimes. So this is a good point to start to work together and try to get more things done for our patients and try to get also the reality.   I think one of the problems we will have in the future that we can face right now is the lack of new figures in this molecular profiling. I am referring, for example, molecular nurses or personnel that is working and helping to get this done. We need to have more people that are working in this education for the patients in the access to treatment and access to the technology, but also to navigate better these problems with payers that sometimes in some patients that seem to be overwhelming. Because when you talk about the $100 that could be extra, it's hard for some patients. So we need to be very conscious about that. So having a new figure in the hospitals and the community practices could help to test more patients.  Dr. Rafeh Naqash: And I think at the end of the day, the payers or the reimbursement mechanisms need to understand that genomics is part of the diagnosis these days. It's not ancillary, it's not an addition, but it is part of the diagnosis. I'm pretty sure you have had similar instances where you get a confusing pathology result but then a genomic result points in a certain direction. You treat the patient in that direction, and then you see the patient benefiting in the tumor shrinking, which suggests that genomics is complementary to the path diagnosis. It's not necessarily a surrogate.You can't replace pathological diagnosis, but you can use genomics as a complementary diagnosis as part of the whole paradigm of treating the entire patient. So I think we definitely need more and more conversations like the ones that you're having or your liquid biopsy consortium is having and then more education from the FDA. Of course, more legislation, more advocacy.   Going back to the paper, I did notice another interesting thing, which is, again, very encouraging is patients with lung cancer with a performance status of 2 or about had a decent proportion of testing done. Which, again, points out to the important concept of avoiding these preconceived biases that, “Hey. If somebody is not a great performance status, testing and finding something in that individual could potentially change a lot for the individual.” Do you have any personal examples from patients you have treated or seen in the clinic for our listeners where you identified something and maybe they were not doing as great initially, and then you identified something in liquid biopsy, treated them and it changed the entire course of their illness and whole trajectory for them? Dr. Christian Rolfo: Being working in lung cancer for years, everyone has this kind of patient that we see that their performance state was very bad. Obviously, as a clinician, we need to identify why the performance is bad and is deteriorating. So we see some patients in lung cancer, some of them, they can have a very important comorbidity packet that is associated with lung cancer. So in patients who have a deterioration for lung cancer, and we find a driver help in some patients that were doing a kind of a weakness, and that is something that we see in several patients, specifically in patients living with leptomeningeal disease. In some cases, when we start to do drivers that have a big impact in the crossing the blood-brain barrier, I have a good response.  I have patients that had an important recovery. So this is something we need to distinguish and sometimes when the patients seem very bad they say, “Okay, we go directly to targeted care or supportive care.” We try to test these patients as well because these patients have an important impact on the quality of life that we are treating. We will not be able to cure patients in this setting with targeted therapies, but we can certainly make an impact in the quality of life and also in our form of survival.  Dr. Rafeh Naqash: One of the other questions that comes up often when you're in a multi display team, since most cancers these days are on the multi display decision making opportunities to treat the patient the best possible way is: Who orders the liquid biopsy? I remember from my fellowship several years back, our program director Paul Walker, who is, again, an amazing lung cancer thoracic oncologist, he had advocated that our endoscopic suite folks, the bronchoscopist, whether it was pulmonary, interventional pulmonology or CT surgeons, whoever did the bronchoscopy for the first time in the patient that they would send it whenever they see the patient from the bronchs. This was around six, seven years back. And I think Paul was a little ahead of his time and I didn't necessarily understand the implications that this would have.  And now, as I progress in my own little career, I can see the vision that he had, which I think a lot of other sectors have tried to do, and I'm pretty sure you have a certain process, too. Is that something we should try to talk more and more about? Because, of course, when you do the bronch, then you get a diagnosis and the patient sees the oncologist. This whole process takes anywhere from two to three weeks, maybe even more for smaller centers. So, is that something that you're doing or you see that you're having more conversations that, “Hey. Whoever sees the patient first should be able to order the liquid biopsy.” It's not necessarily the medical oncologists, it doesn't mean I love to order sequencing results or  sequential tests, but it could cause a delay in the patient care. So, could you tell us a little bit more of that?  Dr. Christian Rolfo: So it's really important, this part, because we need to create in our institution flows that will have this very well organized. And ideally, in the ideal world will be that we have reflex tests coming from the pathologist, but it's not happened in several places, because we don't have our NGS at home, or we are sending to vendors, and sometimes we are not sending to them. So that is one of the aspects.  The second aspect, and that I think is still a problem in some treatment, is that we still have 24:30 cytologists coming out in place of covariances. And in our institution, we were working very hard with our interventional pulmonologists and interventional radiologists to get this quality of tissue appropriate, and we have a very good rate of success and issues in a very minimal quantity of patients. Obviously, some patients are very difficult to get samples, and we need to refer still with cytology. But in some cases, where our surgeons or our pulmonologists have sent in samples for NGS, and I think this is we are coordinating. “I will see this patient next week. Can you please start to order?” And here, our nurse practitioner, our nurses in the team are also playing an important role for the reason I insist in the idea to have new figures that could be these molecular navigators we can call, or molecular nurses that helping coordinate this, not only the coordination, but also in the discussion of molecular tumor boards. We did an experience like that some years ago at Maryland University, and actually it was a very important opportunity to decrease the number of quantities of issues and get the results done very quickly. So I think it's important to come to have conversations with our colleagues, pulmonologists, radiation radiologists, interventional radiologists, pulmonologists and pathologists to get this done very quickly.  Dr. Rafeh Naqash: I love the idea of molecular navigators. And of course, everybody in the current day and age, we're having staffing issues, so getting a molecular navigator would be awesome, but I'm not necessarily sure how everybody would be able to implement it. But I think in the bigger picture, whether it's molecular navigators or multi disciplinary nurse navigators in general, liaisons in general, I think we all can do a better job in trying to coordinate some of these testings. And we have tried to do that through our thoracic oncology group and of course, there's a lot of progress that needs to be made, one step at a time. Dr. Christian Rolfo: If somebody is interested in this topic on the International Society of Liquid Biopsy, we started with a project that is called a Certificate for Advanced Studies in Precision Oncology. So we are educating the healthcare team for all this process and trying to get practical insights to have this career later. Because I think it will be something that's interesting for nurses or pharmacists to get this kind of career later or get another approach in their career.  Dr. Rafeh Naqash: Thank you so much, Christian.  Now, going to not the scientific part, which I think is the most interesting part of this conversation is to talk about you and your personal journey. Could you tell us a little bit about where you started, what your career has been like, how did you progress? Because you have a lot of junior faculty that listen to this and it's always good to take inspiration from people like yourself.  Dr. Christian Rolfo: Thank you. As you can hear my accent, it's not from here. So I was born in Argentina, I did my medical degree there. And then I had the opportunity to get a scholarship in Italy. I went to Italy and I stayed there for seven years. I did my fellowship there again, and I started to know there precision oncologists. My journey started in sarcoma. And actually I was working in the group of Dr. Casali's group, a very well known sarcoma expert. And at that time we were running phase I trials for imatinib, I remember, known as GIST. I saw this kind of response and awakening of patients that were really in very bad condition, with only through this imatinib. Very little to treat that disease at that moment, a median overall survival of two months. So I started to be interested in that. Then I moved from there to Spain and met Dr. Rafael Rossell, who was my mentor. In Italy, I have also a mentor in breast cancer, Dr. Luca Gianni, one of the pioneers in breast cancer treatment. So knowing all these people and having the support of them, was really crucial.  So I think this is the first advice for junior faculty: try to choose your mentor, even if your mentor is not in your center. Like the case, for example, Rafael Rossell was not in my hospital, but he was my mentor. So having this kind of discussion, I did my PhD in EGFR mutation, at that time was the fashion, not immunotherapy, of the moment. And then from there, after eight years in Spain, I moved to Belgium. I have a short period of completing my training at MD Anderson and I went to Belgium to Antwerp University and that was the opportunity to become the Director of the phase I program in the Early Clinical Trials Unit. It was really exciting to see growing a unit, and now they continue  at the center in Belgium. My colleagues that stayed there, they are doing a terrific job of continuing this idea. And from there I went to Baltimore, three years working at Maryland University being the Director of Thoracic Oncology and early clinical trials as well. Three years after, I moved to New York, and here doing this journey in clinical research, also being the Director of Clinical Research at the Center for Thoracic Oncology.  Life has put me in different places, different cultures, different opportunities. For me it was a really good journey to be in different countries, knowing different ways to see oncology as well, and immediately to work, because it was a shock coming from Belgium to the area of Baltimore where I had the reality to discuss peer to peer conversations and things that are not usually discussed in Europe. So it was really a very nice journey to learn, to have the capacity to adapt.  That is the other thing, my second advice, if I can give advice, but if you have the opportunity to go to some place, adaptation is the most important. So try to enjoy what you're doing and try to enjoy and learn from the patients, hopefully, and contribute your knowledge as well. Dr. Rafeh Naqash: Thank you so much, Christian. Two last questions. For all the places that you visited, what is your favorite place? And what is your favorite food? Dr. Christian Rolfo: My favorite place to live, I have Italy in my heart. Obviously, Argentina is my place, family. But Italy is in my heart. And then Spain, Spain gave me my wife and my son. So I have very good memories there and it's a very nice place. Obviously, I'm Argentinian, so for me it means meat in some places, Asado, that is a typical Argentinean one. But also, I am very eager to enjoy the pasta and paella, so we have several things. Anyway, here in New York, the pizza of New York is great. It is not Italian. This new way to make pizza from New York is fantastic.  Dr. Rafeh Naqash: I can try to see you're trying to keep everybody happy in a politically correct way. Dr. Christian Rolfo: I didn't mention Belgium, but we have chocolates there.  Dr. Rafeh Naqash: That is true. Every place is special and unique in different ways.  Christian, thank you so much. This was very entertaining and very informative for me and hopefully for the audience. Thank you so much for being a part of this conversation. And thank you so much for submitting your work to JCO PO. We hope you consider JCO PO for future research in this exciting area as well.  Dr. Christian Rolfo: Thank you. Thank you very much, Rafeh, for the opportunity. And JCO Precision Oncology is a really great forum to discuss precision medicine. Congratulations for all your work. The last, if you allow me to give an advertisement here. We have our Liquid Biopsy Congress, the ISLB, the annual conference will be in Denver from 20 to 25 November, so just before Thanksgiving day. So if you are able to go there, we will have a lot of discussion on liquid biopsy like we did today. Thank you very much.  Dr. Rafeh Naqash: Thank you so much for highlighting that, and hopefully, our listeners will try to register and be part of that meeting.  Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review. And be sure to subscribe so you never miss an episode. You can find all our shows at asco.org/podcasts. 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.      

HOST: Hildy Grossman, Co-Host: Jordan Rich GUESTS: Pasi Janne, MD, Ph.D., Director, Lowe Center for Thoracic Oncology, Dana Farber Cancer Institute, and the Scientific Director of the Belfer Center for Applied Cancer Research Gabrielle Goodman, HER2 patient Bill Brand, HER2 patient Caren Suesserman, Exon 20 Group Virtual Meeting Leader and Patient Advocate Most people are … Continue reading HER2 BIOMARKER ISN'T JUST ABOUT HER Not Just a Breast biomarker! →

Gain valuable insights into the critical importance of lung cancer screening for veterans in this enlightening episode of Hope With Answers Living With Lung Cancer. Explore the unique risks faced by those who have selflessly served our nation. Learn about the occupational hazards, such as asbestos exposure and burn pits, that contribute to the alarming rates of lung cancer among veterans. Delve into the benefits of low-dose CT scans, which can detect lung cancer at earlier stages, potentially leading to more effective treatment options. As LCFA's Breath of Honor: Lung Cancer Screening for Veterans campaign kicks off, join a leading lung cancer specialist and a Navy veteran who is a lung cancer patient as they discuss the need for increased screening and the positive impact it can have on patient outcomes. Discover the curability of smaller tumors, less toxic treatment options, and the hope that lung cancer screening brings to veterans and their families. Guests Drew Moghanaki, MD, UCLA lung cancer specialist and Chief of Thoracic Oncology in the UCLA Department of Radiation Oncology, Co-Director of VA Lung Precision Oncology Program at the Greater Los Angeles VA Healthcare System Jim Pantelas, Navy Veteran, 18-year lung cancer survivor, who has worked for 15 years to increase funding for lung cancer research, improve care for all lung cancer patients, and fight the stigma associated with lung cancer. He is often on Capitol Hill lobbying to increase funding for lung cancer screening and early detection programs. Show Notes | Transcript | Video version “What I would tell vets is that if you're breathing, you can get lung cancer. If you increase the odds of getting lung cancer, which smoking does, then you should be screened. But because you were in the service, you were exposed to toxins, because you were in the service, you were exposed to living in different parts of the country or the world that may have had toxins that you're not aware of. Getting screened is a no-brainer.” – Jim Pantelas Don't miss this opportunity to learn about the latest breakthroughs and the collaborative efforts being made to combat lung cancer among our nation's heroes. Learn the answers to these questions: Why are veterans at a heightened risk for lung cancer? How many veterans are eligible for low-dose CT scans for lung cancer? What are some reasons for hesitancy among veterans to get screened for lung cancer?

Episode 55 - IP & Thoracic Oncology - Scott Oh by AABIP

Caris Precision Oncology Alliance™ Chairman, Dr. Chadi Nabhan, sits down with Dr. Charu Aggarwal, the Leslye M. Heisler Associate Professor for Lung Cancer Excellence at UPENN, and Dr. Balazs Halmos, Director, Thoracic Oncology at Montefiore. Together they discuss adjuvant and neoadjuvant therapy for resected non-small cell lung cancer (NSCLC). Topics discussed will include current treatment options, how treatment decision are made, and when treatment should be given. For more information, please visit: www.CarisLifeSciences.com/POA-Intro/

Caris Precision Oncology Alliance™ Chairman, Dr. Chadi Nabhan, sits down with Dr. Stephen Liu, Associate Professor of Medicine at Georgetown University and Director of Thoracic Oncology and Head of Developmental Therapeutics at the Georgetown Lombardi Comprehensive Cancer Center. Together they discuss the updated results of the ADAURA Trial presented at this year's ASCO meeting which demonstrated the overall survival benefit when adding osimertinib versus placebo in patients with completely resected stage IB-IIIA NSCLC, with/without adjuvant chemotherapy. For more information, please visit: www.CarisLifeSciences.com/POA-Intro/