Lung Cancer Trials at ASCO 2022: What To Expect

Mark G. Kris, MD


June 01, 2022

This transcript has been edited for clarity.

It's Mark Kris from Memorial Sloan Kettering, here today to give a quick heads-up about the lung cancer topics to be discussed at this year's ASCO meeting in Chicago.

I think we're all excited that after 3 years, we're together again in Chicago. We'll be able to see our colleagues and be able to, in my mind, do things right — meet with people and thoroughly discuss new ideas and opportunities. Particularly in the thoracic oncology space, I think these meetings have been super critical for moving the field forward.

We do not have a [lung cancer] plenary presentation this year — other diseases have taken the lead there. So the program committee did not feel there was a development of the magnitude deserving a presentation to the entire group.

In the oral presentations, you're going to find a huge discussion again focusing on the role of checkpoint inhibitors. There are going to be papers about adding other molecules to checkpoint inhibitors, for example, anti-VEGF agents and TIGIT-targeted agents, and also about some very important clinical questions about the role of chemotherapy and checkpoint inhibitors.

There are two presentations coming from investigators from the US Food and Drug Administration analyzing the data that's been submitted to them for the drug approvals and addressing, I think, two really important issues. The first is, what exactly is the role of chemotherapy with a checkpoint inhibitor in patients with PD-L1 expression greater than 50%?

The second is on the role of first-line chemotherapy in patients receiving a checkpoint inhibitor. I think both of those address important clinical questions. We're going to have presentations that will probably provide the greatest breadth and depth of data that we can have to answer these questions.

Targeted therapies are also going to be under discussion. There are presentations on EGFR-sensitizing mutations, EGFR exon 20, KRAS G12C, and also MET, so many common targets. Obviously, we need new drugs in all these areas.

The other large group of presentations is going to be in the neoadjuvant space. I think we're all excited about the data and recent approval for giving neoadjuvant nivolumab with chemotherapy. Here, you're going to see more discussions of neoadjuvant strategies.

An additional abstract, which I'm very interested in, is focused on the role of surgical quality and assessment of surgical quality metrics in patients. I think many of us noticed that when we looked at the patients in the adjuvant trial of osimertinib, there was a substantial number of patients in both arms of the trial for whom the site of failure was not metastatic disease as expected, but intrathoracic disease.

The question is, how can we improve upon those results? Is it simply a matter of insisting that modern techniques are followed? Do we need to rethink how surgery is performed, the extent of surgery, and again, look at how to do surgery better? I'm happy to have that kind of discussion. I think more and more, once again, local control may be back in the mix and we need to think about how to do a better job there.

There are many topics to be discussed at ASCO. I look forward to seeing you there. If you can't be there in person, find a way to see it either virtually or by audio. I know we're going to get some useful information. What everybody tries to do at ASCO is to give a piece of information on Friday that you can take home and use on Monday or Tuesday, and I think we're going to get that this year.

Mark G. Kris, MD, is chief of the thoracic oncology service and the William and Joy Ruane Chair in Thoracic Oncology at Memorial Sloan Kettering Cancer Center in New York City. His research interests include targeted therapies for lung cancer, multimodality therapy, the development of new anticancer drugs, and symptom management with a focus on preventing emesis.

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