What are your top takeaways in Thoracic Cancers from ASCO 2024?

1. ADRIATIC – The addition of consolidation durvalumab after chemo/RT for people with limited-stage SCLC resulted in a 10% improvement in 3-year overall survival, which hopefully means an equivalent improvement in cure rate. Importantly, unlike many trials that are now presented way too early, this on...

1. LAURA trial comparing indefinite osimertinib with placebo in the management of locally advanced unresectable NSCLC. Last piece of the puzzle when it comes to the use of osimertinib in frontline for stage 4 EGFR-mutated NSCLC as per FLAURA and stage IB-III in the adjuvant setting as per ADAURA studi...

1. LAURA study - This study establishes a new standard of care treatment for unresectable stage III NSCLC that harbors an activating EGFR mutation.
   
   
2. ADRIATIC study - This study establishes a new standard of care treatment for limited-stage small cell lung cancer and is the first advance in the systemi...

1. LAURA study:

- This completes the trifecta for EGFR TKI targeted therapy on the 20th anniversary this year marking the discovery of EGFR activating mutations! We now have approved indications for targeted therapy across all disease stages for patients with classical EGFR mutations. The latest LAUR...

My big takeaways were

1. LAURA - Beyond the impressive PFS data with consolidation osimertinib, I think it highlights the NEED for NGS testing for our lung cancer patients at all stages.
2. ADRIATIC - I will be using consolidation durvalumab (when approved) for my patients with LS-SCLC.
3. CROWN - I will be ...

1. CROWN [Solomon et al., PMID 38819031] - This was a practice-changing, 5-year update on the randomized phase 3 clinical trial of lorlatinib versus crizotinib in patients with untreated ALK-rearranged NSCLC. While alectinib remains an excellent drug in this space, there is still a 20% intracranial pr...

1. Interim ADRIATIC trial: Phase III trial in LS-SCLC: 3 arms trial that randomized patients with LS-SCLC after completion of chemo-radiation to 1) Durvalumab + placebo followed by durvalumab; 2) Durvalumab+Tremelimumab followed by durvalumab; 3) placebo+placebo followed by placebo. Only results from ...

What a great ASCO for lung cancer patients!

1. ADRIATIC trial: practice changing for LS-SCLC patients to use durva post-CRT.
2. LAURA trial: practice changing to use osi post-CRT.
3. CROWN trial: practice changing to use lorlatinib upfront.