What are your top takeaways in Thoracic Cancers from ASCO 2025?

More presentations that were interesting for the future, than immediately impactful in thoracic oncology this year at the ASCO meeting.

Immediately impactful: 8006 and 8008 – Both in SCLC.

1. 8006- IMforte trial suggesting improvement in survival with the addition of maintenance lurbinectedin to atezo...

Here are my top three ASCO abstracts:

1. DeLLphi-304, presented by Dr. @Dr. First Last. While tarlatamab has already been approved for relapsed/refractory small cell lung carcinoma, the original DeLLphi-301 study administered tarlatamab predominantly in the third-line and beyond. The DeLLphi-304 study...

1. CheckMate 816

Dr. @Dr. First Last reported the planned final analysis of OS from CheckMate 816 at 5-year follow-up (f/u).

At a median f/u of 68 months, neoadjuvant NIVO + chemo demonstrated a statistically significant OS benefit vs chemo alone (median [95% CI], not reached [NR] vs 73.7 months [47...

There were many great abstracts presented at ASCO 2025, and these three stand out to me as the most important and worth discussing:

1. Abstract 8514
   Phase 3 study of benmelstobart in combination with chemotherapy, followed by sequential combination with anlotinib for the first-line treatment of locally ...

1. Tarlatamab in ES-SCLC
   First new agent approved for 2L SCLC in many years. Novel immunotherapeutic agent, BiTE.
2. OS in CM816
   The second neoadjuvant study to show an OS benefit, this regimen only includes the neoadjuvant portion.
3. Time of immunotherapy Phase III Trial
   First phase III trial to show early ...

1. NeoADAURA
2. SWOG/NRG S1914
3. IMforte

ASCO 2025 was again great for advances in SCLC:

1. The DeLLphi-304 trial also read out as positive for tarlatamab as 2L treatment for ES-SCLC vs chemo with mOS 13.6 vs 8.3 mo (HR of 0.6). The safety profile was as expected, and also employed 6-8 hr of outpatient monitoring later in the trial instead o...

1. Small cell- big changes! We now have the real star of ASCO25, STARlatamab, completely transforming the 2nd line ES-SCLC treatment landscape based on DeLLphi-304 with a whopping HR of 0.60 over SOC chemotherapy, and stated poorly performing SOC chemotherapy sliding gently into the maintenance phase ...

Here are a few thoughts:

The BL-B01D1 EGFR x HER3 bispecific ADC is showing nice efficacy signals in NSCLC, and we saw really impressive responses in Exon 20 EGFR-mutant patients (though a small cohort), as well as a signal in SCLC. Bispecifics are an exciting approach for ADCs as they may improve t...

Here is my top three list of thoracic advancement with my comments in ASCO 2025 with publication references:

1. Overall Survival with Neoadjuvant Nivolumab Plus Chemotherapy in Lung Cancer (Forde et al., ASCO, 2025)

Summary:
This phase 3 trial demonstrated that three cycles of neoadjuvant nivolumab com...

For me, there were two major trials that were immediately practice-changing from ASCO 2025.

1. Tarlatamab is the new standard of care for small cell lung cancer after progression on platinum-etoposide chemotherapy.
   In my opinion, the DeLLphi-304 trial (Mountzios et al., PMID 40454646) was the single mos...

The following were the top 3 from my perspective, answering the questions below:

1. Are 3 cycles of chemoimmunotherapy administered in the neoadjuvant-only setting for EGFR/ALK wild-type NSCLC sufficient to result in OS benefit?
   Answer: Yes. An update of CheckMate 816 (LBA8000) confirmed that indeed 3 c...