Conference MDAngle: ASCO 2024
Advanced NSCLC

June 25, 2024

Conference MDAngle offers personal perspectives from conference attendees, showcasing their anticipation, quick takeaways, and insights into how the presented research will impact their patients.

The 2024 American Society of Clinical Oncology (ASCO) Annual Meeting took place in Chicago, Illinois, from May 31 to June 3. In the setting of advanced non–small cell lung cancer, the meeting offered updates on the latest advancements in research and treatment strategies through abstracts, poster presentations, and clinical symposia exploring emerging areas such as actionable mutations, novel tyrosine kinase inhibitors, and antibody-drug conjugates. 

Tejas Patil, MD

Assistant Professor, Division of Medical Oncology, University of Colorado School of Medicine; Associate Director of Clinical Affairs, University of Colorado Cancer Center, Aurora, Colorado

"There were a lot of thoracic oncology updates this session, and it made contextualizing some of the data very challenging. There was a huge volume of what I would perceive as practice-changing discussions."

Preconference Considerations

ASCO 2024: Anticipating New Data in Advanced NSCLC

Dr Patil looks forward to hearing new data on first-line approaches for KRAS G12C mutations, especially concerning high-risk somatic alteration signatures like KEAP1 or STK11, and insights into antibody-drug conjugates for second-line therapy, with a focus on TROP-2 antibody-drug conjugates. He also anticipates updates on the development of novel tyrosine kinase inhibitors targeting EGFR, ALK, and RET rearrangements, expecting significant strides in personalized treatment options for patients with advanced NSCLC.

Quick Clinical Takeaways

ASCO 2024: Practice-Changing Data for the Treatment of Advanced NSCLC

Dr Patil delves into ASCO's latest NSCLC updates, emphasizing groundbreaking studies such as LAURA, which explores the potential of early intervention with osimertinib in EGFR-mutant lung cancer post-chemoradiotherapy, and CROWN, comparing lorlatinib vs crizotinib in ALK-rearranged lung cancer. He also highlights findings from PALOMA-3 on subcutaneous vs intravenous formulations of amivantamab, BLOSSOM on dosing of osimertinib, and NRG-LU002 on locally consolidated therapy when added to immunotherapy or chemoimmunotherapy, suggesting potential shifts in thoracic oncology practice.

How Will My Patients Benefit?

The Impact of ASCO 2024: Four Key Clinical Scenarios in Advanced NSCLC

Dr Patil recounts how ASCO 2024 presented transformative shifts in NSCLC management. Lorlatinib emerged as a preferred first-line ALK inhibitor for ALK-rearranged NSCLC, while durvalumab post-chemoradiotherapy is positioned to become the new standard for limited-stage SCLC. Osimertinib gained prominence in EGFR-mutant NSCLC, supported by the LAURA trial, while results from the BLOSSOM study advise against dose escalation to 160 mg in patients with leptomeningeal disease, reinforcing a regimen of 80 mg.

Polling Question

Summary

ASCO 2024 highlighted significant advancements in the management of advanced NSCLC. The conference featured new data on first-line approaches for KRAS G12C mutations and insights into antibody-drug conjugates for second-line therapy, alongside updates on novel tyrosine kinase inhibitors targeting EGFR, ALK, and RET rearrangements. In reflecting on the conference, Dr Patil discussed how the meeting showcased practice-changing findings, including lorlatinib emerging as a preferred first-line ALK inhibitor; durvalumab's potential as the new standard for limited-stage SCLC post-chemoradiotherapy; and osimertinib's prominence in EGFR -mutant NSCLC, supported by the LAURA trial, with recommendations against dose escalation in certain cases from the BLOSSOM study. 

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