Isabel Preeshagul, DO, MBS, and colleagues share updates from across the lung cancer space as discussed in a recent State of the Science Summit.

Lung Cancer State of the Science Summit Recap

 on Lung Cancer chaired by Isabel Preeshagul, DO, MBS, she and colleagues highlight key takeaways from their presentations, which covered updates from across the lung cancer treatment paradigm. Preeshagul is a thoracic medical oncologist and assistant attending physician at Memorial Sloan Kettering Cancer Center.

Preeshagul discusses the clinical implications of 

data from the phase 3 ADRIATIC trial (NCT03703297)

, which showed that patients with limited-stage small cell lung cancer (LS-SCLC) whose disease has not progressed following platinum-based concurrent chemoradiotherapy experienced a median overall survival of 55.9 months (95% CI, 37.3-not evaluable) when treated with durvalumab (Imfinzi; n = 264) compared with 33.4 months (95% CI, 25.5-39.9) when given placebo (n = 266; HR, 0.73; 95% CI, 0.57-0.93; 

 = .0104). Based on these data, In August 2024, 

 to the supplemental biologics license application seeking the approval of durvalumab for the treatment of patients with LS-SCLC whose disease has not progressed following platinum-based concurrent chemoradiotherapy.

Next, Alissa J. Cooper, MD, a thoracic medical oncologist and assistant attending physician at Memorial Sloan Kettering Cancer Center, highlights the evolving understanding of the role of antibody-drug conjugates in the treatment of patients with non–small cell lung cancer (NSCLC). Cooper expands on the challenges posed in the clinical study of these agents and how biomarkers could help refine the understanding of which patients may benefit most from these agents.

Kathryn C. Arbour, MD, a thoracic medical oncologist and assistant attending physician at Memorial Sloan Kettering Cancer Center, then delves into the current treatment paradigm for patients with NSCLC harboring 

 G12C mutations. She details the prevalence of 

 mutations in this patient population and how ongoing research could build upon the targeted therapies available for those with 

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Lung Cancer State of the Science Summit Recap | Chaired by: Isabel Preeshagul, DO, MBS

Dr Cooper on Considerations to Help Guide ADC Use in Second-Line NSCLC

Alissa J. Cooper, MD, thoracic oncologist, Memorial Sloan Kettering Cancer Center, highlights key findings and considerations from the 

phase 3 TROPION-Lung01 trial (NCT04656652)

, which compared datopotamab deruxtecan (Dato-DXd), an antibody-drug conjugate (ADC), with docetaxel as second-line treatment in advanced or metastatic non–small cell lung cancer (NSCLC).

Results from the trial demonstrated a statistically significant improvement in median progression-free survival (PFS) with Dato-DXd compared with docetaxel. Patients who received Dato-DXd (n = 299) achieved a median PFS of 4.4 months (95% CI, 4.2-5.6) vs 3.7 months (95% CI, 2.9-4.2) in the docetaxel arm (n = 305; HR, 0.75; 95% CI, 0.62-0.91; 

 =.004). However, the improvement was seen as modest given the expectations for this novel therapy, raising questions regarding the optimal use of ADCs in NSCLC, Cooper says. Additional results indicated that the objective response rate was 26.4% (95% CI, 21.5%-31.8%) in the Dato-DXd arm vs 12.8% (95% CI, 9.3%-17.1%) in the docetaxel arm, with a median duration of response of 7.1 months (95% CI, 5.6-10.9) vs 5.6 months (95% CI, 5.4-8.1), respectively.

Cooper notes that an important finding from the trial was the stratification by histology, which revealed that the efficacy of Dato-DXd varied significantly between NSCLC subtypes. Dato-DXd showed greater efficacy in patients with adenocarcinoma. Conversely, in patients with squamous cell carcinoma, docetaxel outperformed Dato-DXd, suggesting potential harm in this subgroup.

Although the TROPION-Lung01 trial highlights the potential role of ADCs in lung cancer, particularly in adenocarcinoma, further research is needed to refine patient selection strategies, optimize efficacy, and minimize exposure to ineffective or potentially harmful therapies. Cooper concludes that a deeper investigation into biomarkers is essential to guide treatment decisions for ADCs like Dato-DXd, focusing not only on histology but also on molecular characteristics that may predict response or resistance.

Alissa J. Cooper, MD, discusses insights from the TROPION-Lung01 trial that may help guide antibody-drug conjugate use in second-line NSCLC. 



Alissa J. Cooper, MD

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Lung Cancer State of the Science Summit Recap | Chaired by: Isabel Preeshagul, DO, MBS

Dr Cooper on Considerations to Help Guide ADC Use in Second-Line NSCLC