WCLC 2022 – hybrid, vienna
Lecture Board: Maximilian Hochmair, MD; Michael Thomas, MD
Medical Writer: Dr. Judith Moser
Preface – WCLC 2022
The International Association for the Study of Lung Cancer (IASLC) 2022 World Conference of Lung Cancer (WCLC) was held in Vienna, Austria, and virtually from 6th to 9th August and saw leading scientists, researchers and patient advocates from around the world gather again to discuss the most exciting updates in the field of lung cancer and thoracic oncology with key updates summarized in 380 invited lectures, 60 oral and 84 mini oral presentations, as well as almost 1,000 posters and ePosters.
Promising findings across oncogenic targets
The EGFR-MET bispecific antibody amivantamab is being assessed in combination with the third-generation EGFR tyrosine kinase inhibitor lazertinib in the multicohort CHRYSALIS-2 trial in patients with EGFR-mutant non–small-cell lung cancer (NSCLC). Results from the cohort receiving amivantamab/lazertinib in addition to carboplatin/pemetrexed (n = 20) were presented at WCLC 2022 by Marmarelis et al.
Stage I-III disease: surgical and systemic options
Lobar resection has been the surgical standard of care for cT1 N0 non–small-cell lung cancer (NSCLC) for decades, while sublobar resection (SLR) was reserved for a subset of patients with marginal pulmonary reserve. However, the recently published JCOG0802/WJOG4607L study showed that in fit patients with cT1a N0 tumors sized ≤ 2 cm, segmentectomy was not inferior to lobectomy regarding overall survival (OS).
Immune-based strategies are raising hope in small-cell tumors
Especially after frontline chemoimmunotherapy, treatment options are limited in patients with small-cell lung cancer (SCLC). Notch ligand delta-like ligand 3 (DLL3) represents a potential therapeutic target as it is aberrantly expressed on the surface of SCLC cells. By binding both DLL3 and CD3, the bispecific T cell engager (BiTE©) tarlatamab induces T-cell–mediated tumor lysis.
Checkpoint inhibition: subgroups, combination maintenance and retreatment
The global, randomized, open-label, phase III POSEIDON trial was conducted to test the PD-L1 antibody durvalumab with or without the CTLA-4 inhibitor tremelimumab in addition to chemotherapy Q3W for 4 cycles compared to platinum-based chemotherapy Q3W for up to 6 cycles.
EXPERT VIDEOS
All video interviews from virtual WCLC 2022
Filiz Oezkan depicts the most important factors influencing the choice of treatment in patients with PD-L1-positive NSCLC, explains how the 50 % PD-L1 threshold affects the treatment selection and explains which treatment options appear favorable in the setting of PD-L1 levels below 1 % while also taking into account possible challenges associated with biomarker testing for PD-L1 in NSCLC.
Alexander Louie explains which modes of imaging can be particularly helpful when clinicians face unique diagnostic challenges in lung cancer patients with pneumonitis after chemoradiotherapy and immunotherapy. Moreover, he summarizes what needs to be considered regarding pneumonitis treatment and highlights current and future pneumonitis research areas.
Maximilian Hochmair highlights relevant study data in the field of EGFR-mutated advanced lung cancer, novel therapies in the management of KRAS p.G12C mutation as well as MET exon 14 skipping mutations in NSCLC. He draws attention to antibody drug conjugates in the management of NSCLC patients as well as the optimal treatment sequence in the ALK-positive setting.
Federico Cappuzzo discusses the effectiveness and limitations of minimal residual disease (MRD) assessment in the detection of patients with early-stage lung cancer at low risk of relapse and highlights which clinical investigations regarding the clinical impact of MRD assessments in solid tumors are ongoing and what we can expect from them in the future.
Helmut Popper talks about the characteristics of the recently defined molecular subtypes of small-cell lung cancer (SCLC), outlines if this subtyping is suitable for therapeutic decision-making and gives an overview about potential new therapeutic targets in the field of SCLC.
Julia Rotow summarizes the achievements of EGFR tyrosine kinase inhibitors in the neoadjuvant therapy of lung cancer regarding multiple clinical outcomes, discusses if modification of the disease biology will be a feasible treatment goal in the setting of EGFR-directed neoadjuvant treatment sometime and talks about the individualization of neoadjuvant treatment of oncogene-driven lung cancer.