📬 Lung/Head and Neck/Thymoma Intelligence Digest — Week 2026-W41
ASTRO26 and WCLC26 dominate: I-SABR reports a 6-year OS benefit while S1914 shows atezolizumab adds only toxicity to SBRT, MAVERICK and NRG-CC009 reshape brain management in SCLC, OptiTROP-Lung05 brings a TROP2 ADC into first-line PD-L1-positive NSCLC, and MARIPOSA resistance biology, FLAURA2 long-term safety and upfront NGS all draw debate.
⚡ TL;DR
🐦 Twitter / 🦋 Bluesky
- MARIPOSA resistance analysis in JTO: amivantamab-lazertinib suppresses MET amplification and secondary EGFR mutations versus osimertinib — Amivantamab-lazertinib reduces common resistance mechanisms versus osimertinib, suggesting the regimen is changing the underlying biology of EGFR-mutant disease
- FLAURA2 long-term safety: grade 3+ toxicity is front-loaded and the pemetrexed renal signal fuels a maintenance-stopping debate — Grade 3+ treatment-related AEs fell from 43% during induction to 25% with pemetrexed maintenance and 14% with osimertinib alone
- SBRT plus immunotherapy in early-stage NSCLC: I-SABR shows a 6-year survival benefit at ASTRO26 as S1914 publishes negative in the Lancet — S1914 (atezolizumab): 2-year OS 82% vs 82%, HR 1.04, with more grade ≥3 toxicity; I-SABR (nivolumab): 6-year OS 69% vs 55%, HR 0.51
- JTO meta-analysis of HER2-directed therapy in NSCLC favours TKIs over ADCs, as resistance to zongertinib becomes the open question — The JTO review and meta-analysis of HER2-directed therapies suggests preference for TKIs over ADCs given high response rates, particularly in YVMA insertion, and safety
Full details below ↓
📄 What's Being Published
Cancer and the microbiome: from association to intervention. — Moradi Ali et al., Lancet Oncol
This review describes the gut microbiome as a clinically modifiable determinant of efficacy and toxicity across systemic cancer therapies. The most mature evidence comes from patients receiving immune checkpoint inhibitors. In melanoma, NSCLC and renal cell carcinoma, higher microbial diversity and enrichment of immunostimulatory pathways are associated with improved checkpoint inhibitor response and survival. Antibiotics and proton pump inhibitors are linked to inferior outcomes through microbiome disruption. Faecal microbiota transplantation, diet, prebiotics, probiotics and live biotherapeutics remain investigational.
Clinical bottom line: Nothing here changes practice today. It does support avoiding unnecessary antibiotics and proton pump inhibitors around checkpoint inhibitor therapy in lung cancer, while microbiome interventions stay investigational.
Toripalimab consolidation after chemoradiotherapy in limited-stage small cell lung cancer: a phase II, randomized controlled study (GASTO-1052A). — Zhang Pengxin et al., J Immunother Cancer
98 patients with LS-SCLC after CCRT were randomized to toripalimab consolidation (n=49) or observation (n=49), and the trial was prematurely terminated. Median PFS was not reached with toripalimab vs 14.1 months with observation (HR 0.55; 95% CI 0.31 to 0.96). Median OS was not reached vs 30.3 months (HR 0.39; 95% CI 0.19 to 0.80). Objective responses occurred in 14 of 23 (60.9%) vs 9 of 24 (37.5%) patients. Grade 3 pneumonitis or radiation pneumonitis occurred in 2 patients (4.2%) vs 1 (2.0%), with no grade 4 or 5 events.
Clinical bottom line: This small, prematurely terminated phase II supports, but does not establish, PD-1 consolidation after chemoradiotherapy in limited-stage SCLC. Durvalumab already holds the evidence base here, so toripalimab is an alternative only where it is the available agent.
Real-World Association Between Up-Front Next-Generation Sequencing and Overall Survival in Advanced Non-Small Cell Lung Cancer in the United States. — Scott Susan C et al., JCO Precis Oncol
This retrospective cohort included 13,139 patients with aNSCLC: 6,210 with up-front NGS, 2,697 with up-front non-NGS testing and 2,824 with NGS after 1L initiation. Targeted therapy use was higher with up-front NGS than with NGS after 1L initiation (22.6% v 14.8%, P < .0001). Median OS was 20.9 months with up-front NGS vs 17.5 months with up-front non-NGS and 18.2 months with NGS after 1L (P < .005). Multivariable analyses attributed the OS benefit primarily to treatment.
Clinical bottom line: This analysis strengthens the operational case for sequencing before first-line therapy in advanced NSCLC. However, its survival claim is confounded by which patients can afford to wait for results. Treat it as support for faster testing, not proof that testing itself prolongs life.
Prolonged survival after systemic immune reactivation by aglatimagene besadenovec plus valacyclovir in immune checkpoint inhibitor-refractory non-small cell lung cancer. — Aggarwal Charu et al., J Immunother Cancer
This open-label phase 2a enrolled 76 patients: 73 received at least one dose, and 46 formed the evaluable per-protocol population. Median OS was 14.3 months in the 73-patient safety population and 24.5 months (95% CI 16.0 to 33.8) in the 46-patient evaluable population. In the evaluable population, ORR was 10.9% (5/46) and disease control rate 71.7% (33/46). No grade 4 treatment-related adverse events or treatment-related deaths occurred, and 10/73 patients (13.7%) had grade 3 events.
Clinical bottom line: This intratumoral gene therapy, with a 10.9% response rate and encouraging per-protocol survival in checkpoint inhibitor–refractory NSCLC, remains a trial option only. Do not read the per-protocol survival figure as an effect size until the randomized trial reports.
Palliative Care for Advanced Cancer in Medicare Advantage and Physician Networks. — Hu Xin et al., JAMA Netw Open
Among 135,402 beneficiaries with distant-stage cancers, 32.3% were in Medicare Advantage and 67.7% in traditional Medicare. Medicare Advantage beneficiaries had higher 6-month cumulative incidence of palliative care (13.3% vs 9.3%; AHR 1.39, 95% CI 1.35-1.44; P < .001). After matching on treating oncologist, this difference disappeared (AHR 1.05, 95% CI 0.98-1.12; P = .19). Medicare Advantage was associated with lower systemic therapy receipt (-5.38 percentage points) and higher hospice enrollment (3.42 pp), and both differences persisted after matching.
Clinical bottom line: For oncologists treating advanced lung cancer, the apparent palliative-care advantage of Medicare Advantage reflects which oncologists are in-network. The lower systemic therapy use and higher hospice enrollment under Medicare Advantage persist after matching and deserve scrutiny at the plan level.
🗂 Every paper considered this week, including the ones that didn’t make it →
🗣️ What People Were Discussing This Week
How these are chosen: filtered for clinical relevance, grouped by the new development discussed, then ordered by engagement (bookmarks and reposts).
MARIPOSA resistance analysis in JTO: amivantamab-lazertinib suppresses MET amplification and secondary EGFR mutations versus osimertinib
Hayashi et al. found that amivantamab-lazertinib reduces common resistance mechanisms vs osimertinib, which suggests the regimen changes the underlying biology of EGFR-mutant disease. MET amplification and secondary EGFR mutations (C797S/L718X/G724X) were both less frequent, with no significant increase in other known pathways. Overall survival in MARIPOSA also favoured the combination. Clinicians expect HER2 and cell-cycle alterations to rise as MET and C797S are suppressed, much as MET and C797S replaced T790M after osimertinib. The debate is whether this argues for combination first-line therapy in everyone, or simply shifts which second-line drug needs to be ready.
Key numbers: MET amplification 3.4% vs 13.1% (p=0.002) · 2ry EGFR mutations 1.4% vs 7.6% (p=0.01) · OS HR 0.75 · 3-year OS 60% vs 51%
Discussed by: @mgonzalezvelMD, @Jaskirat__SR, @RManochakian, @RManochakian, @Latinamd
FLAURA2 long-term safety: grade 3+ toxicity is front-loaded and the pemetrexed renal signal fuels a maintenance-stopping debate
In FLAURA2, grade 3+ treatment-related AEs are front-loaded: they peak during induction, fall with pemetrexed maintenance, and fall further with osimertinib alone. The renal signal with prolonged pemetrexed was flagged as worth monitoring. Some read the update as reinforcing osimertinib plus chemotherapy as the preferred first-line standard in EGFR-mutant NSCLC. Others cite renal toxicity, edema and chronic fatigue as reasons they usually advise stopping maintenance. The open question is how long pemetrexed maintenance should continue before switching to osimertinib alone.
Discussed by: @dplanchard, @Dr_Oncologista, @drgandara, @dr_yakupergun
Sources cited: Lung Cancer
SBRT plus immunotherapy in early-stage NSCLC: I-SABR shows a 6-year survival benefit at ASTRO26 as S1914 publishes negative in the Lancet
Two randomized trials adding immunotherapy to SBRT in node-negative early-stage NSCLC now point in opposite directions. In S1914, now in the Lancet with an updated 2-year readout, peri-SBRT atezolizumab in high-risk inoperable patients increased toxicity, including two grade 5 respiratory events, without improving PFS or OS; the trial closed early for futility. At ASTRO26, the 6-year update of the randomized phase II I-SABR trial showed that four doses of nivolumab with SABR improved event-free and overall survival with manageable toxicity, which investigators link to persistent cytotoxic T-cell activation. Siva and Yom wrote an accompanying Lancet commentary. The open question is whether the difference is the agent, the schedule or patient selection, and which patients, if any, should receive immunotherapy with SBRT outside a trial. For now, SBRT alone remains the standard.
Key numbers: S1914: 2-y PFS 66% vs 67%, HR 0.93 · 2-y OS 82% vs 82%, HR 1.04 · Grade ≥3 TRAEs 12% vs 3% — I-SABR: 6-y EFS 55% vs 32%, HR 0.48 · 6-y OS 69% vs 55%, HR 0.51
Discussed by: @_ShankarSiva, @JoeChangMD, @CJTsaiMDPhD, @OncoAlert, @stanleytor, @masanaka39
→ View representative tweets: @_ShankarSiva · @JoeChangMD
Sources cited: The Lancet (S1914) · The Lancet (Siva/Yom commentary) · ASTRO 2026 presentation (I-SABR)
JTO meta-analysis of HER2-directed therapy in NSCLC favours TKIs over ADCs, as resistance to zongertinib becomes the open question
A JTO review and meta-analysis favours TKIs over ADCs on response rate, particularly in YVMA insertion, and on safety. Zongertinib is described as rapidly becoming the standard of care for HER2-mutant NSCLC, with sequential biopsies key to understanding resistance. Sevabertinib now carries the identical indication under accelerated approval, but with 7 warnings vs 4 for zongertinib, and ocular toxicity unique to sevabertinib. Clinicians debate whether the meta-analysis settles TKI-first sequencing, or whether ILD risk versus daily diarrhoea makes it a patient-by-patient decision.
Discussed by: @StephenVLiu, @dplanchard, @phsiao4, @GlopesMd
Sources cited: JTO
A 20-year lung SBRT registry of more than 1,100 patients compares single versus multi-fraction treatment for inoperable stage I NSCLC
Greg Videtic presented a 20+ year update from a registry of more than 1,100 patients comparing single- versus multi-fraction lung SBRT for medically inoperable stage I NSCLC. The debate is whether single-fraction treatment is now defensible as the default, or whether multi-fraction should remain standard outside selected peripheral tumours.
Discussed by: @DrewMoghanaki, @stanleytor, @CJTsaiMDPhD
Sources cited: The Lancet
Oligometastatic and oligoprogressive NSCLC: the Great Debates split on whether local therapy adds survival when systemic therapy works
One side argued that, based on trials so far, local ablative therapy in oligoremnant disease adds no survival advantage when systemic therapy is effective. Dr Sarah Goldberg distinguished oligoprogression from oligoremnant disease and won the debate, arguing for local therapy in select cases even in EGFR and ALK disease. CCTG BR38 tested consolidative radiotherapy to block oligoprogression, and the phase III CURB2 trial is enrolling stage IV patients. The open question is which oligoprogressive patients gain from SBRT rather than a change or continuation of systemic therapy.
Discussed by: @Jani_Chinmay, @DrewMoghanaki, @Latinamd, @GlopesMd
Sources cited: CCTG BR38: Randomized Phase III Trial of Consolidative Use of Radiotherapy to Block Oligo… (JCO Oncology Advances, 2026)
OptiTROP-Lung05: sac-TMT plus pembrolizumab quadruples PFS versus pembrolizumab alone in first-line PD-L1-positive NSCLC, but the comparator is contested
Sac-TMT plus pembrolizumab improved PFS and response over pembrolizumab alone, with benefit across PD-L1 levels but more grade ≥3 toxicity. Overall survival is immature. The comparator was pembrolizumab alone rather than platinum-based chemoimmunotherapy, so the trial does not establish whether ADC plus IO should replace chemotherapy plus IO. Clinicians are split on whether OptiTROP-Lung06 must read out before practice changes.
Key numbers: PFS NR vs 5.7 mo, HR 0.35 · ORR 70.2% vs 42.0% · TPS 1–49% HR 0.28 · TPS ≥50% HR 0.47 · Grade ≥3 TEAEs 55% vs 31%
Discussed by: @Dr_Oncologista, @GlopesMd, @jennifermarksmd, @Joshua_Reuss
Sources cited: The Lancet · OncoDaily
COPERNICUS at WCLC26: supportive care plus subcutaneous amivantamab-lazertinib cuts rash, VTE and infusion reactions versus MARIPOSA
COPERNICUS applied COCOON supportive care strategies to first-line subcutaneous amivantamab plus lazertinib in EGFR-mutant NSCLC. Rates of paronychia, rash, VTE, infusion reactions and first-year discontinuation were all lower than published MARIPOSA figures. The debate is whether this changes the monotherapy-versus-combination calculus, or whether a comparison with historical MARIPOSA rates is too soft to rely on.
Key numbers: Paronychia 35% vs 50% · Rash 25% vs 55% · VTE 3% vs 23% · IRR 3% vs 55% · AESI discontinuation <1% vs 9%
Discussed by: @BalazsHalmosMD, @VJOncology, @Latinamd
AstraZeneca's $2B Summit deal moves ivonescimab into ADC combination trials across tumor types
AstraZeneca is partnering with Summit Therapeutics to develop ivonescimab, a VEGF/PD1 bispecific, particularly in ADC combinations. Days after a 2 billion dollar investment, AstraZeneca and Daiichi Sankyo moved Datroway into a phase 3 combination with ivonescimab, with plans to expand into lung cancer. No combination efficacy data exist yet. Given OptiTROP-Lung05's 55% grade ≥3 toxicity, the question is whether a TROP2 ADC can be stacked on dual PD-1 and VEGF blockade without prohibitive cumulative toxicity.
Discussed by: @EladSharonMD, @drgandara, @Tony_Calles
Sources cited: AstraZeneca press release
Tarlatamab's CNS data in JTO: 39% intracranial response and safe treatment beyond isolated CNS progression
Tarlatamab showed meaningful intracranial activity, including in active, untreated brain metastases that trials excluded. Treatment beyond isolated CNS progression with local therapy appeared efficacious and safe. Concurrent CNS radiation produced no grade ≥3 ICANS events. Clinicians ask whether this justifies continuing tarlatamab with local therapy at isolated CNS progression rather than switching systemic therapy.
Key numbers: Intracranial ORR 39% · Median 4.3 extra months on treatment beyond CNS progression
Discussed by: @LauraAlderMD, @mgonzalezvelMD, @IASLC
Sources cited: Elsevier
ASTRO26 head and neck de-escalation: TRINITY, HYDRA and ctHPVDNA-adapted adjuvant RT all test smaller treatment
TRINITY tested reduced dose and volume chemoradiotherapy after transoral robotic surgery and reported excellent PFS. HYDRA tested hypofractionated RT with decreased cisplatin; it performed well in HPV-positive disease, with HPV-negative still to be determined. In a ctHPVDNA-adapted study, the ctDNA-negative group still received reduced-dose RT. A pooled analysis supported keeping iENE patients in de-escalation trials. The debate is which lever — dose, volume, cisplatin or biomarker selection — is safe to adopt outside a trial.
Discussed by: @CJTsaiMDPhD, @AriRosenbergMD, @xrtGenomics
JNCI phase II randomized trial of proton therapy versus IMRT in unilateral head and neck cancer, with an ASTRO26 oropharynx analysis showing no OS difference
A phase II randomized study in JNCI compared proton therapy with IMRT in unilateral head and neck cancer. A companion ASTRO26 analysis found no overall survival difference between protons and photons in oropharyngeal cancer. The question is which toxicity endpoint still justifies the cost and access barrier of proton therapy.
Discussed by: @CJTsaiMDPhD, @xrtGenomics
Sources cited: PubMed
Concomitant medications and tarlatamab: antibiotics linked to 40% versus 73% one-year survival in ES-SCLC
In tarlatamab-treated ES-SCLC, five common drug classes were linked to worse overall survival. Antibiotics gave the strongest signal: 1-yr survival 40% vs 73%. Opioids, acetaminophen, steroids above 10 mg/d prednisone-equivalent and benzodiazepines were also tied to shorter OS, while statins, PPIs, SSRIs, antihistamines and PEG showed no adverse signal. The authors call the analysis observational and hypothesis-generating, which leaves open whether the antibiotic signal is a microbiome effect or a marker of sicker patients.
Discussed by: @LauraAlderMD, @mgonzalezvelMD, @BZhangMD
Sources cited: ScienceDirect
🔥 Top Ranked Tweets
Gil Morgan, MD @weoncologists
RT @OncoAlert: In Collaboration with our partners at ASTRO we continue our coverage of #ASTRO26 🚨
SIX-YEAR OVERALL SURVIVAL OF NIVOLUMAB FOLLOWING STEREOTACTIC ABLATIVE RADIOTHERAPY IN EARLY-STAGE NON-SMALL CELL LUNG CANCER: RANDOMIZED I-SABR TRIAL
Presented by Dr. Joe Chang🇺🇸
@JoeChangMD, @StevenLin_MDPhD, @StephenChunMD, @MehmetAltanMD, @aileenbchen, @pamsharmamdphd, @JHeymach
This randomized phase II trial evaluated SABR ☢️ alone versus SABR plus four doses of nivolumab (I-SABR) in 141 patients with node-negative, early-stage or isolated recurrent #NSCLC 🫁 .
➡️ After nearly 6 years of follow-up, I-SABR significantly improved overall survival (70% vs. 56%) and event-free survival (53% vs. 32%), with manageable toxicity and low rates of severe nivolumab-related adverse events.
✅️ Findings support combining SABR with immunotherapy in appropriately selected patients.
Social Champtions
@DrewMoghanaki, @themednet, @nadinehousri, @IAbuGheidaMD, @lauren_henke, @TugceKutukMD, @ARRO_org, @sarthakshah097, @P_Shams_, @CJTsaiMDPhD, @TylerSbrt, @barrosonco, @AlexisNarvaezMD, @OncoAlert, @CancerNetwrk , @ASTRO_org , @PRJeffWhite
OncoAlert RT Faculty
@MKnoll_MD @HenningWillers @fumikochino @_ShankarSiva
@PercyLeeMD @Icro_Meattini @ErinGillespieMD @seanmmcbride @NiuSanford @to_be_elizabeth
🔖 8 ❤️ 36 🔁 28 👁 2,811
OncoAlert @OncoAlert
RT @OncoAlert: In Collaboration with our partners at ASTRO we continue our coverage of #ASTRO26 🚨
SIX-YEAR OVERALL SURVIVAL OF NIVOLUMAB FOLLOWING STEREOTACTIC ABLATIVE RADIOTHERAPY IN EARLY-STAGE NON-SMALL CELL LUNG CANCER: RANDOMIZED I-SABR TRIAL
Presented by Dr. Joe Chang🇺🇸
@JoeChangMD, @StevenLin_MDPhD, @StephenChunMD, @MehmetAltanMD, @aileenbchen, @pamsharmamdphd, @JHeymach
This randomized phase II trial evaluated SABR ☢️ alone versus SABR plus four doses of nivolumab (I-SABR) in 141 patients with node-negative, early-stage or isolated recurrent #NSCLC 🫁 .
➡️ After nearly 6 years of follow-up, I-SABR significantly improved overall survival (70% vs. 56%) and event-free survival (53% vs. 32%), with manageable toxicity and low rates of severe nivolumab-related adverse events.
✅️ Findings support combining SABR with immunotherapy in appropriately selected patients.
Social Champtions
@DrewMoghanaki, @themednet, @nadinehousri, @IAbuGheidaMD, @lauren_henke, @TugceKutukMD, @ARRO_org, @sarthakshah097, @P_Shams_, @CJTsaiMDPhD, @TylerSbrt, @barrosonco, @AlexisNarvaezMD, @OncoAlert, @CancerNetwrk , @ASTRO_org , @PRJeffWhite
OncoAlert RT Faculty
@MKnoll_MD @HenningWillers @fumikochino @_ShankarSiva
@PercyLeeMD @Icro_Meattini @ErinGillespieMD @seanmmcbride @NiuSanford @to_be_elizabeth
🔖 8 ❤️ 36 🔁 28 👁 2,811
OncoAlert @OncoAlert
In Collaboration with our partners at ASTRO we continue our coverage of #ASTRO26 🚨
SIX-YEAR OVERALL SURVIVAL OF NIVOLUMAB FOLLOWING STEREOTACTIC ABLATIVE RADIOTHERAPY IN EARLY-STAGE NON-SMALL CELL LUNG CANCER: RANDOMIZED I-SABR TRIAL
Presented by Dr. Joe Chang🇺🇸
@JoeChangMD, @StevenLin_MDPhD, @StephenChunMD, @MehmetAltanMD, @aileenbchen, @pamsharmamdphd, @JHeymach
This randomized phase II trial evaluated SABR ☢️ alone versus SABR plus four doses of nivolumab (I-SABR) in 141 patients with node-negative, early-stage or isolated recurrent #NSCLC 🫁 .
➡️ After nearly 6 years of follow-up, I-SABR significantly improved overall survival (70% vs. 56%) and event-free survival (53% vs. 32%), with manageable toxicity and low rates of severe nivolumab-related adverse events.
✅️ Findings support combining SABR with immunotherapy in appropriately selected patients.
Social Champtions
@DrewMoghanaki, @themednet, @nadinehousri, @IAbuGheidaMD, @lauren_henke, @TugceKutukMD, @ARRO_org, @sarthakshah097, @P_Shams_, @CJTsaiMDPhD, @TylerSbrt, @barrosonco, @AlexisNarvaezMD, @OncoAlert, @CancerNetwrk , @ASTRO_org , @PRJeffWhite
OncoAlert RT Faculty
@MKnoll_MD @HenningWillers @fumikochino @_ShankarSiva
@PercyLeeMD @Icro_Meattini @ErinGillespieMD @seanmmcbride @NiuSanford @to_be_elizabeth
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Tyler Seibert MD PhD @TylerSbrt
RT @OncoAlert: In Collaboration with our partners at ASTRO we continue our coverage of #ASTRO26 🚨
SIX-YEAR OVERALL SURVIVAL OF NIVOLUMAB FOLLOWING STEREOTACTIC ABLATIVE RADIOTHERAPY IN EARLY-STAGE NON-SMALL CELL LUNG CANCER: RANDOMIZED I-SABR TRIAL
Presented by Dr. Joe Chang🇺🇸
@JoeChangMD, @StevenLin_MDPhD, @StephenChunMD, @MehmetAltanMD, @aileenbchen, @pamsharmamdphd, @JHeymach
This randomized phase II trial evaluated SABR ☢️ alone versus SABR plus four doses of nivolumab (I-SABR) in 141 patients with node-negative, early-stage or isolated recurrent #NSCLC 🫁 .
➡️ After nearly 6 years of follow-up, I-SABR significantly improved overall survival (70% vs. 56%) and event-free survival (53% vs. 32%), with manageable toxicity and low rates of severe nivolumab-related adverse events.
✅️ Findings support combining SABR with immunotherapy in appropriately selected patients.
Social Champtions
@DrewMoghanaki, @themednet, @nadinehousri, @IAbuGheidaMD, @lauren_henke, @TugceKutukMD, @ARRO_org, @sarthakshah097, @P_Shams_, @CJTsaiMDPhD, @TylerSbrt, @barrosonco, @AlexisNarvaezMD, @OncoAlert, @CancerNetwrk , @ASTRO_org , @PRJeffWhite
OncoAlert RT Faculty
@MKnoll_MD @HenningWillers @fumikochino @_ShankarSiva
@PercyLeeMD @Icro_Meattini @ErinGillespieMD @seanmmcbride @NiuSanford @to_be_elizabeth
🔖 8 ❤️ 36 🔁 28 👁 2,811
C. Jillian Tsai, MD, PhD @CJTsaiMDPhD
RT @OncoAlert: In Collaboration with our partners at ASTRO we continue our coverage of #ASTRO26 🚨
SIX-YEAR OVERALL SURVIVAL OF NIVOLUMAB FOLLOWING STEREOTACTIC ABLATIVE RADIOTHERAPY IN EARLY-STAGE NON-SMALL CELL LUNG CANCER: RANDOMIZED I-SABR TRIAL
Presented by Dr. Joe Chang🇺🇸
@JoeChangMD, @StevenLin_MDPhD, @StephenChunMD, @MehmetAltanMD, @aileenbchen, @pamsharmamdphd, @JHeymach
This randomized phase II trial evaluated SABR ☢️ alone versus SABR plus four doses of nivolumab (I-SABR) in 141 patients with node-negative, early-stage or isolated recurrent #NSCLC 🫁 .
➡️ After nearly 6 years of follow-up, I-SABR significantly improved overall survival (70% vs. 56%) and event-free survival (53% vs. 32%), with manageable toxicity and low rates of severe nivolumab-related adverse events.
✅️ Findings support combining SABR with immunotherapy in appropriately selected patients.
Social Champtions
@DrewMoghanaki, @themednet, @nadinehousri, @IAbuGheidaMD, @lauren_henke, @TugceKutukMD, @ARRO_org, @sarthakshah097, @P_Shams_, @CJTsaiMDPhD, @TylerSbrt, @barrosonco, @AlexisNarvaezMD, @OncoAlert, @CancerNetwrk , @ASTRO_org , @PRJeffWhite
OncoAlert RT Faculty
@MKnoll_MD @HenningWillers @fumikochino @_ShankarSiva
@PercyLeeMD @Icro_Meattini @ErinGillespieMD @seanmmcbride @NiuSanford @to_be_elizabeth
🔖 8 ❤️ 36 🔁 28 👁 2,811
Joe Y Chang @JoeChangMD
RT @OncoAlert: In Collaboration with our partners at ASTRO we continue our coverage of #ASTRO26 🚨
SIX-YEAR OVERALL SURVIVAL OF NIVOLUMAB FOLLOWING STEREOTACTIC ABLATIVE RADIOTHERAPY IN EARLY-STAGE NON-SMALL CELL LUNG CANCER: RANDOMIZED I-SABR TRIAL
Presented by Dr. Joe Chang🇺🇸
@JoeChangMD, @StevenLin_MDPhD, @StephenChunMD, @MehmetAltanMD, @aileenbchen, @pamsharmamdphd, @JHeymach
This randomized phase II trial evaluated SABR ☢️ alone versus SABR plus four doses of nivolumab (I-SABR) in 141 patients with node-negative, early-stage or isolated recurrent #NSCLC 🫁 .
➡️ After nearly 6 years of follow-up, I-SABR significantly improved overall survival (70% vs. 56%) and event-free survival (53% vs. 32%), with manageable toxicity and low rates of severe nivolumab-related adverse events.
✅️ Findings support combining SABR with immunotherapy in appropriately selected patients.
Social Champtions
@DrewMoghanaki, @themednet, @nadinehousri, @IAbuGheidaMD, @lauren_henke, @TugceKutukMD, @ARRO_org, @sarthakshah097, @P_Shams_, @CJTsaiMDPhD, @TylerSbrt, @barrosonco, @AlexisNarvaezMD, @OncoAlert, @CancerNetwrk , @ASTRO_org , @PRJeffWhite
OncoAlert RT Faculty
@MKnoll_MD @HenningWillers @fumikochino @_ShankarSiva
@PercyLeeMD @Icro_Meattini @ErinGillespieMD @seanmmcbride @NiuSanford @to_be_elizabeth
🔖 8 ❤️ 36 🔁 28 👁 2,811
OncoAlert @OncoAlert
RT @OncoAlert: In Collaboration with our partners at ASTRO we continue our coverage of #ASTRO26 🚨
LBA 03 - SWOG S1827/MAVERICK: A RANDOMIZED PHASE III TRIAL OF BRAIN MRI SURVEILLANCE WITH AND WITHOUT PROPHYLACTIC CRANIAL IRRADIATION (PCI) FOR SMALL-CELL LUNG CANCER (SCLC)
Presented by Dr. Paul Brown 🇺🇸
@DrewMoghanaki, @JhanelleGray, @PDBrownOnc, @lynnhenrymd, @LauraAlderMD
This phase III trial evaluated MRI surveillance 🆚 prophylactic cranial irradiation ☢️ (PCI) in 304 patients with #SCLC without brain 🧠 metastases.
➡️ MRI surveillance significantly improved cognitive failure-free survival (HR 0.60) and reduced cognitive failure, with no apparent overall survival detriment (HR 0.90).
➡️Benefits were consistent across stage and immunotherapy subgroups, including patients eligible for hippocampal-avoidant PCI.
➡️Longitudinal analyses also demonstrated improved patient-reported cognitive concerns and quality of life with MRI surveillance alone.
Social Champtions
@DrewMoghanaki, @themednet, @nadinehousri, @IAbuGheidaMD, @lauren_henke, @TugceKutukMD, @ARRO_org, @sarthakshah097, @P_Shams_, @CJTsaiMDPhD, @TylerSbrt, @barrosonco, @AlexisNarvaezMD, @OncoAlert, @CancerNetwrk , @ASTRO_org @PRJeffWhite
OncoAlert RT Faculty
@MKnoll_MD @HenningWillers @fumikochino @_ShankarSiva
@PercyLeeMD @Icro_Meattini @ErinGillespieMD @seanmmcbride @NiuSanford @to_be_elizabeth
🔖 7 ❤️ 28 🔁 17 👁 2,874
C. Jillian Tsai, MD, PhD @CJTsaiMDPhD
RT @OncoAlert: In Collaboration with our partners at ASTRO we continue our coverage of #ASTRO26 🚨
LBA 03 - SWOG S1827/MAVERICK: A RANDOMIZED PHASE III TRIAL OF BRAIN MRI SURVEILLANCE WITH AND WITHOUT PROPHYLACTIC CRANIAL IRRADIATION (PCI) FOR SMALL-CELL LUNG CANCER (SCLC)
Presented by Dr. Paul Brown 🇺🇸
@DrewMoghanaki, @JhanelleGray, @PDBrownOnc, @lynnhenrymd, @LauraAlderMD
This phase III trial evaluated MRI surveillance 🆚 prophylactic cranial irradiation ☢️ (PCI) in 304 patients with #SCLC without brain 🧠 metastases.
➡️ MRI surveillance significantly improved cognitive failure-free survival (HR 0.60) and reduced cognitive failure, with no apparent overall survival detriment (HR 0.90).
➡️Benefits were consistent across stage and immunotherapy subgroups, including patients eligible for hippocampal-avoidant PCI.
➡️Longitudinal analyses also demonstrated improved patient-reported cognitive concerns and quality of life with MRI surveillance alone.
Social Champtions
@DrewMoghanaki, @themednet, @nadinehousri, @IAbuGheidaMD, @lauren_henke, @TugceKutukMD, @ARRO_org, @sarthakshah097, @P_Shams_, @CJTsaiMDPhD, @TylerSbrt, @barrosonco, @AlexisNarvaezMD, @OncoAlert, @CancerNetwrk , @ASTRO_org @PRJeffWhite
OncoAlert RT Faculty
@MKnoll_MD @HenningWillers @fumikochino @_ShankarSiva
@PercyLeeMD @Icro_Meattini @ErinGillespieMD @seanmmcbride @NiuSanford @to_be_elizabeth
🔖 7 ❤️ 28 🔁 17 👁 2,874
OncoAlert @OncoAlert
In Collaboration with our partners at ASTRO we continue our coverage of #ASTRO26 🚨
LBA 03 - SWOG S1827/MAVERICK: A RANDOMIZED PHASE III TRIAL OF BRAIN MRI SURVEILLANCE WITH AND WITHOUT PROPHYLACTIC CRANIAL IRRADIATION (PCI) FOR SMALL-CELL LUNG CANCER (SCLC)
Presented by Dr. Paul Brown 🇺🇸
@DrewMoghanaki, @JhanelleGray, @PDBrownOnc, @lynnhenrymd, @LauraAlderMD
This phase III trial evaluated MRI surveillance 🆚 prophylactic cranial irradiation ☢️ (PCI) in 304 patients with #SCLC without brain 🧠 metastases.
➡️ MRI surveillance significantly improved cognitive failure-free survival (HR 0.60) and reduced cognitive failure, with no apparent overall survival detriment (HR 0.90).
➡️Benefits were consistent across stage and immunotherapy subgroups, including patients eligible for hippocampal-avoidant PCI.
➡️Longitudinal analyses also demonstrated improved patient-reported cognitive concerns and quality of life with MRI surveillance alone.
Social Champtions
@DrewMoghanaki, @themednet, @nadinehousri, @IAbuGheidaMD, @lauren_henke, @TugceKutukMD, @ARRO_org, @sarthakshah097, @P_Shams_, @CJTsaiMDPhD, @TylerSbrt, @barrosonco, @AlexisNarvaezMD, @OncoAlert, @CancerNetwrk , @ASTRO_org @PRJeffWhite
OncoAlert RT Faculty
@MKnoll_MD @HenningWillers @fumikochino @_ShankarSiva
@PercyLeeMD @Icro_Meattini @ErinGillespieMD @seanmmcbride @NiuSanford @to_be_elizabeth
🔖 7 ❤️ 28 🔁 17 👁 2,874
Gil Morgan, MD @weoncologists
RT @OncoAlert: In Collaboration with our partners at ASTRO we continue our coverage of #ASTRO26 🚨
LBA 03 - SWOG S1827/MAVERICK: A RANDOMIZED PHASE III TRIAL OF BRAIN MRI SURVEILLANCE WITH AND WITHOUT PROPHYLACTIC CRANIAL IRRADIATION (PCI) FOR SMALL-CELL LUNG CANCER (SCLC)
Presented by Dr. Paul Brown 🇺🇸
@DrewMoghanaki, @JhanelleGray, @PDBrownOnc, @lynnhenrymd, @LauraAlderMD
This phase III trial evaluated MRI surveillance 🆚 prophylactic cranial irradiation ☢️ (PCI) in 304 patients with #SCLC without brain 🧠 metastases.
➡️ MRI surveillance significantly improved cognitive failure-free survival (HR 0.60) and reduced cognitive failure, with no apparent overall survival detriment (HR 0.90).
➡️Benefits were consistent across stage and immunotherapy subgroups, including patients eligible for hippocampal-avoidant PCI.
➡️Longitudinal analyses also demonstrated improved patient-reported cognitive concerns and quality of life with MRI surveillance alone.
Social Champtions
@DrewMoghanaki, @themednet, @nadinehousri, @IAbuGheidaMD, @lauren_henke, @TugceKutukMD, @ARRO_org, @sarthakshah097, @P_Shams_, @CJTsaiMDPhD, @TylerSbrt, @barrosonco, @AlexisNarvaezMD, @OncoAlert, @CancerNetwrk , @ASTRO_org @PRJeffWhite
OncoAlert RT Faculty
@MKnoll_MD @HenningWillers @fumikochino @_ShankarSiva
@PercyLeeMD @Icro_Meattini @ErinGillespieMD @seanmmcbride @NiuSanford @to_be_elizabeth
🔖 7 ❤️ 28 🔁 17 👁 2,874
Miguel Gonzalez Velez, MD @mgonzalezvelMD
MARIPOSA ami-laz is changing the biology of EGFR NSCLC. Hidetoshi Hayashi, @BenjaminBesseMD at @JTOonline
Take: MET amplification: 3.4% vs 13.1% ( p=0.002)
2ry EGFR mutations (C797S/L718X/G724X): 1.4% vs 7.6% (p=0.01)
No significant increase in other known pathways
Similar story as when osimertinib essentially eliminated T790M, MET and C797S took its place. Ami-laz now suppresses those two mechanisms. It is likely that other mutations like HER2 and cell-cycle alterations will increase (Figure 2). @lungoncdoc @EGFRResisters
#LCSM #lungcancer #thoraciconcology
[Quoting @JTOonline: In #MARIPOSA, amivantamab-lazertinib significantly improved overall survival vs osimertinib. Hayashi et al. found that amivantamab-lazertinib reduces common resistance mechanisms vs osimertinib, suggesting that this regimen is changing the underlying biology of EGFR-mutant disease, contributing to both first- and second-line long-term efficacy outcomes.
Read more here: https://t.co/axK4AtN5p8
#Amivantamab #Lazertinib #LungCancerResearch]
🔖 9 ❤️ 18 🔁 6 👁 2,191
Oncology Brothers @OncBrothers
And then in September 2026: we got 5 more new drugs/indications ✅ @FDADrugs!! As a #CommunityOncologists, we need to know them all:
1. #Camizestrant in mESR1 HR+ breast cancer (before progression). ⬆️mPFS (16mos vs. 9.2mos)
2. #Imlunestrant + #Abemaciclib in 2L metastatic mESR1 HR+ breast cancer. ⬆️mPFS (11.1mos vs. 5.5mos)
3. #Sevabertinib now in 1L Her2 mutated NSCLC. ORR 75%
4. #Lirafugratinib in 2L for FGFR2 fusion/rearrangement cholangiocarcinoma. ORR 46% and DoR 11.8mos
5. #Belzutifan + #Lenvatinib in 2L RCC. ⬆️mPFS (14.6mos vs. 10.6mos)
#OncTwitter #bcsm #lcsm #gusm @OncUpdates @FDA @US_FDA
[Quoting @OncBrothers: What just happened in Oncology? 5 new drugs/indications ✅ @FDADrugs in August 2026. As a #CommunityOncologists, we need to know them all:
1. #Rusfertide in Polycythemia Vera, improved phlebotomy (76.9% vs. 32.9%)
2. #Daraxonrasib in 2L metastatic pancreatic cancer, mOS 13.2 Vs 6.7mos
3. #Zanidatamab + Chemo ± Tislelizumab in 1L metastatic Her2+ GEA/Gastric adenocarcinoma, mOS 26.4mos Vs 19.2mos
4. #Iberdomide + Dara + Dex in 2L RRMM, improved MRD negativity (41% vs. 21%)
5. #Vusolimogene + Nivo in refractory Melanoma. ORR of 24.2% and mDOR: 14.1mos.
#pancsm #mpnsm #OncTwitter #HemeTwitter @OncoAlert @OncUpdates]
🔖 12 ❤️ 35 🔁 13 👁 6,153
Tyler Seibert MD PhD @TylerSbrt
With great imaging comes great responsibility to not overtreat
Time to find more ways for MRI and PSMA PET to reduce overtreatment of #ProstateCancer
@ASTRO_org #ASTRO26
[Quoting @OncoAlert: In Collaboration with our partners at ASTRO we continue our coverage of #ASTRO26 🚨
LBA 03 - SWOG S1827/MAVERICK: A RANDOMIZED PHASE III TRIAL OF BRAIN MRI SURVEILLANCE WITH AND WITHOUT PROPHYLACTIC CRANIAL IRRADIATION (PCI) FOR SMALL-CELL LUNG CANCER (SCLC)
Presented by Dr. Paul Brown 🇺🇸
@DrewMoghanaki, @JhanelleGray, @PDBrownOnc, @lynnhenrymd, @LauraAlderMD
This phase III trial evaluated MRI surveillance 🆚 prophylactic cranial irradiation ☢️ (PCI) in 304 patients with #SCLC without brain 🧠 metastases.
➡️ MRI surveillance significantly improved cognitive failure-free survival (HR 0.60) and reduced cognitive failure, with no apparent overall survival detriment (HR 0.90).
➡️Benefits were consistent across stage and immunotherapy subgroups, including patients eligible for hippocampal-avoidant PCI.
➡️Longitudinal analyses also demonstrated improved patient-reported cognitive concerns and quality of life with MRI surveillance alone.
Social Champtions
@DrewMoghanaki, @themednet, @nadinehousri, @IAbuGheidaMD, @lauren_henke, @TugceKutukMD, @ARRO_org, @sarthakshah097, @P_Shams_, @CJTsaiMDPhD, @TylerSbrt, @barrosonco, @AlexisNarvaezMD, @OncoAlert, @CancerNetwrk , @ASTRO_org @PRJeffWhite
OncoAlert RT Faculty
@MKnoll_MD @HenningWillers @fumikochino @_ShankarSiva
@PercyLeeMD @Icro_Meattini @ErinGillespieMD @seanmmcbride @NiuSanford @to_be_elizabeth]
🔖 1 ❤️ 10 🔁 4 👁 1,262
Joe Y Chang @JoeChangMD
I am pleased to share the results of our phase II randomized I-SABR study @ASTRO_org 2026 which demonstrate improved overall survival (OS) when adding four doses of immunotherapy to SABR in early-stage NSCLC. These exciting findings are associated with the persistent activation of cytotoxic T cells for up to 6.5 years. Further optimization of I-SABR approaches will guide future research and clinical practice.
[Quoting @UTMDAnderson: Dr. Joe Chang shared six-year data from the Phase 2 I-SABR trial. He also shared that patients who received both nivolumab and SBRT treatment showed increased activity of cancer-targeting CD8+ T cells: https://t.co/dA3quutbuy (2/2) #ASTRO26 #EndCancer https://t.co/c2HFA0NIM1]
🔖 15 ❤️ 81 🔁 22 👁 5,417
Elad Sharon @EladSharonMD
RT @ASCOPost: 🫁 Could B7-H3 targeting improve outcomes in relapsed #SCLC?
Phase 3️⃣ TAISHAN-302 showed longer OS and PFS and higher response rates with tambotatug pelitecan vs topotecan, with fewer grade ≥3 AEs.
🔹Li Zhang, MD | @NEJM
🔗 https://t.co/w48hBpyXno https://t.co/DDMw0NKoav
🔖 3 ❤️ 5 🔁 7 👁 1,636
🧪 Newly Recruiting Trials
2 trials (1 phase II, 1 phase I) opened this week, testing telisotuzumab adizutecan and TS-104
Phase 2 · AbbVie · telisotuzumab adizutecan · California, Georgia · CT.gov ↗
Phase 1 · TwoStep Therapeutics, Inc. · TS-104 · Ohio, Oregon, Virginia · CT.gov ↗
Open all 2 on the trials page →
Agent descriptions from the NCI Thesaurus.
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