Discover and read the best of Twitter Threads about #WCLC20

@StephenVLiu

#WCLC20 Results from the phase III non-inferiority J-AXEL study of salvage nab-paclitaxel vs docetaxel in NSCLC. Large study (n>500) with a 1:1 randomization. #LCSM @IASLC @OncoAlert

#WCLC20 Positive study! Shows non-inferiority in OS with nab-paclitaxel over docetaxel (median 16.2m vs 13.6m). PFS favors nab-pac (HR 0.76). #LCSM

#WCLC20 RR favors nab-paclitaxel (30% vs 15%) and in this study, unlike the registrational trial, no real difference between squamous and non-squamous (both 30%, both better than docetaxel). #LCSM

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Stephen V Liu

@StephenVLiu

#WCLC20 Excited about this one: phase I results of the HER3 ADC patritumab deruxtecan (HER3-DXd; U3-1402) in #EGFR mutant #NSCLC presented by @HelenaYu923 #LCSM @IASLC @OncoAlert

#WCLC20 Presentation here is on the combined dose escalation and expansion at the 5.6 mg/kg dose with #EGFR mutant NSCLC. Includes 56 evaluable patients. Median f/u 5 months. #LCSM @IASLC

#WCLC20 Fairly heavily pretreated population with both TKI and chemotherapy and many with IO as well. Biopsy required for HER3 expression (violin plot on right) and nearly all were HER3 positive. #LCSM

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Stephen V Liu

@StephenVLiu

#WCLC20 Results from phase I study of the TROP2 ADC datopotamab deruxtecan (Dato-DXd; DS-1062) in NSCLC by @AlexSpiraMDPhD #LCSM @IASLC @OncoAlert

#WCLC20 This ADC includes an anti-TROP2 IgG1 and a topo-1 inhibitor payload. Phase 1 design shown here. Mostly non-squamous, included some #EGFR+, heavily pretreated including many with CNS metastases. Less intensity at higher 8mg dose, as one would expect. #LCSM

#WCLC20 Safety shown here and manageable but I would say still notable, especially at 8mg (G3+ AEs 34%) including ILD noted in 8% (but 3 grade 5 cases in the 8mg/kg cohort). #LCSM

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Stephen V Liu

@StephenVLiu

#WCLC20 Results from randomized phase II of nivo vs nivo/ipi in #EGFR mutant NSCLC. Unfortunately, study stopped for futility (n=31) but glad to see results presented. #LCSM @IASLC

#WCLC20 Only 1 response (RR 3%) and median PFS of 1.3 months. Spider plot shows some with modest duration stable disease (but others with rapid progression - suggestive of TKI flare?) #LCSM

#WCLC20 Treatment was well tolerated - we are concerned about safety when TKI follows immunotherapy, not really the other way around (as done here). #LCSM

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Stephen V Liu

@StephenVLiu

#WCLC20 Updated data from KEYNOTE 799 presented by @MartinReck2 - pembrolizumab + chemoradiation in unresectable locally advanced stage III NSCLC. #LCSM @IASLC @OncoAlert

#WCLC20 Two different cohorts analyzed. Cohort A used carbo/pac and cohort B used cis/pem. Both give concurrent pembro and pembro consolidation.

#WCLC20 Similar RR in the two cohorts (~70%) and relatively independent of PDL1 expression (and in cohort A, independent of histology). Median DOR not reached. #LCSM

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Stephen V Liu

@StephenVLiu

#WCLC20 The plenary presentation by @GoldmanLisa on patient-directed research and lessons in partnership is a can't miss and gives important insight into the evolution of clinical research #LCSM @IASLC @OncoAlert

#WCLC Great to see so many active biomarker specific patient groups like @ros1cancer @ALKLungCancer @Exon20Group @EGFRResisters @mcrouse53 @RetRenegades @alk_fusion @kRasKickers @NTRKers @METCrusaders. We also need to reach patients that are less tech savvy or who lack access.

#WCLC There are many different ways that patients can be involved in research including biobanks, registries and RWE studies. As a great example: project PRIORITY led by the @EGFRResisters #LCSM

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Stephen V Liu

@StephenVLiu

#WCLC20 This poster outlines biomarker work in the phase I study of patritumab deruxtecan (HER3-DXd), a HER3-ADC, focused on patients with #EGFR mutant NSCLC after prior TKI and chemotherapy. Note diversity of EGFR TKI resistance mechanisms in this small sample! #LCSM @OncoAlert

#WCLC20 The efficacy of HER3-DXd in #EGFR mutant NSCLC was seen across various resistance mechanisms and for such a heterogeneous pretreated population, very promising activity. #LCSM

#WCLC20 At baseline, nearly all tumor expressed HER3 independent of when #EGFR TKI was stopped. Some association with expression and efficacy. I always feel this should be a stronger association given how I think ADCs work but maybe I don't know how ADCs work. #LCSM

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Stephen V Liu

@StephenVLiu

#WCLC20 Summary of molecular epidemiology of Asian lung cancer at the opening plenary by @TakashiKohno2. There are many different genomic subtypes of lung cancer and huge geographic variation. Reminder though: phenotype does not guide testing. #LCSM @OncoAlert

#WCLC20 In the US, actionable genomic alterations more common in never-smokers but still occur at relevant rates in smokers (and smokers probably undertested). In Japan, very high rates of alterations (like EGFR) in both smokers and never-smokers. #LCSM @OncoAlert

#WCLC20 But why? Why are there so many cases of lung cancer in never-smokers in Asia? Unique exposures? HLA differences? Why adeno and not squamous? Important work that will impact screening and treatment but very early. Is there a similar link with Native American ancestry?

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Stephen V Liu

@StephenVLiu

#WCLC20 Dr. Wanqing Chen reviews lung cancer in China. Staggering global burden for this highly lethal disease. Good to see the rise in registries and reporting as well as national funding but huge swaths of the country not represented. #LCSM @OncoAlert

#WCLC20 The trends in lung cancer burden here are very interesting. Drop in stomach cancer mortality in part due to cultural and technological shifts; lung cancer now far and away the most lethal cancer. Increase in proportion diagnosed at late stage - huge screening opportunity.

#WCLC20 Adenocarcinoma rose from 36.4% to 53.5% and squamous cell dropped from 45.4% to 34.4%. Would love to see genomics here given the huge numbers of non-smoking related cancers in China. #LCSM

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Stephen V Liu

@StephenVLiu

#ESMO20 With some of the technical limitations, grateful for this discussion of the mesothelioma #MPM oral abstracts by @GautschiOliver @OncoAlert

#ESMO20 @GautschiOliver reviews the history of immunotherapy in #MPM, with early single arm trials showing efficacy but disappointing randomized trials of tremelimumab and of pembro vs chemo. Still, responses were seen, including his own patient with a 3y response. @OncoAlert

#ESMO20 That finally changed with #WCLC20 @IASLC with CheckMate 743 when first-line nivo/ipi improved OS compared to chemotherapy (OS HR 0.74), particularly in the non-epithelioid subtype (OS HR 0.46). @OncoAlert

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Stephen V Liu

@StephenVLiu

#OncoAlert Online now @JTOonline is the ORIENT-11 trial of sintilimab + platinum/pemetrexed in NSCLC. Simultaneous publication with #VPS20 #WCLC20 @IASLC presentation. Randomized phase III study of chemotherapy +/- anti PD-1 antibody sintilimab. #LCSM

jto.org/article/S1556-…

Sintilimab is a PD1 antibody and the phase Ib of sintilimab with platinum/pem had RR 68.4% and mPFS 11.4m. Phase III included 397 patients in 47 hospitals in China with treatment naive advanced EGFR/ALK wild type non-squamous NSCLC, stratified by PDL1 expression (22C3).

Enrolled in < 1y! All patients received 4 cycles of carboplatin AUC 5 with pemetrexed 500mg/m2 q21d and randomized 2:1 to sintilimab 200mg flat dose or placebo followed by sintilimab/placebo maintenance. After median f/u of 8.9m, primary endpoint met: PFS 8.9m vs 5m (HR 0.482).

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Stephen V Liu

@StephenVLiu

#VPS20 Paul Baas presents the highly anticipated Checkmate-743 trial: a randomized phase III study of nivolumab + ipilimumab vs platinum + pemetrexed chemotherapy as 1L treatment in unresectable malignant pleural mesothelioma. Mature dataset. #MPM #LCSM #WCLC20 @IASLC

#VPS20 Positive #MPM trial! Nivolumab and ipilimumab provided OS benefit over chemo with OS HR 0.74. mOS 18.1m with nivo/ipi and 14.1 with pt/pem. 2y OS 41% vs 27%. RR comparable, more durable in the IO arm. Substantial benefit in the non-epithelioid subset! #WCLC20 @IASLC

#VPS20 Nivolumab + ipilimumab with better outcomes in the PDL1 positive subset. Toxicity with no new signals but 23% of patients in the nivo/ipi arm discontinued part of therapy for toxicity. A new standard emerges for #MPM with this trial. #WCLC20 @IASLC

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Stephen V Liu

@StephenVLiu

#VPS20 Eagerly awaited results of the eXalt3 trial of ensartinib vs crizotinib in #ALK #NSCLC presented by @HornLeora - straightforward randomized design. #LCSM #WCLC20 @IASLC

#VPS20 Demographics as expected. BIRC mPFS 25.8m vs 12.7m with HR 0.51 and impressive waterfall plot and durable responses. #LCSM #WCLC20 @IASLC

#VPS20 OS is immature. No unexpected safety signals. Overall, ensartinib performed well and likely will represent another option in #ALK NSCLC but where to insert this 2nd gen TKI in our treatment algorithm remains to be seen. #LCSM #WCLC20 @IASLC

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Stephen V Liu

@StephenVLiu

#VPS20 The ORIENT-11 trial presented by Dr. Zhang: 1L platinum/pemetrexed +/- sintilimab (anti-PD1) in non-sq NSCLC. Good design: 2:1 randomization, no EGFR/ALK, stratified by PDL1, crossover included. #LCSM @IASLC #WCLC20

#VPS20 Positive study with PFS HR 0.482 favoring sintilimab, mPFS 8.9m vs 5.0m which is very comparable to KEYNOTE-189. Hits all the right subgroups and stepwise benefit by PDL1 expression. Important to have these data in an East Asian population. #LCMS @IASLC #WCLC20

#VPS20 OS is immature but RR favors sintilimab (51.9% vs 29.8%), time to response 1.5 months and median duration not reached. No unexpected safety signals noted with this novel PD1 inhibitor in an East Asian population. #LCSM @IASLC #WCLC20

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Stephen V Liu

@StephenVLiu

#VPS20 Presidential symposium overview of #COVID19 and thoracic cancers by @marinagarassino. First case in Italy reported 2/20/20 and we've learned a great deal since then about COVID outcomes in patients with cancer. #LCSM @IASLC #WCLC20

#VPS20 The UKCCMP registry noted a high mortality rate in patients with cancer (28%) and 22% of patients had disruption in cancer care. Mortality in the CCC19 registry was reported at 16% but higher (26%) in patients with lung cancer. #LCSM @IASLC #WCLC20

#VPS20 #TERAVOLT is an impressive, global registry led by @marinagarassino @HornLeora including only patients with thoracic cancers and #COVID19. Mortality reported at 35.5% and outcomes vary with PS. TERAVOLT now has over 1000 cases! #LCSM @IASLC #WCLC20

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Discover and read the best of Twitter Threads about #WCLC20

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Discover and read the best of Twitter Threads about #WCLC20

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