The Oncology Forum: Expert Panel Weighs in On Advancements in the Lung Cancer Landscape

Sanjay Juneja, MD, partnered with Formedics to host the Oncology Forum during the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, kicking off the robust discussion with the lung cancer panel.

The expert panel featured Stephen Liu, MD, of Georgetown University, Millie Das, MD, of Stanford University, and Eric Singhi, MD, of the University of Texas MD Anderson Cancer Center.

The forum covered critical updates in the fields of non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), addressed important questions on the effectiveness of immunotherapy and other treatment options, and generated discussion on recent trial updates, such as NeoADAURA. Dr. Singhi noted that the observed chemotherapy response was not as “robust” as he would have hoped and that he continues to favor “more of an ADAURA approach.”

“These patients had to have surgically resectable disease, deemed resectable before they enrolled on the study; this wasn’t to try and convert patients to have surgically resectable disease,” Dr. Singhi explained. “It’s a lot to think about, but for me personally, it’s not practice-changing.”

Dr. Juneja also moderated a discussion on ALNEO, which focused on how the phase 2 study met its primary endpoint in the evaluation of neoadjuvant and adjuvant alectinib in patients with resectable locally advanced stage III ALK-positive NSCLC. Dr. Das shared her insights on the higher pathological complete response (pCR) rate observed in ALNEO compared to NeoADAURA.

“We need to get more data, and then we need to really figure out, is this something that we should be applying for all of our patients,” Dr. Das said.

Dr. Das further discussed the potential of using other modalities, such as circulating tumor DNA (ctDNA), to predict patient dosages of and responses to neoadjuvant and adjuvant alectinib.

“That’s one of the big pushes forward,” Dr. Das explained. “To individualize treatment, beyond just the driver mutation, to the duration of treatment.”

Dr. Liu weighed in on key findings from his research on lurbinectedin for SCLC, which demonstrated that “by moving therapy earlier, people live longer.” He discussed what those results mean for therapeutic timing, as well as treatment decision-making between oncologists, other healthcare professionals, and their patients.

“Lurbinectedin [was] approved in the US in the second-line setting after first-line treatment for SCLC in the advanced stage,” Dr. Liu explained. “This is an alkylating agent, it’s a transcription inhibitor and an active drug, and the question is, if we give it earlier, does it help patients? We saw this extended survival, and I think that’s not something you can dismiss.”

Dr. Singhi also weighed in on the findings with lurbinectedin, emphasizing the importance of being mindful of the drug’s toxicity and tolerability in patients.

“We have to be very vigilant about the toxicity,” Dr. Singhi said. “We have to make sure that [patients] can get onto another subsequent line of therapy if they need it.”

In addition, the expert panel discussed and analyzed TROPION-Lung02, which unpacked new data at ASCO 2025 on a combination approach that includes an antibody-drug conjugate (ADC). Dr. Das highlighted the “exciting” nature of the data and how it will expand the already heightened interest in ADCs across tumor types, particularly within the lung cancer space.

“What we saw was that this combination is safe,” Dr. Das explained. “We’re not seeing any unexpected toxicity here. In my mind, an ADC is like a targeted chemotherapy. Can we actually replace the platinum-doublet chemotherapy that’s been in our treatment paradigm for decades now? We need larger studies to confirm that, but that’s really the goal, to be able to provide targeted chemotherapy and perhaps shift the treatment paradigm.”