T.Runciman

Impact of 1L amivantamab + lazertinib vs osimertinib on acquired resistance in EGFR mutant NSCLC @JTOonline. Ami/laz reduces MET amp (3.4% vs 13.1%) and acquired EGFR resistance mts (1.4% vs 7.6%). 2L PFS longer in ami/laz arm vs osi (8.4m vs 5.3m). jto.org/article/S1556-…

Especial médicos🩺⚕️🏥👨🏻‍⚕️👩🏻‍⚕️. Os dejo esta carta en JAMA. Se la pondré a mis alumnos en la próxima clase: He elegido estas frases : 👇🏻⏰ «La medicina puede tener un significado extraordinario. Pero no puede sustituir el estar presente en tu propia vida. El mundo puede necesitarnos como médicos. Pero las personas que nos aman nos necesitan como nosotros mismos. Y ese es el rol que nadie más puede llenar.» «La residencia refuerza la lección de que las instituciones están diseñadas para perdurar más allá de los individuos. En cambio, las familias no.» «Creo en formar a la próxima generación. Creo en el significado de este trabajo. Lo que ha cambiado es mi disposición a absorber el desgaste sin cuestionarlo.» «Ya no estoy dispuesta a seguir posponiendo la vida. La medicina exige mucho. Y nosotros damos profundamente. Pero no puede tomarlo todo.» «El significado de mi trabajo es profundo. El significado de mi presencia en casa es irremplazable.»

Subset data from ALINA - adjuvant alectinib for resected ALK+ NSCLC - shows benefit to alectinib over chemo across subsets - stage, size, N0/N1/N2, and time from surgery. Current standard of care. lungcancerjournal.info/article/S0169-…

Amazing to see the dramatic improvements pushing the PFS curves up and thereby offering extended life and more hope for our patients- a diagnosis of advanced NSCLC was like looking down a precipice in 2002 Revised the image to show that all this is thanks to a lot of passionate weightlifters: Basic/translational scientists Industry friends Clinical trialists/trial teams Reg agencies Patient advocates etc lifting that PFS curve upwards day-by-day But we need to push still more to be able to have our patients rest on and enjoy a comfortable survival plateau! #lcsm

Lung cancer staging always felt confusing to me… until I learnt the simple 3-4-5 rule 👇 • ≤3 cm → IA • 3–4 cm → IB • 4–5 cm → IIA IA → No chemo IB → Gray zone ≥II → Adjuvant chemo Nodes ↑ stage Metastasis → Stage IV #MVOnco #LungCancer

𝐓𝐏𝟓𝟑 is the gene that encodes the tumor-suppressor protein p53. It is commonly mutated in human cancers, and as with other tumor-suppressor genes, loss of function in both alleles (i.e., two "hits") is required for tumorigenesis. Wild-type p53 protein is short-lived and expressed at low levels. Mutant p53 often has an extended life span and accumulates in cancer cells. The p53 protein is a transcription factor that controls the expression of hundreds of target genes by binding and activating specific target genes that, once transcribed and translated, suppress tumorigenesis. Mutant p53 has limited or no tumor-suppressive function because it cannot bind and activate target genes. To learn more about this NEJM Illustrated Glossary term, read the editorial “Restoring Function to a Variant of p53 in Solid Tumors” by Xin Lu, PhD, from @Ludwig_Cancer: nej.md/3N0pQW8 Explore more terms: nej.md/glossary

ASCO Update: 2nd line after osimertinib? Post-progression EGFR+ NSCLC is no longer chemo-only. 📌 Re-biopsy / NGS essential Options: • Carbo-Pemetrexed + Amivantamab • Chemo + Osimertinib (non-CNS / limited access) • MET+ → Osimertinib + Savolitinib / Tepotinib • ADCs: Dato-DXd, Sacituzumab TMT ❌ IO → no OS benefit #OncoDaily #OncoAlert #OncoLive #LungCancer #EGFR #PrecisionOncology #ascoguideline ascopubs.org/doi/10.1200/JC…

Treatment lines for EGFRm NSCLC pts are changing fast with FLAURA2 and new bispecific antibodies and ADCs. While the best strategic sequence isn't yet obvious, the significant boost in patient survival remains the ultimate goal @SpringerNature #EGFR #lungcancer

Fantastic EGFRm session 🇪🇬 diving into the evolving post-FLAURA/FLAURA2 landscape for EGFRmut patients. The field is moving rapidly! #EGFR #lungcancer

2025: Summary of Ttx for NSCLC in 3 slides ➕: IO is SoC in early stage ➖: multiple « me too » agents but cost of drugs is ⬆️ and access is ⬇️ worldwide ✏️: optimal Ttx duration with IO or TT ✏️: access to TT for rare 🧬altertions ✏️: role of ADCs? We need more Academic trials!

Can you still offer chemotherapy in EGFR+ NSCLC after using it in 1L? At ILCS 2025, @tnewsomdavis highlighted data showing that in FLAURA2, 69% of patients received second-line therapy, most with chemotherapy, comparable to MARIPOSA, where 74% received further treatment. His takeaway: using chemo upfront doesn’t preclude effective 2L options for most patients. Watch his talk ⬇️ lungsummit.org/targeted-thera…

#LungCancerAwarenessMonth continues: From groundbreaking EGFR-targeted therapies to #PrecisionMedicine, non-small cell lung cancer care is evolving, bringing hope and better outcomes for patients today and tomorrow. 🔗 acsjournals.onlinelibrary.wiley.com/doi/10.3322/ca… @OncoAlert

🫁 Lung Cancer + Interstitial Lung Disease (ILD) 🌫️ 🎯 AIRO Delphi Consensus 2025 When fibrosis meets photons ⚡ 🇮🇹 Italian Association of Radiotherapy & Clinical Oncology (AIRO) brings expert guidance on how to safely deliver RT in this high-risk duo 👇 🧭 Key Recommendations 🔹 HRCT = Gold standard for ILD detection & risk stratification 🔹 MDT discussion mandatory before RT (Radiation Oncologist + Pulmonologist + Radiologist) 🔹 High-risk ILD (UIP/IPF) → ❌ RT may be contraindicated 🔹 Predictive dosimetry:  • MLD > 12 Gy or V20 > 25 % → ↑ Pneumonitis risk ☠️  • For SBRT → keep MLD < 4.5 Gy, V20 < 6.5 % ✅ 🔹 Antifibrotics (💊 Nintedanib / Pirfenidone) may reduce flares 🔹 Safer chemo partners: Cisplatin / Carboplatin + weekly (nab-)Paclitaxel or Vinorelbine  → 🚫 Avoid Gemcitabine / Docetaxel 🔹 Immunotherapy 💉 possible with close lung monitoring 🔹 Targeted therapy + RT ⚠️ pneumonitis risk - avoid overlap 🔹 Follow-up in ILD-experienced RT centers only 🏥 💬 Takeaway Radiotherapy isn’t forbidden - it’s a precision team effort 🧠🤝 ✅ Multidisciplinary planning ✅ Antifibrotic support ✅ Smart dose constraints 📖 Borghetti et al. Lung Cancer 2025. 🔗 doi.org/10.1016/j.lung… #OncoTwitter #LungCancer #RadiationOncology #ILD #MedTwitter @OncoAlert @esmo_open @ASTRO_org @ASCO @myESMO @ESMO_Open

🚨 Updated EGFRm NSCLC Therapy Guide post-ESMO 2025! @KatsuakiMaehara’s masterpiece for every lung ca clinician 💎

ALEX final OS: - crizo arm dragged down by <50% getting next-gen ALK. Lack of crossover really hurts. - 5-yr OS with alectinib ≈ 5-yr PFS with lorlatinib (CROWN), but only 18% got lorla post alect — we still don’t know the optimal sequence. #ESMO25

Impressive results from MDT-BRIDGE at #ESMO25 from Dr. @MartinReck2. Pts with resectable or borderline had 2 cycles of durvalumab + chemo then reassessed at MDT. If resectable at start, 95% remained resectable. If borderline, 82% were then felt to be resectable. #ESMOAmbassadors

Dr. @APassaroMD with a great overview of next-line therapy for EGFR NSCLC at #BTGGlobalLung2025. Rapid changes emerging and anticipate impact with ADCs. Will be influenced by first-line therapy. More and more, resistance seems to be multifaceted, overlapping mechanisms.

🫁 Sequential therapy for advanced/metastatic #EGFRm #NSCLC 🫁 🫁 I’ve compiled it into a table. (PFS & OS only) 🌟 As of October 2025 🌟 I will update after #ESMO25 #lungcancer #nsclc #egfr #LCSM

Tumor lysis syndrome has evolved and become less predictable with the introduction of new cancer therapies. A new review explores risk factors and causes of the syndrome, as well as strategies for treatment and prevention. Learn more in the Review Article “Tumor Lysis Syndrome” by R. Gregory Bociek, MD, and Matthew Lunning, DO (@lymphomaphilia), from @BuffettCancer, @unmc, and @NebraskaMed: nej.md/4plR9sh