Misty D. Shields, MD, PhD
Articles by Misty D. Shields, MD, PhD

Panelists discuss how recent data from KEYNOTE-671, AEGEAN, and CheckMate 77T reinforce neoadjuvant therapy’s efficacy in early-stage non–small cell lung cancer (NSCLC), showing consistent survival benefits. In contrast, adjuvant data remain conflicting, limiting its role. Neoadjuvant therapy should be prioritized, with adjuvant therapy reserved for select high-risk patients.

Panelists discuss how emerging antibody-drug conjugate (ADC) data from TROPiCS-03 and IDeate-Lung01 suggest potential in extensive-stage small cell lung cancer (ES-SCLC), impacting sequencing with current therapies. T-cell engagers like BI 764532 and HPN328 may reshape treatment. MRI surveillance, per retrospective data and MAVERICK, offers an alternative to prophylactic cranial irradiation (PCI), though select factors may still justify PCI use.

Panelists discuss how the DeLLphi-301 trial demonstrated that tarlatamab, administered biweekly at a 10 mg dose, achieved a 40% objective response rate in patients with previously treated extensive-stage small cell lung cancer (ES-SCLC). This led to its accelerated FDA approval in May 2024. Integrating tarlatamab into clinical practice may present challenges, including managing cytokine release syndrome and neurologic toxicities, as well as addressing financial considerations.

Panelists discuss how recent real-world data comparing atezolizumab and durvalumab in extensive-stage non–small cell lung cancer (ES-NSCLC) informs treatment selection, though direct comparisons remain limited. Lurbinectedin is a key second-line option, with emerging combination strategies.

Panelists discuss how the ADRIATIC regimen integrates immunotherapy post-chemoradiation in late-stage small cell lung cancer (LS-SCLC). In patients with paraneoplastic syndromes or immune disorders, immunotherapy requires caution. Prophylactic cranial irradiation (PCI) is considered for high-risk cases, while MRI surveillance is preferred for select patients to reduce neurotoxicity.

Panelists discuss how, in clinical practice, ADAURA (osimertinib) and ALINA (alectinib) are integrated based on EGFR/ALK status, stage, and recurrence risk. Adjuvant therapy duration is typically 3 years. Circulating tumor DNA (ctDNA), minimal residual disease (MRD) from ADAURA (ASCO 2024, Abs 8005) may refine treatment decisions by detecting MRD.

Panelists discuss how recent data from KEYNOTE-671, AEGEAN, and CheckMate 77T reinforce neoadjuvant therapy’s efficacy in early-stage non–small cell lung cancer (NSCLC), showing consistent survival benefits. In contrast, adjuvant data remain conflicting, limiting its role. Neoadjuvant therapy should be prioritized, with adjuvant therapy reserved for select high-risk patients.

Panelists discuss how emerging antibody-drug conjugate (ADC) data from TROPiCS-03 and IDeate-Lung01 suggest potential in extensive-stage small cell lung cancer (ES-SCLC), impacting sequencing with current therapies. T-cell engagers like BI 764532 and HPN328 may reshape treatment. MRI surveillance, per retrospective data and MAVERICK, offers an alternative to prophylactic cranial irradiation (PCI), though select factors may still justify PCI use.

Panelists discuss how the DeLLphi-301 trial demonstrated that tarlatamab, administered biweekly at a 10 mg dose, achieved a 40% objective response rate in patients with previously treated extensive-stage small cell lung cancer (ES-SCLC). This led to its accelerated FDA approval in May 2024. Integrating tarlatamab into clinical practice may present challenges, including managing cytokine release syndrome and neurologic toxicities, as well as addressing financial considerations.

Panelists discuss how recent real-world data comparing atezolizumab and durvalumab in extensive-stage non–small cell lung cancer (ES-NSCLC) informs treatment selection, though direct comparisons remain limited. Lurbinectedin is a key second-line option, with emerging combination strategies.

Panelists discuss how the ADRIATIC regimen integrates immunotherapy post-chemoradiation in late-stage small cell lung cancer (LS-SCLC). In patients with paraneoplastic syndromes or immune disorders, immunotherapy requires caution. Prophylactic cranial irradiation (PCI) is considered for high-risk cases, while MRI surveillance is preferred for select patients to reduce neurotoxicity.

Misty D. Shields, MD, PhD, discusses the implications of the ADRIATIC trial of adjuvant therapy with durvalumab vs placebo in patients with LS-SCLC.

Misty D. Shields, MD, PhD, discusses the FDA approval of tarlatamab for patients with extensive-stage small cell lung cancer.

Misty D. Shields, MD, PhD, discusses systemic therapy updates for patients with extensive-stage small cell lung cancer.