Lung cancer treatment now varies based on individual tumor biology. Three studies from this year’s American Society of Clinical Oncology Annual Meeting demonstrate how matching patients to therapies improves survival and reshapes care standards.
For decades, lung cancer was treated as a single disease. That approach has changed. Tumors once grouped together are now classified by genetic mutations and protein markers that influence growth. These differences determine whether a patient responds to immunotherapy, targeted drugs, or chemotherapy.
Roy Herbst, deputy director of the Yale Cancer Center, stated that early and thorough testing is essential. He emphasized that standard care should include a multi-disciplinary tumor board and early pathology review. Without testing, patients may miss treatments that could extend their lives significantly.
Data from the meeting provided clear evidence supporting this approach.
A new drug combination for a stubborn subtype
Squamous NSCLC is a subtype of lung cancer that originates in the thin, flat cells lining the airway of the lung. Its typical treatment is chemotherapy with an immune checkpoint inhibitor, which is a type of drug that helps the immune system recognize and attack cancer cells. However, checkpoint inhibitors are not as effective if the lung cancer cells do not have a lot of a molecule called PD-L1 on their surface.
The HARMONi-6 trial examined ivonescimab, a bispecific antibody targeting two proteins: PD-1, which suppresses immune responses, and VEGF, which aids tumor blood vessel formation. The drug aims to both activate the immune system and cut off the tumor’s blood supply.
In the trial, patients with advanced squamous NSCLC received either ivonescimab or the checkpoint inhibitor tislelizumab, each paired with chemotherapy. Ivonescimab delayed disease progression more effectively and improved median overall survival. The results led to a global phase 3 trial, now fully enrolled, including U.S. sites.
The drug is not yet approved outside China, but the findings indicate it could help patients who do not respond to existing therapies.
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Targeted therapy before surgery shows promise
Roughly 15% of NSCLC cases in the U.S have a mutation in the epidermal growth factor receptor (EGFR) gene, which drives uncontrolled cell growth. Osimertinib (Tagrisso) blocks this mutation but is typically given after surgery and chemotherapy. The NeoADAURA trial investigated whether using it earlier—before surgery—could yield better outcomes.
The results showed that osimertinib, with or without chemotherapy, led to a higher major pathological response rate, meaning fewer viable tumor cells remained after treatment.
These findings suggest neoadjuvant osimertinib could make surgery more effective by shrinking tumors and lowering the risk of spread. Study authors advised doctors to consider this approach for patients with resectable EGFR-mutated NSCLC.
The trial also highlights a growing trend: drugs once limited to advanced cancer are now proving effective in earlier stages. This shift could reshape treatment timelines for many patients.
Tumor biology plays a critical role in treatment decisions. Patients with NSCLC should discuss full biomarker testing with their doctors, including checks for EGFR and other actionable mutations. Those with targetable mutations may have alternatives to standard chemotherapy, such as clinical trials or approved targeted therapies.
For patients without known mutations, newer combination approaches or trials may still provide options. The starting point remains testing—without it, treatment becomes a matter of guesswork.
Precision medicine ensures the right patients receive the right treatment at the right time. The data from ASCO show this approach is becoming the norm.
A support group can also help patients handle these treatment decisions.
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