Lung cancer 2022 ASCO

 1. Neoadjuvant nivolumab with platinum doublet: 3 cycles

Checkmate 816: NEJM

Stage IB to IIIA. HR 0.63 for a reduction in progression, death, recurrence

Path CR 24% versus 2% standard arm.

Pearl: the tumor, when it shrinks, does NOT move away from the mediastinum or vital structures

NADIM II- neoadjuvant nivo with carbo taxol 3 cycles in resectable IIIA without EGFR/ALK--> surgery-->adjuvant nivo for 6 months.  Improved path CR, PFS and OS. First trial to show OS benefit.

2. Adjuvant atezo after chemo in non small cell lung ca: IMpower 010 JCO:

Stage II to IIIA

DFS benefit with atezo 1 yr given after 4 cycles of platinum doublet

In those with PDL1 1% or higher, DFS not reached with atezo, 35 months with BSC after 4 cycles chemo.

Pearl: Which staging system( AJCC 7) was used in the study and how does it compare to the current AJCC ( 8 now)

3. EGFR mutated localized disease

Should osimertinib be continued when switching to chemo for progression:

Ans: yes, if CNS mets, otherwise there is an ongoing study looking to answer that question