Oncology Brothers: Practice-Changing Cancer Discussions Lung Cancer ESMO 2025 Highlights: MDT-BRIDGE, FLAURA2, SOHO-01, Beamion LUNG-1
Nov 6, 2025
Dr. Rami Manochakian, a thoracic oncologist from the Mayo Clinic, shares groundbreaking insights from ESMO 2025 on lung cancer. He highlights the significance of the MDT-BRIDGE trial, which showcases a multidisciplinary approach for non-small cell lung cancer. The conversation dives into the FLAURA2 study, showing survival benefits of osimertinib with chemotherapy. Plus, he introduces promising HER2-targeted therapies like Zongertinib and Sevabertinib, emphasizing the need for upfront NGS testing to personalize treatment strategies.
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Reassess Resectability Early
- Reassess resectability after 2 cycles of chemo-immunotherapy rather than committing to a full neoadjuvant course upfront.
- Proceed to surgery for responders and use concurrent chemoradiation for those still unresectable to preserve options.
Chemo Plus Osimertinib Improves Survival
- Combining osimertinib with platinum-pemetrexed chemotherapy improved overall survival with a hazard ratio of 0.77 and ~10 months median benefit.
- The combination shows particular benefit in high-risk subgroups such as CNS or liver metastases and TP53 co-mutations.
Add Local Consolidation Upfront
- Consider local consolidation (surgery or radiation) in EGFR-mutant metastatic patients receiving systemic therapy to improve progression-free and overall survival.
- Discuss local therapy options in multidisciplinary review rather than defaulting to systemic therapy alone.