WCLC2023ネタ　第一弾

WCLCネタ

【既治療EGFRm NSCLC患者へのPatritumab Deruxtecan (HER3-DXd)】

🫁HERTHENA-Lung01

論文の内容も踏まえて載せています.https://t.co/mEHCwEojA2

— slim_shady🫁 | 肺がん診療 (@slimshady__7) September 11, 2023

EGFRmutでTKI後のADC製剤の成績。
正直、かなりのlate line、3rd generation TKIで
この成績なのはすごい。

.@chris_dickhoff presents results from INCREASE trial (surgery after chemoRT+I/O for borderline resectable NSCLC): 63% pCR, 79% major pathologic response, only 15% radiographic response (may be related to nodal flare?). Insightful discussion from @PatelOncology. #WCLC23 pic.twitter.com/RLdfVHIEgO

— Jeff Yang MD FACS (@ChiFuJeffYang) September 10, 2023

IO＋CRTでボーダラインの肺がんのｐCRが63%とのこと
ただ、15%しか放射線学的には縮んでなかったとのこと
これを踏まえて

1/
pCRs after RT for NSCLC #lungcancer are rich #radonc data...

The INCREASE trial:
chemoRT(50Gy)+ipi+nivo
surgery @ 6wks post-RT
pCR: 63%

SWOG 9416 kind of similar setup, minus immunotx
chemoRT 45 Gy, surgery 3-5 weeks
pCR: 36%https://t.co/qLJayrA0mO https://t.co/5PDFXx5uUR

— Todd Scarbrough (@toddscarbrough) September 10, 2023

こんな意見も。

ISABR

From @MDAndersonNews , @JoeChangMD presents the results of the ISABR study at #WCLC23

🚨 IO when added to #SABR in stage 1 NSCLC improves 4yr EFS 53% vs 77%

➡️ Phase 3 study awaited
➡️ Can radiomics identify those patients who will benefit the most? pic.twitter.com/oU0vOSqj4r

— Gerry Hanna (@gerryhanna) September 11, 2023

https://note.com/nijuoti/n/n0b60a84e6589

フォレストプロットや
副作用はnoteではあまり触れてなかったのでスライドを
間違いなくIII相が待たれます。
ラジオミクスの話は確かに、という感じ

https://twitter.com/crispinhiley/status/1700774408179286232

So my personal take home from the EORTC consensus definition of resectability in stage III NSCLC - not much consensus around the contentious groups. Still will be driven by MDTs until we have trials #WCLC23 pic.twitter.com/zPYtFMxIaw

— Crispin Hiley (@crispinhiley) September 10, 2023

EORTCの`resectable`のコンセンサス
今後外科に流れるのは致し方なしか。
N2は「組織をつけろ」が海外の常識

.@peters_solange presents 6yr CM227 part 1 data. Impressive and maintained N/I OS for PDL1negs, esp DOR & 6yr PFS rate #WCLC23 pic.twitter.com/33D3xWOKNL

— Sanjay Popat (@DrSanjayPopat) September 11, 2023

ケモ＋イピニボで日本ではイピニボ人気ないが、
やはり使いどころはあるレジメンと感じる。
とくにPD-L1発現低いのは使いたい…

https://twitter.com/ChiFuJeffYang/status/1701052998372495765

Paradigm-shifting study by @ekslim et al: MARS-2 trial w/ @paugalde20 discussion. pleurectomy / decortication + chemo Vs chemo. Surgery had worse OS: HR 1.28, p=0.03. 2nd landmark surgery RCT from the UK team presented at #WCLC23 by @ekslim in past 3 years. pic.twitter.com/bqBjFX0PdH

— Jeff Yang MD FACS (@ChiFuJeffYang) September 11, 2023

https://twitter.com/DrSanjayPopat/status/1701048092487737670

.@ekslim presents MARS2. Undoubted reduced survival with surgery (EPD) n=355. 28% increased risk of death. No difference due to chemo impact. QOL worse for surgery. Time to dismiss the concept of resectability #WCLC23 @IASLC #mesothelioma pic.twitter.com/1Yf1eqOWxt

— Sanjay Popat (@DrSanjayPopat) September 11, 2023

PL03.10 MARS 2: A Multicentre Randomised Trial Comparing (Extended) Pleurectomy Decortication versus No Radical Surgery for Mesothelioma @ekslim. Practice changing results based on a clinically relevant design.#LCSM #WCLC23 @IASLC @OncoAlert pic.twitter.com/GKI6i4nnsy

— Hidehito Horinouchi (@HHorinouchi) September 11, 2023

今までのところ一番みんな衝撃を受けているstudyのよう
MARS-2
要は中皮腫でケモvs.ケモ＋手術で
（超長期はまだ見ないといけないが）
ケモのほうが
・死亡リスク少ない
・副作用少ない
・QOL良い
・費用対効果も優れる
と呼吸器外科医の心を折りかねない結果…