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In Focus: A Roadmap to Precision #Immunotherapy for Early-Stage Non–Small Cell Lung Cancer brnw.ch/21wSHP4 By Alessandra Vaccaro, Zahraa Rahal, Humam Kadara, and Tina Cascone at MD Anderson Cancer Center

Gavitt Woodard Drew Moghanaki Nice job Gavitt Woodard & Yale Thoracic Surgery Important findings: 1) lobectomy does not ⬆️survival vs sublobar w/occult LN+ 2) Equal survival w/sublobar requires adequate LND So, we can probably save lung parenchyma in select patients, but must do a high quality operation w/LND

Agree completely with this. Would be easy to standardize nodal dissection based on which lobe. 8/9 should not count for upper lobe tumors (or should not be used to replace dissection of more relevant upper lobe LN stations in quality standards)

New research presented by Dr. Giorgio Caturegli Yale Surgical Residency Yale Thoracic Surgery #ASCO25 justifies using radiation after chemoimmunotherapy for patients with stage III #NSCLC. #AACR25 Smilow Cancer Hospital Yale School of Medicine Gavitt Woodard meetings.asco.org/2025-asco-annu…

International clinical trial results reveal a 14-gene molecular assay, #RiskReveal, can identify patients with high-risk, early-stage non-squamous #NSCLC who could benefit from adjuvant #chemotherapy. Learn more: hmpgloballearningnetwork.com/site/onc/confe… #ASCO25 #medtwitter #onctwitter

Out now & open access in Nature Medicine concurrent with presentation at #ASCO2025 is NeoCOAST-2! I have been delighted to collaborate on the first platform neoadjuvant trial in lung cancer led by Dr. Tina Cascone nature.com/articles/s4159… ! #LCSM 1/6

Proud of our Yale Surgery residents Giorgio Caturegli and Oluwaseun Ayoade who are representing Yale Thoracic Surgery at #ASCO2025 with two posters using the National Cancer Database in NSCLC. Keep an eye out for Giorgio who will apply to thoracic surgery fellowships in a few years. 👏👏

In stage I resected NSCLC patients we should AIM-HIGH and identify tumors w bad biology and escalate therapy in these pts. 🫁🧬 International trial interim analysis shows high risk pts (#RiskReveal) randomized to adjuvant chemo have improved 24m DFS vs observation. #ASCO2025

The MPR/pCR data is impressive, particularly in Dato-DXd arm, where 63% had MPR/pCR and 35% had pCR. Combining systemic therapies to achieve systemic rx pCR should be goal moving forward. CM816 data should reinforce that it is the neoadjuvant component that is critical! #ASCO25

So interesting and such important work with benign tumor draining lymph nodes in lung cancer. We have so much to learn in this space! Questions if we are helping verses potentially hurting patients with extensive lymph node dissections that may interfere with future IO response

Congratulations Meghan De Meo and Jonathan Spicer MD PhD on trying a new approach! 👏👏 Limited accuracy of blood based assays in stage I-II is always a reminder for me of how far we have to go. If we can’t reliably detect in stage I and II, application for postop MRD even more limited.

After our Yale Cardiothoracic Surgery Residency graduation this weekend it’s a bittersweet final week for our amazing fellow Kelsey Koch 🫁 and graduating I-6 residents Matt Pichert 🫁 and Alex Sotolongo 🫀. They have been wonderful colleagues and excellent surgeons and we will miss them so much! 💙

This is an excellent review by JonVillenaMD about the importance of regional draining lymph nodes in generating an immune response to lung cancer! Really interesting topic and new way to consider the extent of nodal dissection and timing of immunotherapy treatment

#ELIXR25🍁 Authoritative talk by #SanjaDacic Yale University on %RVT (residual tumor volume) as the new TNM? Unearths some pathology truths: - microscopic tumor assessment is subjective - ⬆️interobserver variability in those with MPR 30-60% OncoAlert #LCSM

A busy week for Yale Thoracic Oncology Yale Cancer Center Yale Thoracic Surgery hosting a wonderful group of 🫁 oncologists, surgeons, and pulmonologists from Brazil. Grupo Oncoclínicas 🇧🇷 Great discussions, presentations, real and mock tumor boards. Look forward to ongoing collaboration!

AIM-HIGH trial published in Lancet Molecular high-risk stage IA-IIA NSCLC as determined by 14-gene assay with improved survival with adjuvant chemo. It is not often we see survival curves like this in early stage lung cancer. thelancet.com/journals/lanre…

Please check out our prospective, randomized trial just out in The Lancet Respiratory Medicine 🫁 Stage IA-IIA, non-squamous, surgically resected NSCLC 🧬 Molecular testing of resected tumor 💉 High-risk pts randomized 📉 Adjuvant chemo had DFS benefit vs observation authors.elsevier.com/sd/article/S22…

We should be doing more to identify bad biology stage I 🫁 tumors and attempting to escalate adjuvant care for these patients who are at higher risk of recurrence New and more effective drugs make this concept even more appealing