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Live · Day 1–2
OncLive Bridging The Gaps in Lung Cancer · decoded by KOL Pulse

BTG Lung 2026

OncLive’s educational meeting on the gaps in lung cancer care, decoded by KOL Pulse. Across both days: small cell lung cancer — tarlatamab as the 2L standard, DLL3-directed T-cell engagers, and emerging ADCs; EGFR-mutant NSCLC — how to choose 1L combinations and treat early-stage disease; and, on Day 2, perioperative / resectable NSCLC (CheckMate-77T by nodal status, management after neoadjuvant therapy) and oligometastatic NSCLC radiotherapy. Below: the presenters’ data slides, transcribed with sources.

38 curated posts Featured voice: Eric K. Singhi, MD California, USA · Jul 21–22, 2026 (2-day) 11 data slides decoded

Live from the podium

Thoracic medical oncologist, MD Anderson Cancer Center · @lungoncdoc · live curator of BTG Lung 2026

Faculty

The physician faculty presenting at BTG Lung 2026. X handles are linked where confirmed; other names are listed as presented.

Day 1
Thoracic medical oncology · MD Anderson Cancer Center · @lungoncdoc
Thoracic medical oncology · Dana-Farber Cancer Institute · @NarjustFlorezMD
Medical oncology · @drshieldsmd
Daniel B. Costa, MD
Medical oncology · EGFR 1L therapy selection
Jay M. Lee, MD
Early-stage EGFR-mutated NSCLC
Day 2
Thoracic surgery · borderline-resectable NSCLC · @BrendonStilesMD
Radiation oncology · oligometastatic NSCLC / RT · @PercyLeeMD
Cheryl Ho, MD
Medical oncology · management after neoadjuvant therapy
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Slides & posts

Every slide presented at BTG Lung 2026 as posted by Eric K. Singhi, MD — his post verbatim, the slide image (click to enlarge), and the full slide text transcribed word-for-word. No summaries.

Small Cell Lung Cancer · Day 1
Eric K. Singhi, MD @lungoncdoc · Jul 21, 2026 · 3 slides
View post ↗
#BTGLung2026 kicks off with small cell lung cancer...

What's known, and what may be changing?

1. Tarlatamab is our preferred 2L option.
2. ADCs are emerging.
3. Will our 1L treatment for ES-SCLC change?

@OncLive @drshieldsmd @NarjustFlorezMD @DrEdKim
DeLLphi-304

What is known: tarlatamab is the preferred SOC 2L therapy

Eric K. Singhi, MD
What is known: tarlatamab is the preferred SOC 2L therapy Improved Survival | Higher response rate | Favorable safety profile [KM curve — Overall Survival] HR 0.60, p<0.001 mOS 13.6 (11.1- NR) — Tarlatamab mOS 8.3 (7.0-10.2) — Chemotherapy Percentage of Patients vs Months since Randomization (0-21) No. at Risk Tarlatamab 254 220 192 131 60 17 0 Chemotherapy 255 210 156 97 42 9 2 0 [Response table] Tarlatamab (n = 254) Chemotherapy (n = 255) Best overall response*t, n (%) Complete response 3 (1) 0 (0) Partial response 86 (34) 52 (20) Stable disease 84 (33) 112 (44) Progressive disease 56 (22) 50 (20) Not evaluable/no post-baseline scan 25 (10) 41 (16) Objective response rate:, % (95% CI) 35 (29-41) 20 (16-26) Median duration of response, months 6.9 5.5 Median time to objective response, months 1.5 1.4 Ongoing response at data cutoff, n§ (%) 42 (47) 8 (15) [Safety table] Tarlatamab (n = 252)* Chemotherapy (n = 244)* Median duration of treatment, months, (range) 4.2 (< 1-17) 2.5 (< 1-15) All grade, TEAEs, n (%) 249 (99) 243 (100) All grade, TRAEs n (%) 235 (93) 223 (91) Grade ≥ 3 TRAEs, n (%) 67 (27) 152 (62) Serious TRAEs, n (%) 70 (28) 75 (31) TRAEs leading to dose interruption and/or dose reduction, n (%) 48 (19) 134 (55) TRAEs leading to discontinuation, n (%) 7 (3) 15 (6) Treatment-related grade 5 events†, n (%) 1 (0.4) 4 (2) Rudin et al, ASCO 2025 Mountzios et al, NEJM 2025
Rudin et al, ASCO 2025; Mountzios et al, NEJM 2025
Cross-trial ADC table (SCLC)

ADCs are emerging key players in SCLC

Eric K. Singhi, MD
ADCs are emerging key players in SCLC ADC Trial / Phase ORR mPFS (mo) mOS (mo) Ifinatamab Deruxtecan¹ B7-H3 IDeate-Lung01 Phase II 48% 4.9 10.3 Sacituzumab Govitecan² TROP2 TROPiCS-03 Phase II 42% 4.4 13.6 ABBV-706³ SEZ6 NCT05599984 Phase I 52% 5.4 11.3 Zocilurtatug pelitecan⁴ DLL3 NCT06179069 Phase I 47% 5.4 - Encouraging results in later-line setting Is there a role for ADCs in earlier treatment settings? ¹Rudin et al, JCO 2025 ²Dowlati et al, ASCO 2026 ³Byers et al, Nature Med 2026 ⁴Patel et al, ASCO 2025
1 Rudin et al, JCO 2025; 2 Dowlati et al, ASCO 2026; 3 Byers et al, Nature Med 2026; 4 Patel et al, ASCO 2025
1L ES-SCLC landscape

The unknown: What is optimal 1L therapy in ES-SCLC?

Eric K. Singhi, MD
The unknown: What is optimal 1L therapy in ES-SCLC? Standard of care: Platinum / Etoposide / ICI 60-70% response rate + Additive BiTE Obrixtamig (DAREON-Lung-1) Tarlatamab (DeLLphi-312) VEGFi Ivonescimab (PD-L1 x VEGF) BNT327 (PD-L1 x VEGF) PF-08634404 (PD-1 x VEGF) Other BMS-986489 (Anti-fucosyl-GM1 antibody + nivolumab) Replacement +/- Carboplatin I-DXd OR ABBV-706 OR ZL-1310 Atezolizumab IDeate-Lung03 SEZanne NCT06179069
IDeate-Lung03; SEZanne; NCT06179069
Eric K. Singhi, MD @lungoncdoc · Jul 21, 2026 · 1 slide
View post ↗
DLL3-directed therapies have officially arrived in SCLC. The question is no longer IF to use them...but WHEN. Dr. @alissajcooper reviews the evolving treatment landscape at #BTGLung2026.
DLL3 T-cell engagers

Controversy 3: Appropriate place in the paradigm

Alissa J. Cooper, MD (presented) · posted by Eric K. Singhi, MD
Controversy 3: Appropriate place in the paradigm 1. EARLIER USE (MAINTENANCE / FRONTLINE) Chemo-IO Induction → Tarlatamab Maintenance (DeLLphi-303/305) · Frontline Induction + Maintenance (DeLLphi-312) Rationale • Earlier immune priming may enhance depth and durability of response • Treat before T-cell exhaustion and high tumor burden Key Uncertainties • Does earlier DLL3 targeting limit activity of later options? • Long-term cumulative immune toxicity • Risk of selecting DLL3-low or -negative escape clones 2. SEQUENCING IN RELAPSED DISEASE (2L AND BEYOND) Tarlatamab (2L) or Other Therapies (e.g., ADCs, chemo, lurbinectedin) or DLL3 TCE Later Line Rationale • Established OS benefit for tarlatamab in 2L • Preserves future options and trial access Key Uncertainties • What is the optimal order of DLL3 TCEs, ADCs, and other agents? • Impact of prior lines on efficacy and toxicity of DLL3 TCEs • Best approach after progression on maintenance IO 3. RATIONAL COMBINATION PARTNERS — WHAT, WHEN, AND FOR WHOM? PD-L1 Blockade — Enhance T-cell activation and persistence ADCs — Tumor debulking + immune engagement (e.g., B7-H3, SEZ6, TROP2 ADCs) Radiation — Potential immunogenic cell death and abscopal effect Cytokines / Immunomodulators — IL-2 agonists or other immune enhancers Biomarker-Selected Approaches — DLL3 expression, CTC DLL3, transcriptional subtype, immune context
Slide as presented at BTG Lung 2026
EGFR-Mutant NSCLC · Day 1
Eric K. Singhi, MD @lungoncdoc · Jul 21, 2026 · 1 slide
View post ↗
Now we tackle gaps in EGFR+ lung cancer here at #BTGLung2026

First take home point... not all EGFR "positive" lung cancers are the same.

@OncLive @EGFRResisters
EGFR 1L decision framework

EGFR Targeting Therapies in Advanced NSCLC: Selecting the Appropriate Therapy in 1L

Daniel B. Costa, MD, PhD, MMSc (presented) · posted by Eric K. Singhi, MD
EGFR Targeting Therapies in Advanced NSCLC: Selecting the Appropriate Therapy in 1L MD Anderson Cancer Center preclinical structure-function classification of EGFR mutants for sensitivity to EGFR TKIs: Classical (EGFR-exon 19 indel or -L858R)-like: little-to-no impact on EGFR TKI drug binding and hypersensitive to EGFR TKIs T790M-like: hydrophobic core P-loop αC-helix compression (PACC): proximal to drug-binding pocket and heterogeneous sensitivity to EGFR TKIs Exon 20 loop insertion: C-terminal look of αC-helix and insensitive to gefitinib, erlotinib, afatinib, dacomitinib, lazertinib and osimertinib Clinically-relevant EGFR mutations (kinase domain, exons 18-24): exon 19 indels (45%) · L858R (35%) · L861Q (3%) · T790M Other clinically-relevant mutations: A763_Y764insFQEA (<0.1%) G719X (>5%) · S768I (>1%) E709X/delE709_T710insX (>0.5%) · G724S · G736K · K757X · V769X · V771G · V774M · V776X · G779F exon 19 insertion K745_E746insXPVAIK (>0.5%) · L747X (<0.5%) exon 20 insertions (10%) Type of EGFR TKI and/or combination therapy is dependent on the specific EGFR kinase mutation My (Daniel B. Costa) personal 1st line choices (July 7th, 2026) EGFR mutated NSCLC "targeted therapies" classical-like mutations (EGFR-exon 19 deletions/indels) *,** (EGFR-L858R) *,** (EGFR-L861Q) osimertinib * lazertinib + amivantamab (SC) (ECOG PS 0-1, eligible for anticoagulation) ** osimertinib + carboplatin/pemetrexed (ECOG PS 0-1, adequate renal function) PACC mutations (EGFR-G719X, EGFR-S768I) (others) afatinib EGFR exon 20 insertion mutations sunvozertinib or amivantamab + carboplatin/pemetrexed Slide adapted from personal collection of Daniel B. Costa, MD, PhD, MMSc (Berg JM, Kobayashi TA, Costa DB. Transl Cancer Res. 2025; 14:16) (Berg JM et al. Transl Lung Can Res. 2026; 15:144)
Slide adapted from personal collection of Daniel B. Costa, MD, PhD, MMSc. (Berg JM, Kobayashi TA, Costa DB. Transl Cancer Res. 2025; 14:16) (Berg JM et al. Transl Lung Can Res. 2026; 15:144)
Eric K. Singhi, MD @lungoncdoc · Jul 21, 2026 · 1 slide
View post ↗
Top 5 gaps in EGFR+ lung cancer today?

1. Who really needs combo therapy?
2. How do we choose b/w frontline combos?
3. Is TKI monotherapy still enough?
4. Can we reduce toxicity w/o sacrificing efficacy?
5. Should we treat earlier to improve long-term outcomes?

#BTGLung2026
1L EGFR combination controversies

Key controversies and open questions for combination therapies in the 1st line setting for NSCLCs with EGFR mutations: How to select patients for and how to manage toxicities of chemotherapy or EGFR-MET antibody

Daniel B. Costa, MD, PhD, MMSc (presented) · posted by Eric K. Singhi, MD
Key controversies and open questions for combination therapies in the 1st line setting for NSCLCs with EGFR mutations: How to select patients for and how to manage toxicities of chemotherapy or EGFR-MET antibody 1. Are there any clinical characteristics or tumor biomarkers (genomic aberrations) that can be used in point-of-care routine clinical practice to determine which patients benefit the most from combination therapies or that could be treated with EGFR TKI monotherapy? 2. Are there any clinical characteristics or tumor biomarkers (genomic aberrations) that can be used in point-of-care routine clinical practice to determine which patients benefit the most from chemotherapy + osimertinib versus amivantamab + lazertinib? 3. Should better/novel EGFR TKI monotherapy strategies be developed to maximize clinical benefits beyond what current approved therapies provide? 4. Should less toxic/less cumbersome/less expensive combination strategies be developed to maximize clinical benefits beyond what current approved therapies provide? 5. Should focus shift to initiating EGFR TKI monotherapy (+/- combinations) at earlier stages of disease burden to minimize need of therapy escalation?
Slide as presented at BTG Lung 2026
Eric K. Singhi, MD @lungoncdoc · Jul 21, 2026 · 1 slide
View post ↗
5 biggest unanswered questions in early-stage #EGFR lung cancer?

1. Who needs chemotherapy?
2. How long should we treat?
3. Can ctDNA guide decisions?
4. Who benefits from perioperative therapy?
5. What's the best strategy at recurrence?

#BTGLung2026 @OncLive
Early-stage EGFR treatment map

Early-stage EGFR-mutated NSCLC: the unresolved treatment map

Jay M. Lee, MD (presented) · posted by Eric K. Singhi, MD
Early-stage EGFR-mutated NSCLC: the unresolved treatment map The major gray zones are no longer whether EGFR-directed therapy works - but who should receive which components, when, and for how long. THE CENTRAL QUESTION How do we individualize curative-intent EGFR therapy? WHO · WHEN · WHAT · HOW LONG · WHAT NEXT? 1 THERAPEUTIC INTENT & DURATION • CURE or SUPPRESSION? • 3 years vs 5 years vs indefinite therapy? • Can low-risk patients safely receive <3 years? 2 TIMING / PERIOPERATIVE STRATEGY • Neoadjuvant, adjuvant, or true perioperative therapy? • Does preoperative osimertinib improve EFS, OS, resectability, or cure beyond surgery followed by adjuvant osimertinib? 3 CHEMOTHERAPY DE-ESCALATION • Who can safely omit platinum chemotherapy? • Stage IB? ctDNA-negative? Major pathologic response? Older/frail? Low molecular risk? 4 RISK & MRD ADAPTATION • What defines "high-risk" EGFRm eNSCLC? • Can MRD guide when to start, stop, extend, restart, or intensify osimertinib? 5 RECURRENCE & NEXT THERAPY • Does timing of recurrence change management? • Osimertinib rechallenge vs chemotherapy, antibody combinations, or resistance-directed therapy? FUTURE DIRECTION: stage + pathologic response + genomic risk + longitudinal ctDNA → adaptive therapy Selected evidence: Wu Y-L et al. N Engl J Med. 2020 (ADAURA); Tsuboi M et al. N Engl J Med. 2023 (ADAURA OS); He J et al. J Clin Oncol. 2025 (NeoADAURA); ClinicalTrials.gov: NCT05120349 (ADAURA2), NCT05526755 (TARGET), NCT05536505 (CTONG2105). Abbreviations: ctDNA, circulating tumor DNA; EFS, event-free survival; EGFRm, EGFR-mutated; eNSCLC, early-stage NSCLC; MPR, major pathologic response; MRD, molecular residual disease; OS, overall survival. Presenter: Jay M. Lee, M.D.
Selected evidence: Wu Y-L et al. N Engl J Med. 2020 (ADAURA); Tsuboi M et al. N Engl J Med. 2023 (ADAURA OS); He J et al. J Clin Oncol. 2025 (NeoADAURA); ClinicalTrials.gov: NCT05120349 (ADAURA2), NCT05526755 (TARGET), NCT05536505 (CTONG2105).
Perioperative & Early-Stage / Local Therapy · Day 2
Eric K. Singhi, MD @lungoncdoc · Jul 22, 2026 · 1 slide
View post ↗
CM77T shows us something important: biology doesn't know whether a patient has single- or multistation N2 disease.

Those at the highest risk of micrometastatic disease may also have the most to gain from our best systemic therapy upfront.

#BTGLung2026 @OncLive @BrendonStilesMD
CheckMate-77T

CheckMate 77T

posted by Eric K. Singhi, MD
CheckMate 77T [nature cancer — Article] Clinical outcomes with perioperative nivolumab by nodal status in patients with stage III resectable NSCLC: phase 3 CheckMate 77T exploratory analysis https://doi.org/10.1038/s43018-025-01104-z Received: 13 January 2025 · Accepted: 25 November 2025 Table 1 | Patient baseline characteristics Stage III N2ᵃ Stage III non-N2ᵃʸᵇ Nivolumab (n=91) Placebo (n=90) Nivolumab (n=55) Placebo (n=57) Disease stage III, n (%) IIIA 48 (53) 57 (63) 55 (100) 57 (100) IIIB 43 (47) 33 (37) 0 0 N2 station status, n (%)ᵈ Single 59 (65) 53 (59) NA NA Multiple 31 (34) 37 (41) NA NA Histology, n (%) Squamous 40 (44) 38 (42) 31 (56) 34 (60) Nonsquamous 51 (56) 52 (58) 24 (44) 23 (40) a pCR rate (%) — Stage III N2 All patients: Nivolumab 22.0%ᵇ (20/91) vs Placebo 5.6%ᶜ (5/90) — Difference 16.4%ᵃ Patients with resection: Nivolumab 28.6%ᵉ (20/70) vs Placebo 7.6%ᶠ (5/66) — Difference 21.0%ᵈ pCR rate (%) — Stage III non-N2 All patients: Nivolumab 25.5%ʰ (14/55) vs Placebo 5.3%ⁱ (3/57) — Difference 20.2%ᶠ Patients with resection: Nivolumab 31.1%ᵏ (14/45) vs Placebo 6.7%ˡ (3/45) — Difference 24.4%ʲ b pCR rate (%) — Stage III single-station N2ᵐ All patients: Nivolumab 18.6%ᵒ (11/59) vs Placebo 7.5%ᵖ (4/53) — Difference 11.1%ⁿ Patients with resection: Nivolumab 24.4%ʳ (11/45) vs Placebo 10.8%ˢ (4/37) — Difference 13.6%۠ pCR rate (%) — Stage III multistation N2ᵐ All patients: Nivolumab 29.0%ᵘ (9/31) vs Placebo 2.7%ᵛ (1/37) — Difference 26.3%ᵗ Patients with resection: Nivolumab 37.5%ˣ (9/24) vs Placebo 3.4%ʸ (1/29) — Difference 34.1%ʷ
Nature Cancer. Clinical outcomes with perioperative nivolumab by nodal status in patients with stage III resectable NSCLC: phase 3 CheckMate 77T exploratory analysis. https://doi.org/10.1038/s43018-025-01104-z (Received: 13 January 2025; Accepted: 25 November 2025)
Eric K. Singhi, MD @lungoncdoc · Jul 22, 2026 · 1 slide
View post ↗
Management after neoadjuvant therapy in NSCLC...

What do we know, and what are the gaps?

#BTGLung2026 @OncLive
Post-neoadjuvant management

Key Takeaways — Management after neoadjuvant therapy in NSCLC

Cheryl Ho, MD (presented) · posted by Eric K. Singhi, MD
Key Takeaways Management After Neoadjuvant Therapy – Is the adjuvant IO component necessary? -Neoadjuvant treatment results including pathologic response, resection margins, ctDNA may influence adjuvant decision making -Use of ctDNA technology requires agreed upon standards Management After Neoadjuvant: AGA -Neoadjuvant TKI results are less robust with EGFR and ALK than treatment with chemo+IO -Adjuvant durvation in the peri-operative setting may be informed by ADAURA, ARTS, ALINA, ELEVATE -Similar to perioperative chemo+IO, decisions may be guided by tools like ctDNA Management after neoadjuvant: Surveillance -Consider risk stratified surveillance by stage, residual viable tumor, ctDNA positivity, driver alterations -Tools for surveillance may also include MRI brain, ctDNA -Metastases directed therapy options and better systemic treatments increase the value of surveillance Cheryl Ho
Slide as presented at BTG Lung 2026 (Cheryl Ho)
Eric K. Singhi, MD @lungoncdoc · Jul 22, 2026 · 1 slide
View post ↗
Borderline resectable NSCLC - the path forward? @BrendonStilesMD

1. Think biology > anatomy.
2. Systemic therapy first.
3. Always reassess resectability.
4. Don't label unresectable too early.
5. Right patient. Right therapy. Right time.

#BTGLung2026
Borderline-resectable NSCLC

Conclusions: the path forward in borderline resectable NSCLC

Brendon M. Stiles, MD (presented) · posted by Eric K. Singhi, MD
CONCLUSIONS: THE PATH FORWARD IN BORDERLINE RESECTABLE NSCLC 1. Borderline resectability is a biologic—not simply an anatomic—concept. 2. Neoadjuvant systemic therapy should precede irreversible decisions whenever feasible. 3. Borderline N2—and perhaps selected N3—patients deserve reassessment after induction therapy. (Dynamic nodal reclassification) 4. Surgery arguably remains the most effective local therapy and provides the best biological assessment. 5. However, the future is unlikely to be "surgery versus radiation"—instead, the future is identifying which patients benefit from local therapy after receiving the most effective systemic therapy available. (Best systemic therapy → Multidisciplinary reassessment → Tailored local therapy → Long-term systemic therapy when indicated) Our goal is not just to treat disease—but to offer the right treatment, to the right patient, at the right time.
Slide as presented at BTG Lung 2026 (Brendon Stiles)
Eric K. Singhi, MD @lungoncdoc · Jul 22, 2026 · 1 slide
View post ↗
Top 5 questions still shaping the role of RT in oligometastatic NSCLC:

1. Who?
2. When?
3. Where?
4. How much?
5. Which biology?

Quick plug for our @JAMAOnc patient page on LCT in lung cancer. @maraantonoff: https://t.co/4q3x431Jaw

#BTGLung2026 @PercyLeeMD
Patient education — LCT

Local consolidative therapy (LCT) in lung cancer — JAMA Oncology Patient Page

shared by Eric K. Singhi, MD (JAMA Oncology patient page)
Local consolidative therapy (LCT) in lung cancer treats remaining cancer spots in some patients whose lung cancer has spread beyond the lungs, after it has already responded to bodywide (systemic) therapy. LCT may include focused radiation, surgical removal, or ablation. LCT may be an option for select patients who could benefit from additional treatment and are able to tolerate the risks. Benefits Keep spread of cancer controlled longer Delay cancer growth or spread Reduce risk of complications from remaining cancer spots Potential risks or side effects Fatigue, skin irritation, pain, or discomfort Lung inflammation Breaks in drug therapy (Remaining cancer spot seen on scans) LCT patient eligibility considers a number of overlapping circumstances. Patient response and health • Good response to drug therapy • Mostly controlled cancer growth with only few remaining spots • Patient's goals and ability to tolerate additional therapy Timing • After good response to drug therapy • Before remaining cancer spots cause symptoms • When LCT can be done safely Care team involvement • Patient and caregivers • Medical oncologist • Radiation oncologist • Surgeon LCT is not for everyone and should only be considered for certain patients with careful timing, planning, monitoring, and guidance from the care team.
JAMA Oncology Patient Page on local consolidative therapy in lung cancer (linked by @lungoncdoc, crediting @maraantonoff). Not a podium data slide.

The BTG Lung 2026 polls — and how the room voted

Eric K. Singhi, MD ran 8 practice polls on X before and during the meeting; 289 votes were cast. Questions and answer options are reproduced exactly as posted. Percentages are the live X poll results.

Small Cell Lung Cancer
Poll Q1 Final result · 46 votes

What's the biggest unmet need in SCLC care today?

  • Predictive biomarkers48%22
  • Better CNS-directed tx11%5
  • Better 2L options28%13
  • Faster dx & tx13%6
View poll on X ↗
Poll Q2 Final result · 17 votes

Are DLL3-directed T-cell engagers changing how you sequence 2L SCLC therapy?

  • Yes using earlier65%11
  • Only in select patients18%3
  • Not yet but plan to12%2
  • No sequencing not changed6%1
View poll on X ↗
EGFR-Mutant NSCLC
Poll Q2 Final result · 51 votes

For newly diagnosed EGFR del 19 mNSCLC, is combination therapy your default over monotherapy?

  • Yes, for most patients55%28
  • Only high-risk features10%5
  • No, monotherapy default4%2
  • Case-by-case decision31%16
View poll on X ↗
Poll Q2 Final result · 30 votes

How comfortable are you managing EGFR exon 20 insertion NSCLC with newer options like sunvozertinib?

  • Very, already using13%4
  • Somewhat, limited exp33%10
  • Not used it40%12
  • Prefer Ami + Chemo13%4
View poll on X ↗
Poll Q3 Final result · 32 votes

How long do you typically continue adjuvant osimertinib after resection?

  • Fixed 3 yrs for all41%13
  • Beyond 3 yrs for all6%2
  • Extend >3yrs if high risk28%9
  • Routine MRD/ctDNA guided25%8
View poll on X ↗
Early-Stage & Perioperative NSCLC
Poll Q1 Voting open · 47 votes

Do you consider a patient with multi-station N2 disease for definitive surgical resection?

  • Yes routinely19%9
  • Only favorable biology13%6
  • No, chemoRT is default36%17
  • Depends on surgery team32%15
View poll on X ↗
Poll Q2 Voting open · 30 votes

Does ctDNA influence your decision-making about surgery after neoadjuvant therapy?

  • Yes frequently7%2
  • Sometimes20%6
  • Rarely23%7
  • Not at all50%15
View poll on X ↗
Poll Q3 Voting open · 36 votes

For a patient with a solitary brain metastasis and otherwise resectable NSCLC, what is your preferred initial strategy?

  • Local tx to both sites25%9
  • Systemic tx 1st, reassess28%10
  • Case by case multiD17%6
  • Depends on biomarker(s)31%11
View poll on X ↗

Singhi’s poll wrap-up — “If you voted for our #BTGLung2026 polls, you’ll want to see the results here!!” — points to the OncLive live broadcast where the faculty panel discussed the results against their own practice. View his post ↗

KOL voices

Verbatim posts from BTG Lung 2026, ranked by reach.

Eric K. Singhi, MD @lungoncdoc
Beyond EGFR

Which recently emerged/emerging biomarker are you most excited about testing for today?

#BTGLung2026 @OncLive @DrEdKim @NarjustFlorezMD
3,706 impressions2026-07-19
Eric K. Singhi, MD @lungoncdoc
Poll Q1. What's the biggest unmet need in SCLC care today?

#BTGLung2026 @OncLive @DrEdKim @NarjustFlorezMD @drshieldsmd
3,110 impressions2026-07-15
Eric K. Singhi, MD @lungoncdoc
Where are the biggest gaps in lung cancer care?

Ahead of #BTGLung2026, vote in our upcoming polls on some of the most debated questions in thoracic oncology.

We'll share how your responses compare with our expert panel discussion.

@OncLive @NarjustFlorezMD @DrEdKim https://t.co/66kCHuZSbl
1,836 impressions2026-07-15
Eric K. Singhi, MD @lungoncdoc
Poll Q2. EGFR+ NSCLC

For newly diagnosed EGFR del 19 mNSCLC, is combination therapy your default over monotherapy?

#BTGLung2026 @OncLive @DrEdKim @NarjustFlorezMD
1,830 impressions2026-07-17
Eric K. Singhi, MD @lungoncdoc
Poll Q2. Are DLL3-directed T-cell engagers changing how you sequence 2L SCLC therapy?

#BTGLung2026 @OncLive @drshieldsmd @NarjustFlorezMD @DrEdKim
1,544 impressions2026-07-15
Eric K. Singhi, MD @lungoncdoc
Early-Stage NSCLC Polls!

Poll Q1. Do you consider a patient with multi-station N2 disease for definitive surgical resection?

#BTGLung2026 @OncLive @NarjustFlorezMD @DrEdKim @BrendonStilesMD @PercyLeeMD
1,527 impressions2026-07-18
Eric K. Singhi, MD @lungoncdoc
@OncLive @DrEdKim @NarjustFlorezMD @BrendonStilesMD @PercyLeeMD Poll Q3. For a patient with a solitary brain metastasis and otherwise resectable NSCLC, what is your preferred initial strategy?

#BTGLung2026 @OncLive @DrEdKim @NarjustFlorezMD @BrendonStilesMD @PercyLeeMD
1,349 impressions2026-07-18
Misty Dawn Shields, MD @drshieldsmd
@lungoncdoc @OncLive @DrEdKim @NarjustFlorezMD It’s like watching “Inception” here with Dr. Eric Singhi tweeting live top clinical and research gaps in lung cancer care at the #BTGLung26 https://t.co/FdveSm2NH0
1,307 impressions2026-07-21
Eric K. Singhi, MD @lungoncdoc
Poll Q2. Does ctDNA influence your decision-making about surgery after neoadjuvant therapy?

#BTGLung2026 @OncLive @DrEdKim @NarjustFlorezMD @BrendonStilesMD @PercyLeeMD
1,145 impressions2026-07-18
Eric K. Singhi, MD @lungoncdoc
Beyond EGFR…

What's your first-line choice for HER2-mutant mNSCLC?

#BTGLung2026 @OncLive @DrEdKim @NarjustFlorezMD
935 impressions2026-07-19
Narjust Florez, MD, FASCO @NarjustFlorezMD
Day 1 of #BTGLung26 in the books! Powerful discussions on small cell lung cancer beyond first-line therapy and EGFR-mutated NSCLC, from advanced disease to early-stage

Grateful to our incredible faculty for the honest debate and consensus-building. On to Day 2! 🫁

@OncLive https://t.co/EFDGVjxros
914 impressions2026-07-22
Eric K. Singhi, MD @lungoncdoc
Final set of polls before #BTGLung2026
Immunotherapy and Beyond…

Are you routinely adding CTLA-4 blockade to first-line chemo-immunotherapy for PD-L1–negative NSCLC?

@OncLive @DrEdKim @NarjustFlorezMD
895 impressions2026-07-20
Eric K. Singhi, MD @lungoncdoc
Poll Q2. EGFR+ NSCLC

How comfortable are you managing EGFR exon 20 insertion NSCLC with newer options like sunvozertinib?

#BTGLung2026 @OncLive @DrEdKim @NarjustFlorezMD
885 impressions2026-07-17
Eric K. Singhi, MD @lungoncdoc
@OncLive @DrEdKim @NarjustFlorezMD Q. Do VEGF/PD-1 bispecific antibodies have you rethinking your frontline immunotherapy approach?

@OncLive @DrEdKim @NarjustFlorezMD #BTGLung2026
848 impressions2026-07-20
Eric K. Singhi, MD @lungoncdoc
@OncLive @DrEdKim @NarjustFlorezMD Poll Q3. EGFR+ NSCLC

How long do you typically continue adjuvant osimertinib after resection?

#BTGLung2026 @OncLive @DrEdKim @NarjustFlorezMD
798 impressions2026-07-17
Narjust Florez, MD, FASCO @NarjustFlorezMD
When the agenda says “EGFR,” you know you’re in for an afternoon of great science and even better discussions about existing gaps

#BTGLung26

@JorgeAlatorreA1 @ElaineShumMD @OncLive @EGFRResisters @DFEGFRcenter @EgfrUk https://t.co/lueZZGIv4Y
676 impressions2026-07-21
OncLive.com @OncLive
Media
The stage is set and we couldn’t be more thrilled to kick off #BTGLung2026 today in sunny California ☀️ #lcsm @NarjustFlorezMD @DrEdKim https://t.co/LweQKIZegC
610 impressions2026-07-21
Eric K. Singhi, MD @lungoncdoc
Q. Which ADC have you used most commonly after progression on chemo-immunotherapy?

@OncLive @DrEdKim @NarjustFlorezMD #BTGLung2026
608 impressions2026-07-20
Eric K. Singhi, MD @lungoncdoc
Pulse check: What's the biggest unmet need in SCLC care today? #BTGLung2026 https://t.co/smQX9Kyzn2 https://t.co/PYLotngik4
497 impressions2026-07-21
Eric K. Singhi, MD @lungoncdoc
DLL3-directed therapies have officially arrived in SCLC. The question is no longer IF to use them...but WHEN. Dr. @alissajcooper reviews the evolving treatment landscape at #BTGLung2026. https://t.co/9gGEJIzhqT
477 impressions2026-07-21
Eric K. Singhi, MD @lungoncdoc
One of the most challenging problems in thoracic oncology? SCLC transformation.

It's an area of tremendous unmet need, particularly for our patients with young-onset lung cancer.
@triparnasen reviews the latest data and emerging directions at #BTGLung2026. https://t.co/1lVlWuw2nK
402 impressions2026-07-21
OncLive.com @OncLive
Media
What better way to kick off #BTGLung2026 than with an interview on SCLC with @alissajcooper of @DanaFarber #lcsm https://t.co/lPRfJThpmx
391 impressions2026-07-21
Eric K. Singhi, MD @lungoncdoc
I've said this often... in lung cancer management, think chess, not checkers.

Dr. @PatelOncology agrees, and stresses this message here at #BTGLung2026 for our patients w/ EGFR+ lung cancer.

@OncLive https://t.co/8QrpW8wufz
356 impressions2026-07-21
Narjust Florez, MD, FASCO @NarjustFlorezMD
The slides end. The ideas don’t.

One unforgettable evening with brilliant colleagues, meaningful conversations, and spectacular views.

Thank you, @DrEdKim , for hosting the Bridging the Gaps faculty dinner.

#BTGLung26 @OncLive https://t.co/lm0tSn5l9j
351 impressions2026-07-22
Eric K. Singhi, MD @lungoncdoc
5 biggest unanswered questions in early-stage #EGFR lung cancer?

1. Who needs chemotherapy?
2. How long should we treat?
3. Can ctDNA guide decisions?
4. Who benefits from perioperative therapy?
5. What's the best strategy at recurrence?

#BTGLung2026 @OncLive https://t.co/0ixpIFkrLQ
348 impressions2026-07-21
Eric K. Singhi, MD @lungoncdoc
#BTGLung2026 kicks off with small cell lung cancer...

What's known, and what may be changing?

1. Tarlatamab is our preferred 2L option.
2. ADCs are emerging.
3. Will our 1L treatment for ES-SCLC change?

@OncLive @drshieldsmd @NarjustFlorezMD @DrEdKim https://t.co/KXG6fwQhZp
325 impressions2026-07-21
Eric K. Singhi, MD @lungoncdoc
Paraneoplastic syndromes in SCLC: a rare "board exam" topic, or truly something every practicing oncologist should recognize? Dr. @COlazagasti reviews the latest data at #BTGLung2026. https://t.co/CyuLBch64u
305 impressions2026-07-21
Narjust Florez, MD, FASCO @NarjustFlorezMD
Not every patient needs more treatment. The challenge is knowing who does.

Today’s discussions on ctDNA, pathologic response, immunotherapy, and surveillance highlighted how precision medicine is changing decisions in early-stage NSCLC.

#BTGLung26
@OncLive @lungoncdoc https://t.co/1P4dFtfjVL
281 impressions2026-07-22
Eric K. Singhi, MD @lungoncdoc
Borderline resectable NSCLC - the path forward? @BrendonStilesMD

1. Think biology > anatomy.
2. Systemic therapy first.
3. Always reassess resectability.
4. Don't label unresectable too early.
5. Right patient. Right therapy. Right time.

#BTGLung2026 https://t.co/S99Kp9RaG4
272 impressions2026-07-22
Eric K. Singhi, MD @lungoncdoc
Now we tackle gaps in EGFR+ lung cancer here at #BTGLung2026

First take home point... not all EGFR "positive" lung cancers are the same.

@OncLive @EGFRResisters https://t.co/Mz2fW12TKS
265 impressions2026-07-21
Eric K. Singhi, MD @lungoncdoc
Top 5 gaps in EGFR+ lung cancer today?

1. Who really needs combo therapy?
2. How do we choose b/w frontline combos?
3. Is TKI monotherapy still enough?
4. Can we reduce toxicity w/o sacrificing efficacy?
5. Should we treat earlier to improve long-term outcomes?

#BTGLung2026 https://t.co/ceHoJiZOAV
244 impressions2026-07-21
Eric K. Singhi, MD @lungoncdoc
CM77T shows us something important: biology doesn't know whether a patient has single- or multistation N2 disease.

Those at the highest risk of micrometastatic disease may also have the most to gain from our best systemic therapy upfront.

#BTGLung2026 @OncLive @BrendonStilesMD https://t.co/UXwlYJJcRO
182 impressions2026-07-22
Narjust Florez, MD, FASCO @NarjustFlorezMD
Precision oncology keeps expanding. Outstanding session at #BTGLung26 covering the rapidly evolving treatment landscape for KRAS, BRAF, MET, ROS1, ALK, HER2, NRG1, MTAP, STK11, and the growing role of ctDNA in guiding care.

@LeXiuning @OncLive https://t.co/97ZdHcq1XU
161 impressions2026-07-22
OncLive.com @OncLive
Media
Thank you to David Gerber, MD, of @UTSWMedCenter, @NouraChoudhury, of @UChicagoMed, and @PatelOncology, of @UCSDHealth, for sharing key pieces of the #BTGLung2026 discussion in SCLC and oncogene-driven #lcsm https://t.co/eQL54Ncxbs
106 impressions2026-07-21
Eric K. Singhi, MD @lungoncdoc
@BrendonStilesMD kicks off day 2 of #BTGLung2026.

"Unresectable" should be a multidisciplinary discussion...not a reflex.

As our systemic therapies improve, reassessment after induction may create opportunities that didn't exist at diagnosis. Are we reevaluating enough? https://t.co/uQA604psHZ
76 impressions2026-07-22
Eric K. Singhi, MD @lungoncdoc
Management after neoadjuvant therapy in NSCLC...

What do we know, and what are the gaps?

#BTGLung2026 @OncLive https://t.co/3g8tXRcYUY
59 impressions2026-07-22
Eric K. Singhi, MD @lungoncdoc
Top 5 questions still shaping the role of RT in oligometastatic NSCLC:

1. Who?
2. When?
3. Where?
4. How much?
5. Which biology?

Quick plug for our @JAMAOnc patient page on LCT in lung cancer. @maraantonoff: https://t.co/4q3x431Jaw

#BTGLung2026 @PercyLeeMD https://t.co/s7pif2JHWP
51 impressions2026-07-22
Eric K. Singhi, MD @lungoncdoc
Oligometastatic NSCLC - what would be your next step in management? @PercyLeeMD @OncLive #BTGLung2026 https://t.co/FnfJ27AH3c
37 impressions2026-07-22

Is “unresectable” a reflex? The multidisciplinary debate

Brendon Stiles’ borderline-resectable talk drew 32 posts from 7 clinicians — thoracic surgery, radiation oncology and medical oncology — including the presenter answering his critics directly. X split it across branches; it is reassembled here in time order, every post verbatim. Participants: @lungoncdoc, @Jheseltineonc, @jryckman3, @5_utr, @BrendonStilesMD, @MuzamilArshad18, @MohitKasibhatla.

  1. Eric K. Singhi, MD Thoracic medical oncologist · MD Anderson Jul 22, 3:46 PM
    kicks off day 2 of #BTGLung2026.

    "Unresectable" should be a multidisciplinary discussion...not a reflex.

    As our systemic therapies improve, reassessment after induction may create opportunities that didn't exist at diagnosis. Are we reevaluating enough?
    View on X ↗
  2. Jonny Heseltine Thoracic & acute oncologist · Clatterbridge Jul 24, 7:33 AM
    Pretty controversial to present and contrast headline data from different populations/staging
    View on X ↗
  3. Jeff Ryckman Radiation oncologist Jul 24, 10:21 AM
    🍎🍊

    #BTGLung2026
    View on X ↗
  4. Jeff Ryckman Radiation oncologist Jul 24, 10:36 AM
    Talk about asymmetric populations!

    Where are the randomized data in the NAC-ICI era showing that NAC-ICI → surgery is superior to definitive CRT or NAC-ICI → CRT?

    Or are we jumping to conclusions… again?

    Comparing fundamentally different patient populations on a balance scale and implying causality doesn’t help foster multidisciplinary collaboration.

    #BTGLung2026 #LCSM
    View on X ↗
  5. NonsparseOncologist Medical & radiation oncologist Jul 24, 10:47 AM
    Confounding by indication: surgical candidates skew toward single-station/favorable N2 disease, adequate FEV1/DLCO, fewer comorbidities, younger age, better PS. That selection alone could explain much of the gap, independent of what surgery adds.
    View on X ↗
  6. NonsparseOncologist Medical & radiation oncologist Jul 24, 10:50 AM
    Worth remembering the other side too:CRT spares patients thoracotomy, perioperative mortality, and lasting QOL/functional decline. “Which is superior” isn’t just an efficacy question, it’s efficacy and morbidity, and neither is settled without RCT
    View on X ↗
  7. Jeff Ryckman Radiation oncologist Jul 24, 10:57 AM
    Preach!
    View on X ↗
  8. NonsparseOncologist Medical & radiation oncologist Jul 24, 11:00 AM
    Good example of confounding by indication: surgical candidates skew toward single-station/favorable N2 disease, adequate FEV1/DLCO, fewer comorbidities, younger age, better PS. That selection alone could explain much of the gap, independent of what surgery adds
    View on X ↗
  9. Brendon Stiles Thoracic surgeon · presenter of this talk Jul 24, 11:27 AM
    Of course! And I describe as such. But it is also important to acknowledge that many in PACIFIC were likely resectable. And many Rx'ed w/ neoadjuvant paradigm are likely similar to PACIFIC population.

    Best chance at cure is neoadj chemo/ICI, no matter the local therapy used.
    View on X ↗
  10. Jeff Ryckman Radiation oncologist Jul 24, 11:34 AM
    (image only)
    View on X ↗
  11. Jeff Ryckman Radiation oncologist Jul 24, 11:37 AM
    Either way, I hope you can agree that the figure is highly misleading.

    It visually compares fundamentally different patient populations on a balance scale, inviting a causal interpretation that the data simply cannot support. That isn’t the kind of message that promotes multidisciplinary collaboration.
    View on X ↗
  12. Brendon Stiles Thoracic surgeon · presenter of this talk Jul 24, 11:41 AM
    This is a misleading statement. RT is not lung sparing. Look at this patient I just reviewed yesterday.

    4 month mortality in PAC2 was 4.6% in CRT only arm, total grade 5 AE 10.2%. Grade 3/4 AEs in 47.2%. That is the data.

    Here is long term QOL after neoadj chemo/ICI-surgery.
    View on X ↗
  13. Brendon Stiles Thoracic surgeon · presenter of this talk Jul 24, 11:48 AM
    Show me the data...
    View on X ↗
  14. Brendon Stiles Thoracic surgeon · presenter of this talk Jul 24, 11:53 AM
    In fact, radiographic assessment & RECIST likely OVERestimate local control after RT.

    Look - the intent wasn't to antagonize. Rather it was to open minds to the concept of neoadj for all irrespective of local modality. I showed some great work led by @NitinOhri3 @MontefioreNYC.
    View on X ↗
  15. Brendon Stiles Thoracic surgeon · presenter of this talk Jul 24, 12:15 PM
    Only when taken out of context! 😉
    View on X ↗
  16. NonsparseOncologist Medical & radiation oncologist Jul 24, 12:21 PM
    “Here’s one CT scan I saw yesterday” isn’t a rebuttal to confounding by indication and need for randomized trial. Meanwhile prior chemo/surgery vs chemo/RT RCTs = no clear benefit to surgery, and there is no evidence IO isn’t simply additive to either approach here.
    View on X ↗
  17. NonsparseOncologist Medical & radiation oncologist Jul 24, 12:24 PM
    Meanwhile, in fit/operable: Lobectomy: ~13-28% major complications. Pneumonectomy: 21% major complications, 90-day mortality up to 17%. Removing part or all of a lung is functionally a grade 3-4 toxicity — it just comes with a scalpel instead of a package insert.
    View on X ↗
  18. NonsparseOncologist Medical & radiation oncologist Jul 24, 12:31 PM
    We have had 6 RCTs which failed to showed benefit to surgery here, independently, or pooled. Show me the data for immunotherapy not simply being additive to either CRT or chemo and surgery; the burden is on surgeons at this point…
    View on X ↗
  19. Brendon Stiles Thoracic surgeon · presenter of this talk Jul 24, 12:43 PM
    Show me this data from the neoadjuvant chemo/ICI RCTs...
    View on X ↗
  20. Brendon Stiles Thoracic surgeon · presenter of this talk Jul 24, 12:44 PM
    How about PACIFIC 2? How about RCT QOL data for RT trials? Anchor on the data not the scan.
    View on X ↗
  21. Jeff Ryckman Radiation oncologist Jul 24, 12:45 PM
    1/3 I think we’re closer than the original slide suggested. I agree that neoadjuvant therapy and multidisciplinary reassessment deserve serious study, and I appreciate “arguably,” which appropriately acknowledges the uncertainty around the optimal local therapy.
    View on X ↗
  22. Jeff Ryckman Radiation oncologist Jul 24, 12:45 PM
    2/3 I’d still be cautious with the RECIST claim. RECIST is an imperfect surrogate for local control after RT, and across many solid tumors, there are well-described examples of post-RT treatment effect or pseudoprogression being called progression, thus underestimating control.
    View on X ↗
  23. Jeff Ryckman Radiation oncologist Jul 24, 12:46 PM
    3/3 I’m grateful for the exchange; I learned about LungMate-013 and TRIPL through it. But the key question remains unanswered: in comparable patients, is NAC-ICI→surgery superior to definitive CRT or NAC-ICI→CRT? We still lack randomized evidence in the modern post-NAT era.
    View on X ↗
  24. Brendon Stiles Thoracic surgeon · presenter of this talk Jul 24, 12:47 PM
    Times have changed my friend. Intellectually, look at the difference between neoadjuvant and adjuvant trials with immunotherapy and surgery and ask yourself where is the bang for the buck.

    Don't you think same would be true for RT?

    That is my main point. Rethink the strategy.
    View on X ↗
  25. NonsparseOncologist Medical & radiation oncologist Jul 24, 12:54 PM
    While discussing trials that are not current SOC, how about Intrist? The probability chemo/IO/RT beats chemo/IO/surgery is a whopping 97%; very low pneumonitis and 0 grade 4-5 😉
    View on X ↗
  26. NonsparseOncologist Medical & radiation oncologist Jul 24, 1:00 PM
    Times do change, but I would question the direction of the way it moves, with non-operative rectal cancer, MRM -> lumpectomy, SLN omission now; see also MARS2. My wager is on a regimen like Intrist, but there will never be one standard here, rather a toolset, imo.
    View on X ↗
  27. Muzamil Arshad, MD/PhD Radiation oncologist · UChicago Jul 24, 1:20 PM
    Actually likely underestimated with RT bc of fibrosis. Original SABR comet showed poor LC. Subsequent studies show how firbsosi evolves. When in doubt and enough time (>6-12 months) pet can help truly avid tumor vs fibrosis.
    View on X ↗
  28. Muzamil Arshad, MD/PhD Radiation oncologist · UChicago Jul 24, 1:25 PM
    while different cancers in Cervix Neoadj chemo > Surg worse the cRT . No immuno but my point is don’t know if cIO> Surgery better than cRT>IO. agree cIO>cRT might be as good as cRT>surgery. Finally whether resectable or or shouldn’t matter quest is what gives best outcomes
    View on X ↗
  29. Mohit Kasibhatla Radiation oncologist Jul 24, 1:55 PM
    Resectable a judgement call but no one is going to recommend a patient with resectable lung cancer who can receive ICI get CMT instead.
    View on X ↗
  30. Muzamil Arshad, MD/PhD Radiation oncologist · UChicago Jul 24, 2:24 PM
    ICI >surgery is CMT right, swapping local (🔪vs ☢️ ). big question though , if resectable or borderline is ici>surg better than pacific . If same then reflex should not be 🔪. Like prostatectomy vs RT reflex shouldnt be operate bc it’s better other factors matter
    View on X ↗
  31. Mohit Kasibhatla Radiation oncologist Jul 24, 2:29 PM
    Agree many outstanding questions but the trend will be optimizing ICI followed by surgery. And while that neoadjuvant “stack” may include RT, the optimizing CMT ship has probably sailed.
    View on X ↗
  32. Jeff Ryckman Radiation oncologist Jul 24, 4:56 PM
    One of the things I dislike about X is how branched conversations are on here making discussions hard to follow at times. For those who may be lurking, we had a very nice discussion on this topic!

    Equal partners in care, same page 🤝🫡

    @lungoncdoc
    View on X ↗

Reassembled from the X conversation threads rooted at Singhi’s day-2 post and Ryckman’s quote-post. Two posts repeated verbatim across both branches appear once. Non-clinician replies are not included.

Trial buzz

Trials referenced from the podium at BTG Lung 2026. Each links to its full KOL Pulse trial profile.

Media coverage