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California + Seoul editions
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. The Seoul sessions (Sep 10–11 — the WCLC26 curtain-raiser, curated live by Stephen V. Liu, MD): 1L EGFR strategy and ctDNA-adaptive escalation, uncommon EGFR / exon 20 mutations, leptomeningeal disease, HER2 — TKI or ADC first?, MET alterations, three generations of ALK inhibitors, RET, NRG1 fusions, BRAF V600E, frontline and post-progression immunotherapy, and the TROP2 / ADC race. The California sessions (Jul 21–22, curated by Eric K. Singhi, MD): small cell lung cancer — tarlatamab as the 2L standard, DLL3-directed T-cell engagers and emerging ADCs; 1L EGFR combinations and early-stage disease; perioperative / resectable NSCLC and oligometastatic radiotherapy. Below: the presenters’ data slides, transcribed with sources, and the meeting polls — including Dr. Liu’s live Seoul polls.

67 curated posts Featured voices: Eric K. Singhi, MD · Stephen V. Liu, MD California, USA · Jul 21–22, 2026 Seoul, South Korea · Sep 10–11, 2026 29 data slides decoded · 11 polls
Featured Curator

Live from the podium

Eric K. Singhi, MD
Thoracic medical oncologist, MD Anderson Cancer Center · @lungoncdoc · live curator of BTG Lung 2026 (California sessions)
Stephen V Liu, MD
Thoracic medical oncologist, Georgetown Lombardi Comprehensive Cancer Center · @StephenVLiu · live curator of BTG Lung 2026 (Seoul sessions)
The Presenters

Faculty

The physician faculty across both meetings — Seoul (September 10–11) and California (July 21–22). X handles are linked where confirmed; other names are listed as presented.

Seoul · September 10–11, 2026
Daniel Tan, MBBS PhD
Medical oncology · National Cancer Centre Singapore / Duke-NUS · 1L EGFR-mutant NSCLC, ctDNA-adaptive escalation · @danieltanmd
Tetsuya Mitsudomi, MD PhD
Thoracic surgery · uncommon EGFR mutations / exon 20 insertions · @t_mitsudomi
Xiuning Le, MD PhD
Thoracic medical oncology · MD Anderson Cancer Center · leptomeningeal disease in EGFRm · @LeXiuning
Yi-Long Wu, MD
Thoracic oncology · Guangdong Lung Cancer Institute · adjuvant osimertinib / ADAURA
Solange Peters, MD PhD
Medical oncology · CHUV Lausanne · perioperative immunotherapy · @peters_solange
Kevin Chua, MBBS FRCR
Radiation oncology · National Cancer Centre Singapore / Duke-NUS · curative-paradigms discussant · @drkevin_chua_lm
Molly Li, MD
Medical oncology · Chinese University of Hong Kong · HER2-mutant NSCLC: 1L TKI vs ADC meta-analysis · @mollylisc
Enriqueta Felip, MD PhD
Medical oncology · Vall d’Hebron, Barcelona · MET alterations · @EnriquetaFelip
Benjamin Besse, MD PhD
Medical oncology · Gustave Roussy · three generations of ALK inhibitors · @BenjaminBesseMD
Byoung Chul Cho, MD PhD
Medical oncology · Yonsei Cancer Center, Seoul · treatment selection after immunotherapy · @cbcbc1971
David Planchard, MD PhD
Medical oncology · Gustave Roussy · TROP2-targeted ADCs · @dplanchard
Mihaela Aldea, MD PhD
Medical oncology · Gustave Roussy · the ADC race · @mihaela_aldea
Luis Paz-Ares, MD PhD
Medical oncology · Hospital Universitario 12 de Octubre, Madrid · ES-SCLC: tarlatamab & T-cell engagers · @LuisPaz_Ares
Martin Wermke, MD
Medical oncology · University Hospital Dresden · SCLC blood-based biomarkers (DLL3 on CTCs)
So Yeon Kim, MD
Thoracic oncology · Yale Cancer Center · BRAF-mutant NSCLC · @Sokim_33
Delvys Rodríguez-Abreu, MD
Medical oncology · Las Palmas de Gran Canaria · RET-fusion NSCLC · @delvysra
Stephanie Saw, MD
Medical oncology · National Cancer Centre Singapore · NRG1 fusions · @stephanieplsaw
California · July 21, 2026 (Day 1)
Eric K. Singhi, MDCurator
Thoracic medical oncology · MD Anderson Cancer Center · @lungoncdoc
Narjust Florez, MD
Thoracic medical oncology · Dana-Farber Cancer Institute · @NarjustFlorezMD
Misty Dawn Shields, MD
Medical oncology · @drshieldsmd
Daniel B. Costa, MD
Medical oncology · EGFR 1L therapy selection
Jay M. Lee, MD
Early-stage EGFR-mutated NSCLC
California · July 22, 2026 (Day 2)
Brendon Stiles, MD
Thoracic surgery · borderline-resectable NSCLC · @BrendonStilesMD
Percy Lee, MD
Radiation oncology · oligometastatic NSCLC / RT · @PercyLeeMD
Cheryl Ho, MD
Medical oncology · management after neoadjuvant therapy
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The Data, Verbatim

Slides & posts

Every slide shared from BTG Lung 2026 by Eric K. Singhi, MD (July sessions) and Stephen V Liu, MD (Seoul sessions, Sept 2026) — each post verbatim, the slide image (click to enlarge), and the full slide text transcribed as fully as the slide photo allows.

Seoul Sessions
September 10–11, 2026 · Seoul, South Korea · the WCLC26 curtain-raiser · slides shared live by Stephen V. Liu, MD (@StephenVLiu)
Stephen V Liu, MD @StephenVLiu · Sep 10, 2026 · 1 slide
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At #BTGLung2026 ahead of #WCLC26, Dr. @danieltanmd discusses the gaps in the 1L EGFR NSCLC space. Challenging selecting between available strategies. Can ctDNA be used for adaptive designs? Looking foward to results from the US SHEDDER study.
SHEDDER / FLAME

Prospective trials using ctDNA persistence for escalation

Daniel Tan, MD PhD
SHEDDER (NCT04410796) is recruiting (estimated enrollment 571); the randomization schema shown is the planned design, not an observed readout. FLAME (NCT04769388, N=80) read out at ASCO 2026.
Prospective trials using ctDNA persistence for escalation SHEDDER study (NCT04410796) Screening: Untreated metastatic EGFR M+ NSCLC, no prior treatment with EGFR TKI -> Osimertinib 80 mg OM (571 pts) -> Plasma EGFR testing cycles 1-3 -> Positive (N=76) -> Randomized: Arm A: Osimertinib 80 mg PO daily (n=38), cycles 4-7 and cycle 8 Arm B: Osimertinib 80 mg PO daily + pemetrexed (500 mg/m2) carboplatin (AUC 5) x 4 cycles (n=38), then osimertinib + pemetrexed (500 mg/m2) maintenance FLAME Patients with locally advanced/metastatic EGFRm NSCLC who receive 3 weeks first-line osimertinib. Key inclusion: aged >=18; history of EGFRm (19del/21 L858R) in plasma ctDNA prior to 1L osimertinib; persistence ctDNA EGFRm at 3 weeks after 1L osimertinib; no disease progression by RECIST 1.1; asymptomatic and stable brain metastases allowed; ECOG PS 0-1. N=80, randomized 1:1, stratified by brain metastasis status (yes/no) and EGFR mutation type (19Del/21 L858R). Arm 1: Osimertinib 80mg QD + pemetrexed 500 mg/m2 + carboplatin AUC5 (Q3W) for 4-6 cycles -> maintenance osimertinib 80 mg (QD) + pemetrexed 500 mg/m2 (Q3W). Arm 2: Osimertinib 80mg QD. ctDNA: SuperARMS PCR Amoy Dx at randomization, 6 weeks after randomization, disease progression. Primary endpoint: PFS by investigator assessment per RECIST 1.1. Secondary: 18-month OS rate, ORR, DCR, DoR, depth of response, safety, resistance mechanisms. Exploratory: dynamic change of molecular alterations by plasma analysis, QoL. Wang et al. ASCO 2026 | OncLive Bridging the Gaps in Lung Cancer
Stephen V Liu, MD @StephenVLiu · Sep 10, 2026 · 1 slide
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Very nice overview of uncommon EGFR mutations and the now crowded exon 20 space from Dr. @t_mitsudomi at #BTGLung2026. With so many variants that can impact biology, how do we best generate data. Functional databases, international registries, prospective real-world evidence?
Uncommon EGFR / Ex20ins

EGFR uncommon/Ex20ins EGFR mutations

Tetsuya Mitsudomi, MD PhD
EGFR uncommon/Ex20ins EGFR mutations Mutation distribution (total = 11,619; Robichaux Nature 2021): Ex19del 32.7% | L858R 23.0% | Ex20ins 9.1% | Complex atypical 9.1% | Other atypical 12.6% | Classical + T790M 11.1% | Classical + atypical 2.2% | T790M 0.3%. Major Ex20ins = ASV, SVD, NPH, H, PH (Ou et al., JTO 2023): A767_V769dup (ASV) 20.1% | S768_D770dup (SVD) 16.5% | N771_H773dup (NPH) 9.1% | H773dup (H) 5.8% | P772_H773dup (PH) 4.7% | others. Major uncommon = G719X, S768I, L861X, E709K (Wen et al., Oncologist 2019): G719A/C/S 21% | S768I 10% | L861M/Q/R 8% | E709A/K 8% | R108K/S 3% | others 25%. Ex20ins mutations: strong transforming activities; sensitive to 1-3G TKIs (A763_Y764insFQEA); sensitive to 2G TKIs (D770G containing: D770>GV, GY, D770insG, etc.); higher sensitivity to Ex20-active TKI near-loop (A767~P772); lower sensitivity to Ex20-active TKIs far loop (H773, V774). Refs: Yasuda Science Transl Med 2013; Kosaka Cancer Res 2017 [slide prints "Clin Cancer Res"]; Ruan PNAS 2018; Kobayashi et al., Cells 2021; Robichaux Nature 2021. Uncommon mutations: many classified as "PACC" mutations with weaker transforming activity and less sensitivity to 1G TKI; more sensitive to 2G TKI; frequent EGFR compound-mutation. Compound-mutation table: single uncommon 28 (26%) | compound 80 (74%) - common + uncommon 42 (39%): L858R+uncommon 32, +V834L/E709X/R108K/other 5/4/4/19, Ex19del+uncommon 10; uncommon + uncommon 38 (35%): G719X+S768I/E709X 10/6, L833V+H835L 3, other 19. Refs (slide maps 1-3 to the PACC/TKI-sensitivity bullets, 4 to compound-mutation frequency): 1. Kobayashi Clin Cancer Res 2015; 2. Kohsaka Science Transl Med 2017; 3. Robichaux Nature 2021; 4. Wen Oncologist 2019.
Stephen V Liu, MD @StephenVLiu · Sep 10, 2026 · 1 slide
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Dr. @LeXiuning highlights the unmet needs for leptomeningeal disease in EGFR mutant NSCLC (and beyond) at #BTGLung2026. In the modern era, we can see LMD in 11% of patients with EGFR NSCLC with incidence increasing with prolonged survival.
Leptomeningeal disease

Increasing prevalence of LMD in modern era (2015-2024)

Xiuning Le, MD PhD
Source: Zheng MM et al., Ann Oncol 2026;37(1):104–116 (PMID 41125209; senior author X. Le) — 14,931-patient cohort, 2015–2024.
Increasing prevalence of LMD in modern era (2015-2024) LMD prevalence in modern era (2015-2024) - incidence rate of LMD by driver: EGFR 11.1% (EGFR subtypes: EGFR 19DEL 10.6% | EGFR L858R 13.4% | EGFR 20ins 7.9% | Atypical EGFR 7.2%) | negative 3.6% | ALK 11% | ERBB2 12.3% | ROS1 15.7% | RET 4.6%. LMD increased with prolonged survival - probability of LMD over time from LM diagnosis: mTime to LMD 14.2 months (95% CI 13.2-15.2 months).
Stephen V Liu, MD @StephenVLiu · Sep 10, 2026 · 1 slide
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Review of open controversies with targeted thearpy in early stage NSCLC with Dr. Yilong Wu @ThomasW35874311 at #BTGLung2026 ahead of #WCLC26. Interesting discussion on importance of adjuvant chemotherapy when TKIs provide so much benefit - lots of selection, gaps in data.
ADAURA

What is role of adjuvant chemo in this setting?

Yi-Long Wu, MD
What is role of adjuvant chemo in this setting? [Panel A/B - ADAURA DFS with and without adjuvant chemotherapy, Wu YL et al. JTO 2022;17:423-433 (online-first 2021; slide prints "JTO 2021")] With adjuvant chemotherapy: osimertinib (n=203) median DFS NR (38.8-NC) vs placebo (n=207) median DFS 22.1 months (95% CI 17.4-32.9); HR 0.16 (0.10-0.26); maturity 30% (osimertinib 11%, placebo 50%); 89% vs 49% landmark. Without adjuvant chemotherapy: 89% vs 58% landmark; osimertinib (n=136) vs placebo (n=136); median DFS values [not legible on slide photo]. Annotation: "The difference of HR seems driven by poor adjuvant chemo" [Forest plot - Herbst et al. JCO 2023] HR for disease recurrence or death: overall stratified 0.27 (0.21-0.34); adjuvant chemotherapy yes 0.29 (0.21-0.39) / no 0.36 (0.24-0.55); plus sex, age, smoking, race, stage, EGFR mutation subgroups. [Panels - Tsuboi et al. NEJM 2023] 5-yr OS: patients who received adjuvant chemotherapy - osimertinib 87 (82-91) vs placebo 77 (70-82), HR for death 0.49 (95% CI 0.30-0.79, subgroup); patients who did not receive adjuvant chemotherapy - osimertinib 88 (81-93) vs placebo 79 (71-85), HR 0.47 (0.25-0.83). Annotation: "No difference in OS". Takeaways: adjuvant targeted therapy benefit regardless of adjuvant chemo; benefit seems better without adjuvant chemo.
Stephen V Liu, MD @StephenVLiu · Sep 10, 2026 · 1 slide
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Dr. @peters_solange summarizes the state of immunotherapy for PD-L1+ early stage NSCLC with benefit seen across strata. Many open questions remain regarding biomarkers, accurate assessment of pCR, and how to assess and use MRD. #BTGLung2026
Perioperative IO

Neoadjuvant and perioperative immunotherapy - cross-trial table

Solange Peters, MD PhD
Neoadjuvant / Perioperative immunotherapy in resectable NSCLC (Remon & Peters, Lancet Resp Med 2026) CheckMate 816 (neoadjuvant, CT+nivolumab->surgery vs CT->surgery, 3 cycles): pCR 24% vs 2.2%; 2y EFS 64 vs 45; EFS HR 0.65 (0.44-0.96); 5y OS 65 vs 55; OS HR 0.72 (0.52-0.99). US all PD-L1 / EU PD-L1 >=1%. KEYNOTE 671 (CT+pembrolizumab->S->P vs CT->S->placebo): pCR 18% vs 4.0%; 2y EFS 61 vs 42; EFS HR 0.59 (0.46-0.72); 5y OS 65 vs 54; OS HR 0.72 (0.56-0.93). All PD-L1. AEGEAN (CT+durvalumab->S->D vs CT->S->placebo): pCR 17.2% vs 4.3%; 2y EFS 63 vs 52; EFS HR 0.69 (0.55-0.88); OS HR 0.89 (0.70-1.14). All PD-L1 (US & EU). (AEGEAN study was supported by AstraZeneca.) CheckMate 77T (CT+nivolumab->S->nivo vs CT->S->placebo): pCR 25.3% vs 4.3%; 2y EFS 67 vs 44; EFS HR 0.61 (0.46-0.80); OS HR 0.85 (0.58-1.25). US all PD-L1 / EU PD-L1 >=1%. RATIONALE 315 (CT+tislelizumab->S->Ti vs CT->S->placebo): pCR 41% vs 5.7%; 2y EFS 67 vs 52; EFS HR 0.58 (0.43-0.79); 4y OS 72 vs 62; OS HR 0.65 (0.45-0.93). All PD-L1. NEOTORCH (CT+toripalimab->S->CT+T vs CT->S->CT): pCR 24.8% vs 1.0%; 2y EFS 67 vs 46; EFS HR 0.40 (0.28-0.57); OS HR 0.62 (0.38-1.00). ADEBRELIMAB (CT+adebrelimab->S->A vs CT->S->placebo, 3 cycles): pCR 31.1% vs 7.6%; 2y EFS 75 vs 56; EFS HR 0.52 (0.38-0.72); OS HR 0.57 (0.36-0.88). Timeframes 2y EFS / 5y OS except RATIONALE 315 (2y EFS / 4y OS). Source: Remon & Peters - Lancet Resp Med 2026.

This table, machine-readable: the KOL Pulse perioperative cross-trial comparison →

Regulatory note (Sept 2026): the CheckMate 816, KEYNOTE-671, AEGEAN and CheckMate 77T regimens are FDA-approved in resectable NSCLC; tislelizumab (RATIONALE 315) is EU-approved only, and toripalimab (NEOTORCH; China, stage IIIA–IIIB) and adebrelimab (China) have no FDA or EMA approval in this setting. Values above are as printed on the slide — the published CheckMate 77T control-arm pCR is 4.7% (NEJM 2024), and the CheckMate 816 “EFS HR 0.65 (0.44–0.96)” corresponds to 5-year lung-cancer-specific survival (published EFS HRs: 0.63 primary, 0.68 final).

Stephen V Liu, MD @StephenVLiu · Sep 10, 2026 · 1 slide
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Nice summary of the blurring boundaries between two curative paradigms, surgery and radiation based, for locally advanced lung cancer by @drkevin_chua_lm at #BTGLung2026 ahead of #WCLC26. Choosing between both curative paradigms remains the evidence gap.
Curative paradigms

Two Curative Paradigms and a Blurring Boundary

Kevin Chua, MD
Two Curative Paradigms and a Blurring Boundary - Evidence at both ends with uncertainty in the middle RESECTABLE - Perioperative systemic therapy -> Surgery: CheckMate 816 | KEYNOTE-671 | AEGEAN | CheckMate 77T. Increasing systemic efficacy + deeper pathologic response. BORDERLINE RESECTABLE - Chemo-IO -> Surgery OR CRT -> Consolidation. Which gives the better chance of cure? UNRESECTABLE - Definitive CRT -> Consolidation. PACIFIC 5y OS 42.9% * 5y PFS 33.1% - established the durable benchmark. Moving IO earlier has not improved it: PACIFIC-2 NEGATIVE; CheckMate 73L NEGATIVE. Pivotal trials validated treatment pathways after resectability had already been assigned. Choosing between both curative paradigms remains the evidence gap. References: Forde et al NEJM 2022; Wakelee et al NEJM 2023; Heymach et al NEJM 2023; Cascone et al NEJM 2024; Spigel et al JCO 2022; Bradley et al JCO 2025; Peters et al Nat Cancer 2026. Kevin Chua - Duke-NUS Medical School / National Cancer Centre Singapore.
Stephen V Liu, MD @StephenVLiu · Sep 10, 2026 · 1 slide
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BRAF V600E NSCLC is a unique subset of NSCLC that can respond well to targeted therapy but can also respond to immunotherapy, outlined by Dr. @Sokim_33 at #BTGLung2026 ahead of #WCLC26. Is there debate as to optimal first-line management?
BRAF V600E · FRONT-BRAF

Challenging questions in BRAF-mutant NSCLC

So Yeon Kim, MD — Yale Cancer Center
Challenging questions in BRAF-mutant NSCLC 1L Sequencing for BRAF-V600E: Targeted therapy vs. Chemo +/- IO? | FRONT-BRAF (IO+/-chemo vs. BRAF/MEKi) | Retrospective, 284 pts/17-centers | OS: 40.9 vs. 25.1 mo (HR 0.69) | IO Benefit: Smokers, PD-L1 >=1%, age >=70, no CNS mets, TP-53 mutant CNS: Extrapolated from melanoma data | No prospective CNS data in NSCLC | Timing of SRS Acquired resistance: Heterogenous — MAPK activation (NRAS, KRAS, MEK) | Bypass signaling e.g. EGFR, MET, HER2, PI3K activation | Cell cycle escape | Histologic transformation Class II, III BRAF-mutations: No approved targeted therapy | Pan-RAF, ERK1/2 inhibitors under investigation Di Federico, A et al. The Lancet 2025 | OncLive Bridging the Gaps in Lung Cancer
Stephen V Liu, MD @StephenVLiu · Sep 11, 2026 · 1 slide
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Dr. @mollylisc at #BTGLung2026 highlights a burning question for HER2 mutant NSCLC - what is the optimal first line therapy? We now have zongertinib and sevabertinib approved as 1L TKIs and trastuzumab deruxtecan 1L study was positive, to be seen at #WCLC26. How do we select?
HER2 · SOHO-01 · Beamion LUNG-1 · DESTINY-Lung

Q1: 1st line treatment — TKI or ADC?

Molly Li, MD — CUHK
Q1: 1st line treatment – TKI or ADC? Efficacy · Toxicity · Sequencing EFFICACY — YVMA: 74% (TKI) vs 57% (ADC); other TKD: 57% (TKI) vs 60% (ADC) (a) TKI, YVMA: SOHO-01 cohort D 38/49, ORR 0.78 [0.63; 0.88] | cohort E 18/39, 0.46 [0.30; 0.63] | cohort F 40/56, 0.71 [0.58; 0.83] | Beamion LUNG-1 cohort 1 120mg 39/48, 0.81 [0.67; 0.91] | cohort 2 42/48, 0.88 [0.75; 0.95] | Common effect model n=240: 0.74 [0.68; 0.79] (I2=79.7%, p=0.0006) TKI, non-YVMA TKD: SOHO-01 cohort D 13/23, 0.57 [0.34; 0.77] | cohort E 2/12, 0.17 [0.02; 0.48] | cohort F 9/11, 0.82 [0.48; 0.98] | Beamion LUNG-1 cohort 1 120mg 14/27, 0.52 [0.32; 0.71] | cohort 2 17/24, 0.71 [0.49; 0.87] | Common effect model n=97: 0.57 [0.47; 0.66] (I2=61.9%, p=0.0326) (b) ADC, YVMA: HORIZON-Lung 49/68, 0.72 [0.60; 0.82] | SHR-A1811 phase I 4.8mg/kg 12/27, 0.44 [0.25; 0.65] | DESTINY-Lung01 35/57, 0.61 [0.48; 0.74] | DESTINY-Lung02 6.4mg/kg 19/35, 0.54 [0.37; 0.71] | DESTINY-Lung02 5.4mg/kg 27/64, 0.42 [0.30; 0.55] | DESTINY-Lung05 31/55, 0.56 [0.42; 0.70] | Common effect model n=306: 0.57 [0.51; 0.62] (I2=63.8%, p=0.0169) ADC, non-YVMA TKD: HORIZON-Lung 19/23, 0.83 [0.61; 0.95] | SHR-A1811 5/13, 0.38 [0.14; 0.68] | DESTINY-Lung01 14/28, 0.50 [0.31; 0.69] | DESTINY-Lung02 6.4mg/kg 9/15, 0.60 [0.32; 0.84] | 5.4mg/kg 21/35, 0.60 [0.42; 0.76] | DESTINY-Lung05 10/17, 0.59 [0.33; 0.82] | Common effect model n=131: 0.60 [0.51; 0.68] (I2=35.8%, p=0.1686) TOXICITY — G3+ AE: 33% (TKI) vs 57% (ADC). TKI pooled n=409: 0.33 [0.29; 0.38] (SOHO-01 D 31/81, E 17/55, F 17/73; Beamion LUNG-1 cohort 1 120mg 35/75, cohort 2 13/74, cohort 3 7/20, cohort 5 16/31; I2=73%, p=0.0011). ADC pooled n=310: 0.57 [0.52; 0.62] (HORIZON-Lung 62/94, SHR-A1811 4.8mg/kg 18/43, DESTINY-Lung02 5.4mg/kg 57/101, DESTINY-Lung05 5.4mg/kg 40/72; I2=57.2%, p=0.0715). Test for subgroup differences: chi2=39.92, p<0.0001. SEQUENCING — ADC: 66%/62% (prior/no TKI); TKI: 42%/69% (prior/no ADC). ADC prior TKI, pooled n=85: ORR 0.66 [0.55; 0.75] (HORIZON-Lung 17/21, SHR-A1811 15/26, DESTINY-Lung01 9/12, DESTINY-Lung02 6.4 5/11, 5.4 10/15). ADC no prior TKI, pooled n=289: 0.62 [0.56; 0.67] (HORIZON-Lung 53/72, SHR-A1811 7/17, DESTINY-Lung01 48/74, DESTINY-Lung02 6.4 25/39, 5.4 46/87). TKI prior ADC, pooled n=86: 0.42 [0.32; 0.52] (SOHO-01 cohort E 21/55, Beamion LUNG-1 cohort 5 15/31). TKI no prior ADC, pooled n=229: 0.69 [0.62; 0.74] (SOHO-01 cohort D* 52/81, cohort F 52/73, Beamion LUNG-1 cohort 1 53/75). M Li et al, JTO (under revision) | OncLive Bridging the Gaps in Lung Cancer
Stephen V Liu, MD @StephenVLiu · Sep 11, 2026 · 1 slide
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Dr. @EnriquetaFelip reviews all the ways in which MET contributes to NSCLC and can be targeted but many questions remain regarding optimal sequencing and combinations at #BTGLung2026
MET ex14 · fusions · OE · amplification

MET alterations: key takeaway and open questions

Enriqueta Felip, MD PhD
MET alterations: key takeaway and open questions MET exon14 mut: Capmatinib and tepotinib, SoC | Best sequence: MET-TKI 1L+ (FDA approval) vs 2L+ (EMA approval) — 1L MET-TKI improved outcomes in PDL1<50% and brain/bone m1, whereas ICI+/-CT prolonged PFS in PDL1>=80% (Pecci CCR 2025); 1L ICI +/- CT better OS vs MET-TKI in PDL1>=50. However, patients with PDL1<50 prolonged PFS with MET TKI (Pradhan ASCO 2026) MET fusions: Rare oncogenic drivers, patients can benefit from MET-TKIs MET OE: Telisotuzumab-vedotin, FDA-approved for high c-MET OE | Randomized trial in 2L (non-squamous) ongoing MET amplification (primary driver alteration): Diagnostics challenging (FISH, NGS), definition of high-level amplification inconsistent OncLive Bridging the Gaps in Lung Cancer
Stephen V Liu, MD @StephenVLiu · Sep 11, 2026 · 1 slide
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Dr. @BenjaminBesseMD with an insightful perspective on ALK NSCLC at #BTGLung2026. First-line strategies balance efficacy &amp; safety - as landmark trials mature, the plateau in PFS is very impressive - at some point, progression becomes unlikely. How will neladalkib change things?
ALK · ALEX · ALTA-1 · CROWN

3 generations of ALK inhibitors

Benjamin Besse, MD PhD
3 generations of alk inhibitors Crizotinib | Ceritinib | Alectinib | Brigatinib | Lorlatinib PFS — ALEX (alectinib n=152 vs crizotinib n=151): HR 0.43 (95% CI 0.32-0.58); median 34.8 months (17.7-NE) vs 10.9 months (9.1-12.9). ALTA-1 (brigatinib n=137 vs crizotinib n=138): HR for disease progression or death 0.49 (95% CI 0.35-0.68), P<0.0001 by log-rank test. CROWN (lorlatinib n=149 vs crizotinib n=147): events 62 vs 119; median PFS NR (68.5-NR) vs 9.1 (7.4-10.9) months; HR 0.19 (0.13-0.26); lorlatinib landmark PFS 70% / 65% / 63% / 60% / 57% / 55% vs crizotinib 15% / 10% / 10% / 8% / 7% / 3%. OS — ALEX: HR 0.78 (0.56-1.08), cross over 48%; 5-yr landmarks 59.5% vs 48.1%, then 48.6% vs 38.2%. ALTA-1: HR 0.81 (0.53-1.22), p=0.305; cross over 82%; survival probability 3 years 71% (62-78) vs 68% (59-75), 4 years 66% (56-74) vs 60% (51-68). 3rd Gen ALK inhibitors are defined by their activity against the ALK G1202R resistance mutation. PFS plateau — evidence of an immune-mediated effect of lorlatinib? CROWN OS is not reported. Camidge JTO 2019, Popat ESMO 2020, Mok ASCO 2026, Camidge JTO 2021, Mok ESMO 2025 | OncLive Bridging the Gaps in Lung Cancer
Stephen V Liu, MD @StephenVLiu · Sep 11, 2026 · 1 slide
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Good options for NSCLC with a RET fusion include selpercatinib and pralsetinib - how will the latest agent, lunbotinib, make an impact? Dr. @delvysra outlines the field, highlights differences in toxicity, and stresses how important NGS is here. #BTGLung2026
RET · LIBRETTO-431 · AcceleRET-Lung

RET: two established options… and a new player

Delvys Rodríguez-Abreu, MD — Las Palmas de Gran Canaria
RET: Two established options… and a new player LIBRETTO-431 (EMA 1L 2022) — established frontline benchmark. Selpercatinib vs control: mPFS 24.8m vs 11.2m, HR 0.46 (95% CI 0.31-0.70), P<0.001. ORR 83.7% vs 65.1% | mDoR 24.2m vs 11.5m | icORR 82.4% vs 58.3% | icPFS 16.1m vs 10.4m | mOS: crossover 74% (NA). AcceleRET-Lung — CLOSED (23 Jan 2024); practice-affirming phase III evidence. Pralsetinib (n=110) vs SOC (n=113): mPFS 18.7m (11.1, 25.2) vs 9.0m (7.1, 11.5), HR 0.59 (0.42, 0.84), log-rank p=0.0027. ORR 65.5% vs 41.6% | mDoR 20.6m vs 9.7m | icORR NR vs NR | icPFS NR vs NR | mOS NA vs 39.8m (34%). Blueprint Medicines' decision to discontinue global marketing and development of pralsetinib in all territories (excluding US and Greater China). LUNBOTINIB (A400/EP0031), phase II new RET inhibitor — treatment-naive: ORR 81.3%, mPFS NR, 2-y PFS 59.9%. Previously treated: ORR 87.1%, mPFS 27.5 mo (prior-treatment cohort had not received selpercatinib or pralsetinib). High potency? YES | Brain penetration? YES | Activity after chemotherapy/IO? YES | Activity after current selective RET-TKIs? ? Popat S et al. ASCO 2026; Zhou C et al. N Engl J Med 2023; Zhou Q et al. ASCO 2026
Stephen V Liu, MD @StephenVLiu · Sep 11, 2026 · 1 slide
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NRG1 fusions are rare but actionable alterations across cancer types, including NSCLC, outlined at #BTGLung2026 by Dr. @stephanieplsaw. Zenocutuzumab is a HER2/HER3 bispecific antibody approved in this setting. Given poor outcomes with standard therapy, should this be 1L?
NRG1 fusions · eNRGy

What is unique about these alterations? NRG1

Stephanie Saw, MD — National Cancer Centre Singapore
What is unique about these alterations? NRG1 NRG1 fusions: Prevalence <1%, enriched in invasive mucinous adenoCA | Drive oncogenic signalling by binding to HER3 | Zenocutuzumab (MCLA-128) binds to HER2 and HER3, inhibiting dimerization | eNRGy trial: ORR 29%, mPFS 6.8m in NRG1+ NSCLC Llorente et al, Sig Transduct Target Ther 2025; Schram et al, NEJM 2025; Galan-Cobo et al, Cancer Cell 2025; Federico et al, Lancet Oncol 2025 | OncLive Bridging the Gaps in Lung Cancer
Stephen V Liu, MD @StephenVLiu · Sep 11, 2026 · 1 slide
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Front-line immunotherapy data gaps include how to select patients for dual checkpoint inhibition, duration of therapy, role for emerging bispecifics and ADC combinations, biomarkers, possibility of lower doses. Very provocative summary from Dr. @HendriksLizza at #BTGLung2026.
1L immunotherapy · dual ICI

Dual ICI–chemo vs ICI–chemo

Dual ICI – ChT vs ICI – ChT CM227 & CM9LA pooled PD-L1 NEG: nivolumab plus ipilimumab with or without chemotherapy (n=322) vs chemotherapy (n=315) — median OS 17.4 mo (13.8-20.0) vs 11.3 (9.0-13.3), HR vs chemotherapy 0.64 (0.54-0.76); OS landmarks 61% / 39% / 30% / 23% / 20% vs 48% / 22% / 15% / 12% / 7%. Indirect comparisons: PD-L1 NEG, loss STK11 and esp KEAP1 associated with increased benefit dual ICI. TRITON: NSQ metastatic NSCLC with STK11m +/- KEAP1m +/- KRASm, no prior systemic treatment, no EGFR/ALK, ECOG 0-1; R 1:1 tremelimumab + durvalumab + platinum-pemetrexed (induction 4 cycles -> tremelimumab wk 16 & mo 24 + durvalumab + pemetrexed maintenance) vs pembrolizumab + platinum-pemetrexed -> pembrolizumab + pemetrexed. Stratification: STK11m vs KEAP1m vs KRASm | PD-L1 TC >=1% vs <1%. Amended to phase IIB because of poor enrollment: N=84! (aim was 280 in phIII), ~40% PD-L1 NEG. Confirmed ORR: STK11 mut +/- co-mut 36.4 (n=11) vs 25.0 (n=12); KEAP1 33.3 (n=9) vs 33.3 (n=9); KRAS +/- co-mut 45.2 (n=31) vs 31.4 (n=35); KRAS only 48.0 (n=25) vs 33.3 (n=27). JAPANESE NIPPON (CM9LA vs KEYNOTE): pembrolizumab mPFS 7.4 mo (5.9-8.9) vs nivolumab-ipilimumab 6.0 mo (5.5-8.8), unstratified HR 0.95 (0.73-1.25), p=0.74; mOS 20.5 mo (17.6-NE) vs 23.7 mo (17.6-NE), stratified HR 0.98 (90% CI 0.72-1.34), p=0.46. Prematurely closed: tox CM9LA arm; N=295/414, ~40% PD-L1 NEG; PD-L1 NEG OS HR 1.44 (0.82-2.50). Skoulidis ASCO 2026; Shiraishi Lancet Resp Med 2024; Peters JTO 2024; Skoulidis Nature 2024 | OncLive Bridging the Gaps in Lung Cancer
Stephen V Liu, MD @StephenVLiu · Sep 11, 2026 · 1 slide
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Dr. @cbcbc1971 summarizes some of the challenges in selecting treatment post immunotherapy at #BTGLung2026. Novel agents hopefully coming but how do we select the right drug for each patient and can we still rebuild immunity with a potential for durable response?
Post-IO strategy

Key controversies and open questions — after ICI failure

Byoung Chul Cho, MD PhD
Key Controversies and Open questions (2) How show we identify the right patient? [as printed] - Should rebiopsy at ICI progression become routine? Heterogeneity!! - Tissue vs. ctDNA vs. immune profiling — what is clinically actionanable? [as printed] - Do we need a biomarker of resistance or biomarker of response to next therapy (target expression or TROP2 QCS-NMR for ADCs) How should we rebuild antitumor immunity afater ICI failure? [as printed] - Reinvigorate/expand residual tumor-reactive T cells: immunocytokine, next-generation CPI - Redirect existing T cells toward tumor: T cell engagers - Prime a new antitumor T cell response: cancer vaccines OncLive Bridging the Gaps in Lung Cancer
Stephen V Liu, MD @StephenVLiu · Sep 11, 2026 · 1 slide
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Dr. @dplanchard at #BTGLung2026 discusses some of the current ADCs including those targeting TROP2. Clear efficacy, especially in EGFR NSCLC, but many data gaps regarding biomarkers, patient selection, mechanisms of resistance, CNS efficacy and in EGFR, alone or with TKI?
TROP2 ADCs

Main studies with TROP2-targeted ADCs

David Planchard, MD PhD
Main studies with ADCs-targeded TROP2 [as printed] (Gustave Roussy) Sac-TMT (TROP2) — OptiTROP-Lung04 — EGFR-mut NSCLC after EGFR-TKI — Positive phase III PFS + OS Sac-TMT (TROP2) — OptiTROP-Lung03 — EGFR-mut NSCLC, previously treated — Positive randomized PFS + OS Dato-DXd (TROP2) — TROPION-Lung05 — EGFR-mut / actionable genomic alterations after targeted therapy — Positive phase II; ORR 43.6%, mPFS 5.8 mo Dato-DXd (TROP2) — TROPION-Lung01 — Previously treated NSCLC — PFS benefit; no significant OS benefit. EGFRm benefit sac-TMT has the most compelling efficacy evidence in the post-EGFR-TKI/2L setting, whereas Dato-DXd has more mature international experience but is currently positioned mainly after EGFR-TKI + platinum. Dato-DXd + pembrolizumab +/- platinum — TROPION-Lung02 — 1L NSCLC without actionable genomic alterations — Encouraging phase Ib activity; ORR ~55% in treatment-naive patients; not randomized Sac-TMT + immunotherapy — OptiTROP-Lung01 — 1L advanced NSCLC without actionable genomic alterations — Positive phase II signal; rationale for subsequent randomized development Sacituzumab govitecan (TROP2) — EVOKE-01 — Previously treated NSCLC — OS negative; HR 0.84, P=0.0534 Sacituzumab govitecan + pembrolizumab — EVOKE-02 — 1L NSCLC without actionable genomic alterations — Positive phase II activity, particularly PD-L1 >=50%; no randomized OS evidence Sacituzumab govitecan + pembrolizumab — EVOKE-03 — 1L PD-L1 >=50% NSCLC — Negative phase III; discontinued Sac-TMT + pembrolizumab — OptiTROP-Lung05 — 1L PD-L1+ NSCLC, EGFR/ALK-negative — Positive phase III PFS
Stephen V Liu, MD @StephenVLiu · Sep 11, 2026 · 1 slide
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Many new ADCs emerging but a real challenge, highlighted by Dr. @mihaela_aldea at #BTGLung2026, is the commonalities specifically related to payload. Would we expect efficacy in sequencing these agents? Need to learn more about resistance and biomarkers to optimize use!
ADC landscape

The ADC race

Mihaela Aldea, MD PhD
The ADC race NSCLC targets -> TROP2: Dato-DXd, Sac-TMT | HER2: T-DXd, RC48, SHR-A1811 | c-MET: ABBV-400, Teliso-V | EGFR | HER3: HER3-DXd, YL202 | CEACAM5: M9140 | B7-H3: I-DXd, YL201, DB-1311, HS-20093 | integrin beta6: SGN-B6A | FRalpha: Rina-S SCLC targets -> B7-H3: I-DXd, YL201, DB-1311, HS-20093 | SEZ6: ABBV-706 | DLL3: ZL-1310 Bispecific / biparatopic ADCs: AZD9592 (EGFRxc-MET) | BL-B01D1 (EGFRxHER3) | JSKN003 (HER2xHER2) Legend: TOP1 payload / non-TOP1 payload / bispecific ADC | OncLive Bridging the Gaps in Lung Cancer
Stephen V Liu, MD @StephenVLiu · Sep 11, 2026 · 1 slide
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Lots of discussion about tarlatamab and TCEs in SCLC at #BTGLung2026 in session on ES-SCLC with Dr. @LuisPaz_Ares. What will the barriers to implementation be? How will ADCs impact the first-line setting?
SCLC · tarlatamab · DeLLphi-305 · DeLLphi-312 · DAREON-Lung-1

Ongoing phase III trials: from early promise to pivotal confirmation

Session with Luis Paz-Ares, MD PhD — Hospital 12 de Octubre, Madrid
Ongoing phase III trials: From Early Promise to Pivotal Confirmation DeLLphi-305 (Completed): P/E + durvalumab, no DP -> R -> Tarlatamab 10 mg Q2W + durvalumab vs durvalumab. Endpoint: OS. DeLLphi-312 (Recruiting): R -> Tarlatamab 20 mg Q3W + C/E + durvalumab -> tarlatamab 20 mg Q3W + durvalumab | vs C/E + durvalumab -> durvalumab. Endpoint: OS. DAREON(R)-Lung-1 (Designed): R 1:1 — induction phase, 3 cycles: obrixtamig + atezolizumab + etoposide + carboplatin vs atezolizumab + etoposide + carboplatin; maintenance phase: obrixtamig + atezolizumab vs atezolizumab. Endpoint: OS.
Stephen V Liu, MD @StephenVLiu · Sep 11, 2026 · 1 slide
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Dr. Martin Wermke at #BTGLung2026 discusses SCLC and the unmet need. DLL3 seems to have some predictive power - can DLL3 expression on CTCs help with patient identification?
SCLC · DLL3 biomarkers

What about blood-based biomarkers?

Martin Wermke, MD — University Hospital Dresden
What about blood-based biomarkers? Metastatic SCLC (n=20): peripheral blood drawn pre-tarlatamab and post-tarlatamab -> Circulating Tumor Cell (CTC) isolation on the CTC-iChip -> IF-staining separates DLL3- vs DLL3+ CTCs; single-cell RNAseq (10X-Chromium) -> t-SNE clustering. Mishra 2026, doi: 10.1158/2159-8290.CD-25-1483 | OncLive Bridging the Gaps in Lung Cancer
California Sessions
July 21–22, 2026 · California, USA · slides posted by Eric K. Singhi, MD (@lungoncdoc)
Small Cell Lung Cancer · Day 1
Eric K. Singhi, MD @lungoncdoc · Jul 21, 2026 · 3 slides
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#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
DeLLphi-304 trial profile →
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
Citations as printed on the slide. Published records: 1 Rudin et al, J Clin Oncol 2026;44(4):261-273 (epub Oct 2025); 2 Dowlati et al, J Thorac Oncol 2025;20(6):799-808 (TROPiCS-03; presented WCLC 2024, not ASCO 2026); 3 Byers et al, Nature Med 2026;32:2898-2908; 4 ZL-1310 ORR 47% / PFS 5.4 per Dy et al, AACR-NCI-EORTC Oct 2025 (Patel et al, ASCO 2025 reported ORR 36.5% confirmed, no PFS)
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
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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
DeLLphi-304 trial profile →
EGFR-Mutant NSCLC · Day 1
Eric K. Singhi, MD @lungoncdoc · Jul 21, 2026 · 1 slide
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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)
FLAURA trial profile →FLAURA2 trial profile →MARIPOSA trial profile →
Eric K. Singhi, MD @lungoncdoc · Jul 21, 2026 · 1 slide
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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
FLAURA2 trial profile →MARIPOSA trial profile →
Eric K. Singhi, MD @lungoncdoc · Jul 21, 2026 · 1 slide
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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).
ADAURA trial profile →
Perioperative & Early-Stage / Local Therapy · Day 2
Eric K. Singhi, MD @lungoncdoc · Jul 22, 2026 · 1 slide
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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)
CheckMate-77T trial profile →
Eric K. Singhi, MD @lungoncdoc · Jul 22, 2026 · 1 slide
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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)
ADAURA trial profile →
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)
CheckMate-77T trial profile →
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.
Audience Answers

The BTG Lung 2026 polls — and how the room voted

Stephen V. Liu, MD is running live practice polls from the Seoul sessions (288 votes and counting — still open), and Eric K. Singhi, MD ran 8 practice polls around the California sessions (289 votes). Questions and answer options are reproduced exactly as posted; percentages are the X poll results at capture time.

Seoul · live polls by Stephen V. Liu, MD
Seoul Q1 LIVE · open until Sep 12 · 183 votes so far

What is your current preference for 1L treatment of EGFR G719X NSCLC (assuming you have access to all below)?#BTGLung2026

  • Afatinib21%39
  • Amivantamab + Lazertinib41%75
  • Osimertinib + Chemotherap38%69
Vote / view poll on X ↗
Seoul Q2 LIVE · open until Sep 12 · 56 votes so far

What would your preferred first-line approach be today (assume access to all below) for a patient with metastatic NSCLC with a BRAF V600E mutation and high PD-L1 expression at 70%? #BTGLung2026 @OncLive

  • Dabrafenib + trametinib12%7
  • Encorafenib + binimetinib34%19
  • Immunotherapy +/- chemo41%23
  • Depends on smoking status12%7
Vote / view poll on X ↗
Seoul Q3 LIVE · open until Sep 13 · 49 votes so far

Assuming you had access to all options, what would your preference be for a patient with advanced NSCLC with a HER2 mutation and asymptomatic brain metastases? #BTGLung2026 @OncLive

  • Zongertinib78%38
  • Sevabertinib8%4
  • Trastuzumab deruxtecan12%6
  • Chemo-Immunotherapy2%1
Vote / view poll on X ↗
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 Final result · 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 Final result · 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 Final result · 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 ↗

The Conversation

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
Extended Discussion

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.
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  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.
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  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
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  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.
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  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
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  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.
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  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
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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.

Referenced Trials

Trial buzz

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

DeLLphi-304

Tarlatamab (DLL3 BiTE) vs chemo in 2L SCLC — the established 2L standard-of-care voice at BTG Lung 2026.

View trial profile →
MARIPOSA

Amivantamab + lazertinib vs osimertinib in 1L EGFR-mutant NSCLC — one side of the FLAURA2-vs-MARIPOSA 1L combo debate.

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FLAURA2

Osimertinib + chemotherapy vs osimertinib in 1L EGFR-mutant NSCLC — the chemo-combination arm of the 1L controversy.

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FLAURA

Osimertinib monotherapy in 1L EGFR-mutant NSCLC — the TKI-monotherapy benchmark referenced in the 1L decision framework.

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ADAURA

Adjuvant osimertinib in resected EGFR-mutant NSCLC — anchor of the early-stage EGFR treatment-map discussion.

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CheckMate-77T

Perioperative nivolumab in resectable NSCLC — the Day-2 exploratory pCR-by-nodal-status analysis (pCR is a surrogate; EFS is the primary endpoint) suggesting benefit across single- and multistation N2 disease.

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AEGEAN

Perioperative durvalumab in resectable NSCLC — one of the seven regimens in the Seoul cross-trial table; FDA & EU approved, all PD-L1.

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DeLLphi-305

1L maintenance tarlatamab + durvalumab in ES-SCLC — interim OS endpoint met Sept 8, 2026; the 1L combination remains investigational.

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ALINA

Adjuvant alectinib in resected ALK-positive NSCLC — referenced in the Day-2 discussion of adjuvant duration after neoadjuvant therapy.

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In the News

Media coverage

Media
OncLive — Bridging The Gaps in Lung Cancer 2026
OncLive.com · live conference coverage · @OncLive
Compiled and reviewed by the KOL Pulse research team, led by Brian Shields, Founder, KOL Pulse. Slide text is transcribed verbatim from the presenter’s posted slide images; posts are reproduced verbatim as published on X. Last updated September 10, 2026.