OptiTROP-Lung06: Sac-TMT + Pembro, PD-L1-Negative Nonsquamous NSCLC, PFS HR 0.49

Q: What is the OptiTROP-Lung06 trial?

OptiTROP-Lung06 (NCT06711900) is a randomized, open-label phase 3 trial run in China by Sichuan Kelun-Biotech. It compared sacituzumab tirumotecan (sac-TMT), a TROP2-directed antibody-drug conjugate, plus pembrolizumab with pemetrexed-platinum chemotherapy plus pembrolizumab as first-line treatment in 455 patients with advanced nonsquamous NSCLC, PD-L1 TPS below 1% and no EGFR or ALK alteration.

Q: What did OptiTROP-Lung06 show at ESMO 2026?

At the prespecified interim PFS analysis (data cutoff June 9, 2026; median follow-up 9.7 months), the primary endpoint was met: median PFS by blinded independent central review was 15.0 vs 5.7 months, HR 0.49 (95% CI 0.36–0.65). ORR was similar (50.2% vs 47.3%) but median duration of response was 13.6 vs 6.8 months. Results were published simultaneously in NEJM.

Q: Did sac-TMT plus pembrolizumab improve overall survival?

Not yet shown. Overall survival is a secondary endpoint and the data are immature: 36 vs 55 deaths, medians not reached, HR 0.58 (95% CI 0.38–0.88), reported as a descriptive analysis at the PFS interim analysis. The 12-month OS rate was 77.6% vs 66.4%.

Q: Is sacituzumab tirumotecan FDA approved?

No. Sacituzumab tirumotecan is not approved by the FDA or the European Medicines Agency for any indication. In China (NMPA) it is approved in four other indications (previously treated triple-negative breast cancer, EGFR-mutant NSCLC after EGFR-TKI in two settings, and pretreated HR+/HER2− breast cancer). First-line sac-TMT plus pembrolizumab for PD-L1-negative NSCLC is investigational everywhere. Merck (MSD) holds sac-TMT rights outside Greater China. It is a different drug from sacituzumab govitecan (TRODELVY).

Q: How did the safety profiles compare?

Grade ≥3 treatment-emergent adverse events occurred in 47.6% vs 60.6% of patients, and 5.7% vs 14.2% discontinued a study drug because of an adverse event. Sac-TMT brought stomatitis (51.1% any grade, 2.2% grade 3) and ocular surface toxicity (13.5%, all grade 1–2); pneumonitis, including ILD, occurred in 10.5% vs 13.7%.

Q: Was the trial conducted only in China?

Yes. All 81 sites listed on ClinicalTrials.gov are in China. Several physicians flagged the China-only population and asked for global data; one noted results have been similar in Asian and other populations (see Discussion Threads and Physician Reactions).

Event, n (%)	Sac-TMT + pembro (n=229)	Chemo + pembro (n=226)
Grade ≥3 TEAEs	109 (47.6)	137 (60.6)
Serious TEAEs	82 (35.8)	82 (36.3)
TEAEs leading to dose reduction	11 (4.8)	45 (19.9)
TEAEs leading to discontinuation of any study drug	13 (5.7)	32 (14.2)
TEAEs leading to death	5 (2.2)	14 (6.2)
Treatment-related AEs leading to death	1 (0.4)	3 (1.3)
Stomatitis, any grade / grade ≥3 (AESI)	117 (51.1) / 5 (2.2)	19 (8.4) / 0
Ocular surface toxicity, any grade (all grade 1–2)	31 (13.5)	6 (2.7)
Pneumonitis incl. ILD, any grade / grade ≥3	24 (10.5) / 4 (1.7)	31 (13.7) / 7 (3.1)

Influence Leaders

Top KOLs Discussing OptiTROP-Lung06

The physicians whose OptiTROP-Lung06 posts drew the most views. The presenter, Caicun Zhou, MD (Shanghai East Hospital, Tongji University), has no X profile we could verify; his slides are in Key Slides. The invited discussant was Melissa L. Johnson, MD (SCRI, Nashville).

Dr. Antonio Calles 🫁🚭

@Tony_Calles

1.7K views

Rami Manochakian MD, FASCO

Aya Mohamed | MSc, MD 🎗

@Dr_Oncologista

1.1K views

Conference Presentations

OptiTROP-Lung06 Key Slides & Visuals

ESMO 2026 slides

The LBA66 presentation (presenter: Caicun Zhou, MD) and the discussion by Melissa L. Johnson, MD, as photographed and shared on X by physicians on October 25, plus NEJM figures and the abstract. Survival curves, response data and subgroups are summarized in number tables under the slide groups. Click any image to view it full size, and open the transcribed text under each group. All ESMO 2026 OptiTROP-Lung06 slides in the KOL Pulse slide library →

Stephen V Liu, MD@StephenVLiu

Presenter, study design, PFS and OS

Oct 25, 2026 · ESMO 2026 · LBA66

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ESMO 2026 LBA66: presenter Professor Caicun Zhou at the podium, OptiTROP-Lung06 (photo shared by Stephen V. Liu, MD)

OptiTROP-Lung06 ESMO 2026 LBA66 slide: study design, randomized open-label phase 3, sac-TMT 4 mg/kg Q2W plus pembrolizumab vs pemetrexed-platinum plus pembrolizumab, n=455, PD-L1 TPS below 1% (shared by Stephen V. Liu, MD)

OptiTROP-Lung06 ESMO 2026 LBA66 slide: PFS by BICR, median 15.0 vs 5.7 months, HR 0.49, 12-month PFS 51.1% vs 22.8% (shared by Stephen V. Liu, MD)

OptiTROP-Lung06 ESMO 2026 LBA66 slide: descriptive overall survival at the PFS interim analysis, HR 0.58, 12-month OS 77.6% vs 66.4%, medians not reached (shared by Stephen V. Liu, MD)

Progression-free survival by BICR (primary endpoint), interim analysis, data cutoff Jun 9, 2026, as printed on the LBA66 slide

	Sac-TMT + pembro (n=229)	Chemo + pembro (n=226)	HR (95% CI)
PFS events, n (%)	79 (34.5)	126 (55.8)	—
Median PFS, months (95% CI)	15.0 (9.9–NE)	5.7 (5.5–7.4)	0.49 (0.36–0.65), P < 0.0001
12-month PFS rate	51.1%	22.8%	—
PFS by investigator	—	—	0.52 (0.40–0.69)

Overall survival (secondary endpoint), descriptive analysis at the PFS interim analysis, median follow-up 9.7 months, as printed on the LBA66 slide

	Sac-TMT + pembro (n=229)	Chemo + pembro (n=226)	HR (95% CI)
OS events, n (%)	36 (15.7)	55 (24.3)	—
Median OS, months (95% CI)	Not reached (NE–NE)	Not reached (15.6–NE)	0.58 (0.38–0.88)
12-month OS rate	77.6%	66.4%	—

Same slides also posted by @Alfdoc2, @AdamJanuszewski, @oncologician.

Slide text (transcribed from the slide images) [Photo] Professor Caicun Zhou at the ESMO 2026 podium, Madrid, 23-27 October 2026 (no slide text). [OptiTROP-Lung06 Study Design] Randomized, multicenter, open-label, phase 3 trial (NCT06711900) Key eligibility criteria: Locally advanced (stage IIIB/IIIC) or metastatic (stage IV) nsq-NSCLC; No prior systemic therapy for advanced disease; No sensitizing EGFR or ALK alteration; PD-L1 TPS< 1% (IHC 22C3, central lab); ECOG PS score 0 or 1 Stratification factors: Sex (male vs. female); ECOG PS score (0 vs. 1); Disease stage (IIIB/IIIC vs. IV) R 1:1, n = 455: Sac-TMT 4 mg/kg Q2W + Pembro 400 mg Q6W(a) (n = 229) | Pemetrexed 500 mg/m2 + Carboplatin AUC 5 or Cisplatin 75 mg/m2 Q3W(b) + Pembro 400 mg Q6W(a) (n = 226) Treatment until disease progression or unacceptable toxicity Endpoints(c): Primary: PFS assessed by BICR. Secondary endpoints included: OS; PFS assessed by investigator; ORR, DCR, DOR; Safety (a) Pembro was administered for a maximum of 18 cycles (6 weeks per cycle). (b) Platinum chemotherapy was administered for up to 4 doses Q3W (two 6-week cycles), followed by maintenance pemetrexed plus pembrolizumab. (c) Tumor response was assessed using RECIST version 1.1 every 6 weeks for the first 54 weeks after randomization, then every 12 weeks. Professor Caicun Zhou [PFS by BICR] Sac-TMT + pembro significantly improved PFS vs. Chemo + pembro, with a 51% reduction in risk of disease progression or death. Sac-TMT + Pembro (n = 229) | Chemo + Pembro (n = 226): PFS events, n (%) 79 (34.5) | 126 (55.8); Median, mo (95% CI) 15.0 (9.9–NE) | 5.7 (5.5–7.4) HR 0.49 (95% CI: 0.36–0.65); P < 0.0001(a). 12-month PFS (marked on curve): 51.1% vs 22.8% At risk, months 0-18: Sac-TMT+Pembro 229 224 197 173 162 141 107 88 77 60 45 41 28 15 15 12 2 2 2; Chemo+Pembro 226 221 192 157 141 109 77 64 56 38 25 22 16 5 4 4 1 1 0 PFS by investigator assessment was consistent with the results of BICR: HR 0.52 (95% CI: 0.40–0.69). (a) Updated efficacy boundary (corresponding to 205 actual PFS events by BICR): 0.0160 (2-sided). NE, not estimable. (Kaplan-Meier curve: values are in the number table above.) [Descriptive Overall Survival at PFS IA] A favorable trend in overall survival was observed with sac-TMT + pembro over chemo + pembro. Sac-TMT + Pembro (n = 229) | Chemo + Pembro (n = 226): OS events, n (%) 36 (15.7) | 55 (24.3); Median, mo (95% CI) NR (NE–NE) | NR (15.6–NE) HR 0.58 (95% CI: 0.38–0.88). 12-month OS (marked on curve): 77.6% vs 66.4% At risk, months 0-18: Sac-TMT+Pembro 229 228 228 215 200 184 166 148 130 109 92 79 60 51 36 24 21 7 4; Chemo+Pembro 226 226 220 210 188 167 152 136 122 98 85 67 51 39 25 17 10 3 1 Median follow-up was 9.7 months. (Kaplan-Meier curve: values are in the number table above.)

Hidehito HORINOUCHI@HHorinouchi

Study design, PFS, OS and response

Oct 25, 2026 · ESMO 2026 · LBA66

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OptiTROP-Lung06 ESMO 2026 LBA66 slide: PFS by BICR, median 15.0 vs 5.7 months, HR 0.49, 12-month PFS 51.1% vs 22.8% (shared by Hidehito Horinouchi, MD)

OptiTROP-Lung06 ESMO 2026 LBA66 slide: ORR, deep response and duration of response by BICR, ORR 50.2% vs 47.3%, median DOR 13.6 vs 6.8 months (shared by Hidehito Horinouchi, MD)

Response by BICR (ITT), as printed on the LBA66 slide

	Sac-TMT + pembro (n=229)	Chemo + pembro (n=226)
ORR, % (95% CI)	50.2 (43.6–56.9)	47.3 (40.7–54.1)
Deep response (CR/PR with ≥50% shrinkage), %	28.8	17.3
DCR, % (95% CI)	90.4 (85.8–93.9)	88.5 (83.6–92.3)
Median DOR, months (95% CI)	13.6 (9.7–NE)	6.8 (4.2–10.6)
DOR HR (95% CI)	0.47 (0.29–0.77)
12-month DOR rate, % (95% CI)	61.7 (47.5–73.1)	27.2 (11.2–46.0)

Same slides also posted by @Rtsugitom.

Slide text (transcribed from the slide images) [OptiTROP-Lung06 Study Design] Randomized, multicenter, open-label, phase 3 trial (NCT06711900) Key eligibility criteria: Locally advanced (stage IIIB/IIIC) or metastatic (stage IV) nsq-NSCLC; No prior systemic therapy for advanced disease; No sensitizing EGFR or ALK alteration; PD-L1 TPS< 1% (IHC 22C3, central lab); ECOG PS score 0 or 1 Stratification factors: Sex (male vs. female); ECOG PS score (0 vs. 1); Disease stage (IIIB/IIIC vs. IV) R 1:1, n = 455: Sac-TMT 4 mg/kg Q2W + Pembro 400 mg Q6W(a) (n = 229) | Pemetrexed 500 mg/m2 + Carboplatin AUC 5 or Cisplatin 75 mg/m2 Q3W(b) + Pembro 400 mg Q6W(a) (n = 226) Treatment until disease progression or unacceptable toxicity Endpoints(c): Primary: PFS assessed by BICR. Secondary endpoints included: OS; PFS assessed by investigator; ORR, DCR, DOR; Safety (a) Pembro was administered for a maximum of 18 cycles (6 weeks per cycle). (b) Platinum chemotherapy was administered for up to 4 doses Q3W (two 6-week cycles), followed by maintenance pemetrexed plus pembrolizumab. (c) Tumor response was assessed using RECIST version 1.1 every 6 weeks for the first 54 weeks after randomization, then every 12 weeks. Professor Caicun Zhou [PFS by BICR] Sac-TMT + pembro significantly improved PFS vs. Chemo + pembro, with a 51% reduction in risk of disease progression or death. Sac-TMT + Pembro (n = 229) | Chemo + Pembro (n = 226): PFS events, n (%) 79 (34.5) | 126 (55.8); Median, mo (95% CI) 15.0 (9.9–NE) | 5.7 (5.5–7.4) HR 0.49 (95% CI: 0.36–0.65); P < 0.0001(a). 12-month PFS (marked on curve): 51.1% vs 22.8% At risk, months 0-18: Sac-TMT+Pembro 229 224 197 173 162 141 107 88 77 60 45 41 28 15 15 12 2 2 2; Chemo+Pembro 226 221 192 157 141 109 77 64 56 38 25 22 16 5 4 4 1 1 0 PFS by investigator assessment was consistent with the results of BICR: HR 0.52 (95% CI: 0.40–0.69). (a) Updated efficacy boundary (corresponding to 205 actual PFS events by BICR): 0.0160 (2-sided). NE, not estimable. (Kaplan-Meier curve: values are in the number table above.) [Descriptive Overall Survival at PFS IA] A favorable trend in overall survival was observed with sac-TMT + pembro over chemo + pembro. Sac-TMT + Pembro (n = 229) | Chemo + Pembro (n = 226): OS events, n (%) 36 (15.7) | 55 (24.3); Median, mo (95% CI) NR (NE–NE) | NR (15.6–NE) HR 0.58 (95% CI: 0.38–0.88). 12-month OS (marked on curve): 77.6% vs 66.4% At risk, months 0-18: Sac-TMT+Pembro 229 228 228 215 200 184 166 148 130 109 92 79 60 51 36 24 21 7 4; Chemo+Pembro 226 226 220 210 188 167 152 136 122 98 85 67 51 39 25 17 10 3 1 Median follow-up was 9.7 months. (Kaplan-Meier curve: values are in the number table above.) [ORR, Deep Response, and DOR (BICR)] ORR was similar between groups, with deeper and more durable responses observed with sac-TMT + pembro. Sac-TMT + Pembro (n = 229) | Chemo + Pembro (n = 226) ORR, % (95% CI): 50.2 (43.6–56.9) | 47.3 (40.7–54.1) Deep response, %: 28.8 | 17.3 DCR, % (95% CI): 90.4 (85.8–93.9) | 88.5 (83.6–92.3) Median DOR, mo (95% CI): 13.6 (9.7–NE) | 6.8 (4.2–10.6); HR (95% CI) 0.47 (0.29–0.77) 12-mo DOR rate, % (95% CI): 61.7 (47.5–73.1) | 27.2 (11.2–46.0) DOR at risk, months 0-13: Sac-TMT+Pembro 115 103 92 77 72 59 46 37 32 25 10 8 7 5; Chemo+Pembro 107 97 80 57 53 43 32 26 22 12 6 4 2 2 ORR: the proportion of patients with a CR/PR. Deep response: CR or PR with ≥ 50% reduction from baseline in the sum of target-lesion diameters. Percentages are based on the ITT population.

Prof Tom John@TommyJohn00

Baseline characteristics

Oct 25, 2026 · ESMO 2026 · LBA66

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OptiTROP-Lung06 ESMO 2026 LBA66 slide: baseline characteristics, median age 63, 72.1% male, never smokers 34.5% vs 37.2%, stage IV 91.7% vs 91.6% (shared by Tom John, MD)

OptiTROP-Lung06 ESMO 2026 LBA66 slide: PFS by BICR, median 15.0 vs 5.7 months, HR 0.49, 12-month PFS 51.1% vs 22.8% (shared by Tom John, MD)

Dr Riyaz Shah@DrRiyazShah

PFS in subgroups

Oct 25, 2026 · ESMO 2026 · LBA66

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OptiTROP-Lung06 ESMO 2026 LBA66 slide: baseline characteristics, median age 63, 72.1% male, never smokers 34.5% vs 37.2%, stage IV 91.7% vs 91.6% (shared by Riyaz Shah, MD)

OptiTROP-Lung06 ESMO 2026 LBA66 slide: PFS by BICR, median 15.0 vs 5.7 months, HR 0.49, 12-month PFS 51.1% vs 22.8% (shared by Riyaz Shah, MD)

OptiTROP-Lung06 ESMO 2026 LBA66 slide: PFS by BICR in subgroups, including sex, smoking history and TROP2 expression (shared by Riyaz Shah, MD)

PFS by BICR in subgroups (unstratified HRs, exploratory), as printed on the LBA66 slide

Subgroup	Events/patients, sac-TMT + pembro	Events/patients, chemo + pembro	HR (95% CI)
All patients	79/229	126/226	0.49 (0.36–0.65)
Male	53/165	99/163	0.39 (0.28–0.55)
Female	26/64	27/63	0.88 (0.51–1.51)
Age <65	46/126	75/122	0.44 (0.30–0.64)
Age ≥65	33/103	51/104	0.57 (0.37–0.88)
ECOG 0	13/40	22/40	0.49 (0.24–1.00)
ECOG 1	66/189	104/186	0.49 (0.36–0.66)
Stage IV	75/210	120/207	0.49 (0.37–0.66)
Current or former smoker	47/150	88/142	0.36 (0.25–0.51)
Never smoker	32/79	38/84	0.80 (0.50–1.29)
No liver metastasis	73/212	108/200	0.52 (0.39–0.70)
<3 distant metastatic sites	52/158	78/149	0.52 (0.36–0.74)
≥3 distant metastatic sites	23/52	42/58	0.47 (0.28–0.78)
TROP2 low (H-score ≤200)	26/77	47/87	0.49 (0.30–0.80)
TROP2 high (H-score >200)	32/89	47/83	0.59 (0.37–0.92)
TROP2 unknown	21/63	32/56	0.38 (0.22–0.67)

Slide text (transcribed from the slide images) [OptiTROP-Lung06 Study Design] Randomized, multicenter, open-label, phase 3 trial (NCT06711900) Key eligibility criteria: Locally advanced (stage IIIB/IIIC) or metastatic (stage IV) nsq-NSCLC; No prior systemic therapy for advanced disease; No sensitizing EGFR or ALK alteration; PD-L1 TPS< 1% (IHC 22C3, central lab); ECOG PS score 0 or 1 Stratification factors: Sex (male vs. female); ECOG PS score (0 vs. 1); Disease stage (IIIB/IIIC vs. IV) R 1:1, n = 455: Sac-TMT 4 mg/kg Q2W + Pembro 400 mg Q6W(a) (n = 229) | Pemetrexed 500 mg/m2 + Carboplatin AUC 5 or Cisplatin 75 mg/m2 Q3W(b) + Pembro 400 mg Q6W(a) (n = 226) Treatment until disease progression or unacceptable toxicity Endpoints(c): Primary: PFS assessed by BICR. Secondary endpoints included: OS; PFS assessed by investigator; ORR, DCR, DOR; Safety (a) Pembro was administered for a maximum of 18 cycles (6 weeks per cycle). (b) Platinum chemotherapy was administered for up to 4 doses Q3W (two 6-week cycles), followed by maintenance pemetrexed plus pembrolizumab. (c) Tumor response was assessed using RECIST version 1.1 every 6 weeks for the first 54 weeks after randomization, then every 12 weeks. Professor Caicun Zhou [Baseline Characteristics] Sac-TMT + Pembro (n = 229) | Chemo + Pembro (n = 226) Age, median (range), years: 63 (29, 75) | 63 (37, 75); ≥65: 103 (45.0) | 104 (46.0) Sex, male: 165 (72.1) | 163 (72.1) ECOG PS score 1: 189 (82.5) | 186 (82.3) Smoking history: current or former smoker 150 (65.5) | 142 (62.8); never smoker 79 (34.5) | 84 (37.2) Histology: adenocarcinoma 228 (99.6) | 226 (100); large-cell carcinoma 1 (0.4) | 0 Disease stage: IIIB/IIIC 19 (8.3) | 19 (8.4); IV 210 (91.7) | 207 (91.6) Metastases: ≥3 distant metastatic sites 52 (22.7) | 58 (25.7); brain 5 (2.2) | 6 (2.7); liver 17 (7.4) | 26 (11.5); bone 75 (32.8) | 89 (39.4) Professor Caicun Zhou [PFS by BICR] Sac-TMT + pembro significantly improved PFS vs. Chemo + pembro, with a 51% reduction in risk of disease progression or death. Sac-TMT + Pembro (n = 229) | Chemo + Pembro (n = 226): PFS events, n (%) 79 (34.5) | 126 (55.8); Median, mo (95% CI) 15.0 (9.9–NE) | 5.7 (5.5–7.4) HR 0.49 (95% CI: 0.36–0.65); P < 0.0001(a). 12-month PFS (marked on curve): 51.1% vs 22.8% At risk, months 0-18: Sac-TMT+Pembro 229 224 197 173 162 141 107 88 77 60 45 41 28 15 15 12 2 2 2; Chemo+Pembro 226 221 192 157 141 109 77 64 56 38 25 22 16 5 4 4 1 1 0 PFS by investigator assessment was consistent with the results of BICR: HR 0.52 (95% CI: 0.40–0.69). (a) Updated efficacy boundary (corresponding to 205 actual PFS events by BICR): 0.0160 (2-sided). NE, not estimable. (Kaplan-Meier curve: values are in the number table above.) [PFS (BICR) in Subgroups] A generally consistent PFS benefit of sac-TMT + pembro over chemo + pembro was observed across subgroups. Subgroup: events/patients sac-TMT+pembro | chemo+pembro; HR (95% CI) All subjects 79/229 | 126/226; 0.49 (0.36-0.65) Sex: Male 53/165 | 99/163; 0.39 (0.28-0.55). Female 26/64 | 27/63; 0.88 (0.51-1.51) Age: <65 years 46/126 | 75/122; 0.44 (0.30-0.64). ≥65 years 33/103 | 51/104; 0.57 (0.37-0.88) ECOG PS: 0 13/40 | 22/40; 0.49 (0.24-1.00). 1 66/189 | 104/186; 0.49 (0.36-0.66) Clinical stage at enrollment: Stage IV 75/210 | 120/207; 0.49 (0.37-0.66) Smoking history: Current or former smoker 47/150 | 88/142; 0.36 (0.25-0.51). Never smoker 32/79 | 38/84; 0.80 (0.50-1.29) Liver metastasis: No 73/212 | 108/200; 0.52 (0.39-0.70) Number of distant metastatic sites: <3 52/158 | 78/149; 0.52 (0.36-0.74). ≥3 23/52 | 42/58; 0.47 (0.28-0.78) TROP2 expression: Low (H-score ≤200) 26/77 | 47/87; 0.49 (0.30-0.80). High (H-score >200) 32/89 | 47/83; 0.59 (0.37-0.92). Unknown 21/63 | 32/56; 0.38 (0.22-0.67) HR along with the 95% CI were estimated using unstratified Cox Proportional Hazards model in each subgroup. Subgroup analyses will not be presented for any subgroup variable in which one or more levels account for less than 10% of the total analysis population. TROP-2 expression was evaluated in formalin-fixed, paraffin-embedded tumor specimens by immunohistochemistry.

Aya Mohamed | MSc, MD 🎗@Dr_Oncologista

Summary of safety

Oct 25, 2026 · ESMO 2026 · LBA66

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OptiTROP-Lung06 ESMO 2026 LBA66 slide: presenter conclusions, sac-TMT plus pembrolizumab as a potential new first-line option for PD-L1-negative nonsquamous NSCLC (shared by Aya Mohamed, MD)

OptiTROP-Lung06 ESMO 2026 LBA66 slide: PFS by BICR, median 15.0 vs 5.7 months, HR 0.49, 12-month PFS 51.1% vs 22.8% (shared by Aya Mohamed, MD)

OptiTROP-Lung06 ESMO 2026 LBA66 slide: ORR, deep response and duration of response by BICR, ORR 50.2% vs 47.3%, median DOR 13.6 vs 6.8 months (shared by Aya Mohamed, MD)

OptiTROP-Lung06 ESMO 2026 LBA66 slide: summary of safety, grade 3 or higher TEAEs 47.6% vs 60.6%, discontinuation of any study drug 5.7% vs 14.2% (shared by Aya Mohamed, MD)

Same slides also posted by @BalazsHalmosMD.

Slide text (transcribed from the slide images) [Conclusions] • Sac-TMT + pembro demonstrated a statistically significant and clinically meaningful improvement in PFS compared with chemo + pembro. • Sac-TMT + pembro showed a higher deep response rate and longer DOR, reflecting deeper and more durable responses. • OS data were immature, but a favorable trend was observed (HR 0.58; 95% CI, 0.38–0.88). • The safety profile was manageable and consistent with the known profiles of the individual agents, with no new safety signals identified. Median PFS by BICR: Sac-TMT + Pembro 15.0 mo vs Chemo + Pembro 5.7 mo; HR 0.49; 95% CI: 0.36–0.65; P < 0.0001. Median DOR by BICR: 13.6 mo vs 6.8 mo; HR 0.47; 95% CI: 0.29–0.77 Results from OptiTROP-Lung06 study support sac-TMT + pembro as a potential new first-line treatment option for PD-L1-negative advanced nonsquamous NSCLC without EGFR or ALK alterations [PFS by BICR] Sac-TMT + pembro significantly improved PFS vs. Chemo + pembro, with a 51% reduction in risk of disease progression or death. Sac-TMT + Pembro (n = 229) | Chemo + Pembro (n = 226): PFS events, n (%) 79 (34.5) | 126 (55.8); Median, mo (95% CI) 15.0 (9.9–NE) | 5.7 (5.5–7.4) HR 0.49 (95% CI: 0.36–0.65); P < 0.0001(a). 12-month PFS (marked on curve): 51.1% vs 22.8% At risk, months 0-18: Sac-TMT+Pembro 229 224 197 173 162 141 107 88 77 60 45 41 28 15 15 12 2 2 2; Chemo+Pembro 226 221 192 157 141 109 77 64 56 38 25 22 16 5 4 4 1 1 0 PFS by investigator assessment was consistent with the results of BICR: HR 0.52 (95% CI: 0.40–0.69). (a) Updated efficacy boundary (corresponding to 205 actual PFS events by BICR): 0.0160 (2-sided). NE, not estimable. (Kaplan-Meier curve: values are in the number table above.) [ORR, Deep Response, and DOR (BICR)] ORR was similar between groups, with deeper and more durable responses observed with sac-TMT + pembro. Sac-TMT + Pembro (n = 229) | Chemo + Pembro (n = 226) ORR, % (95% CI): 50.2 (43.6–56.9) | 47.3 (40.7–54.1) Deep response, %: 28.8 | 17.3 DCR, % (95% CI): 90.4 (85.8–93.9) | 88.5 (83.6–92.3) Median DOR, mo (95% CI): 13.6 (9.7–NE) | 6.8 (4.2–10.6); HR (95% CI) 0.47 (0.29–0.77) 12-mo DOR rate, % (95% CI): 61.7 (47.5–73.1) | 27.2 (11.2–46.0) DOR at risk, months 0-13: Sac-TMT+Pembro 115 103 92 77 72 59 46 37 32 25 10 8 7 5; Chemo+Pembro 107 97 80 57 53 43 32 26 22 12 6 4 2 2 ORR: the proportion of patients with a CR/PR. Deep response: CR or PR with ≥ 50% reduction from baseline in the sum of target-lesion diameters. Percentages are based on the ITT population. [Summary of Safety] Grade ≥3 TEAEs were less frequent with sac-TMT + pembro (47.6% vs. 60.6%), particularly hematologic events. Event, n (%): Sac-TMT + Pembro (n = 229) | Chemo + Pembro (n = 226) TEAEs 228 (99.6) | 225 (99.6); Grade ≥3 TEAEs 109 (47.6) | 137 (60.6); Serious TEAEs 82 (35.8) | 82 (36.3); TEAEs leading to dose reduction(a) 11 (4.8) | 45 (19.9); TEAEs leading to discontinuation of any study drug 13 (5.7) | 32 (14.2); TEAEs leading to death 5 (2.2) | 14 (6.2); TRAEs leading to death 1 (0.4) | 3 (1.3) Any grade TEAEs with incidence ≥20% in either group, any grade % (grade ≥3 %), sac-TMT+pembro | chemo+pembro: Anaemia 83 (6) | 85 (20); Alopecia 62 (0) | 14 (0); WBC decreased 48 (10) | 65 (16); NEUT decreased 47 (20) | 65 (29); Stomatitis 45 (2) | 7 (0); Decreased appetite 40 (0) | 45 (0); Asthenia 31 (2) | 34 (2); Nausea 31 (0) | 31 (0); Hypoalbuminaemia 30 (0) | 27 (0); ALT increased 29 (0) | 37 (3); AST increased 26 (1) | 38 (1); Constipation 21 (0) | 23 (0); Rash 21 (1) | 14 (0); PLT decreased 19 (4) | 51 (15); LDH increased 17 (0) | 25 (0) (a) Only dose of sac-TMT and chemotherapy was allowed to be modified.

Dr. Antonio Calles 🫁🚭@Tony_Calles

Adverse events of special interest and conclusions

Oct 25, 2026 · ESMO 2026 · LBA66

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OptiTROP-Lung06 ESMO 2026 LBA66 slide: PFS by BICR, median 15.0 vs 5.7 months, HR 0.49, 12-month PFS 51.1% vs 22.8% (shared by Antonio Calles, MD)

OptiTROP-Lung06 ESMO 2026 LBA66 slide: adverse events of special interest, stomatitis 51.1% any grade and 2.2% grade 3, ocular surface toxicity 13.5% all grade 1-2, pneumonitis 10.5% vs 13.7% (shared by Antonio Calles, MD)

Same slides also posted by @dr_dirican.

Slide text (transcribed from the slide images) [OptiTROP-Lung06 Study Design] Randomized, multicenter, open-label, phase 3 trial (NCT06711900) Key eligibility criteria: Locally advanced (stage IIIB/IIIC) or metastatic (stage IV) nsq-NSCLC; No prior systemic therapy for advanced disease; No sensitizing EGFR or ALK alteration; PD-L1 TPS< 1% (IHC 22C3, central lab); ECOG PS score 0 or 1 Stratification factors: Sex (male vs. female); ECOG PS score (0 vs. 1); Disease stage (IIIB/IIIC vs. IV) R 1:1, n = 455: Sac-TMT 4 mg/kg Q2W + Pembro 400 mg Q6W(a) (n = 229) | Pemetrexed 500 mg/m2 + Carboplatin AUC 5 or Cisplatin 75 mg/m2 Q3W(b) + Pembro 400 mg Q6W(a) (n = 226) Treatment until disease progression or unacceptable toxicity Endpoints(c): Primary: PFS assessed by BICR. Secondary endpoints included: OS; PFS assessed by investigator; ORR, DCR, DOR; Safety (a) Pembro was administered for a maximum of 18 cycles (6 weeks per cycle). (b) Platinum chemotherapy was administered for up to 4 doses Q3W (two 6-week cycles), followed by maintenance pemetrexed plus pembrolizumab. (c) Tumor response was assessed using RECIST version 1.1 every 6 weeks for the first 54 weeks after randomization, then every 12 weeks. Professor Caicun Zhou [PFS by BICR] Sac-TMT + pembro significantly improved PFS vs. Chemo + pembro, with a 51% reduction in risk of disease progression or death. Sac-TMT + Pembro (n = 229) | Chemo + Pembro (n = 226): PFS events, n (%) 79 (34.5) | 126 (55.8); Median, mo (95% CI) 15.0 (9.9–NE) | 5.7 (5.5–7.4) HR 0.49 (95% CI: 0.36–0.65); P < 0.0001(a). 12-month PFS (marked on curve): 51.1% vs 22.8% At risk, months 0-18: Sac-TMT+Pembro 229 224 197 173 162 141 107 88 77 60 45 41 28 15 15 12 2 2 2; Chemo+Pembro 226 221 192 157 141 109 77 64 56 38 25 22 16 5 4 4 1 1 0 PFS by investigator assessment was consistent with the results of BICR: HR 0.52 (95% CI: 0.40–0.69). (a) Updated efficacy boundary (corresponding to 205 actual PFS events by BICR): 0.0160 (2-sided). NE, not estimable. (Kaplan-Meier curve: values are in the number table above.) [Adverse Events of Special Interest] Sac-TMT + Pembro (n = 229) any grade / grade ≥3 | Chemo + Pembro (n = 226) any grade / grade ≥3 Sac-TMT AEOSI: Anaemia 189 (82.5) / 14 (6.1) | 191 (84.5) / 46 (20.4); Stomatitis(b) 117 (51.1) / 5 (2.2) | 19 (8.4) / 0; Neutrophil count decreased(c) 108 (47.2) / 46 (20.1) | 149 (65.9) / 67 (29.6); Ocular surface toxicity(d) 31 (13.5) / 0 | 6 (2.7) / 0; Infusion-related reaction 10 (4.4)(e) / 0 | 3 (1.3) / 0 Pembro AEOSI(a): Pneumonitis(f) 24 (10.5) / 4 (1.7) | 31 (13.7) / 7 (3.1); Hypothyroidism 23 (10.0) / 0 | 20 (8.8) / 0; Hyperthyroidism 18 (7.9) / 0 | 10 (4.4) / 0; Infusion reaction 10 (4.4)(e) / 0 | 3 (1.3) / 0; Adrenal insufficiency 6 (2.6) / 1 (0.4) | 3 (1.3) / 0; Severe skin reactions 5 (2.2) / 4 (1.7) | 0 / 0 • Stomatitis occurred in 51.1% of patients receiving sac-TMT + pembro: grade 1 in 21.8%, grade 2 in 27.1%, and grade 3 in 2.2%. • All ocular surface toxicities were grade 1–2; the most common were dry eye (8.3%), conjunctivitis (5.7%), and increased tearing (5.2%). • No apparent excess of pneumonitis, including ILD, was observed with sac-TMT + pembro (10.5% vs. 13.7%). AEOSIs are reported regardless of causality. (a) Summary of any grade AEOSI for pembro with incidence ≥ 2% in either treatment group. (b) Stomatitis includes the preferred term of stomatitis, oral ulcer and aphthous ulcer. (c) Neutrophil count decreased includes preferred terms neutrophil count decreased, neutropenia, febrile neutropenia, among others. (d) Ocular surface toxicity includes preferred terms dry eye, conjunctivitis, increased tearing, among others. (e) Infusion-related reactions occurred in 9 patients during the course of sac-TMT infusion, and 1 patient during pembrolizumab infusion. (f) Pneumonitis includes the preferred term of immune-related pneumonitis, pneumonitis, and interstitial lung disease. [Conclusions] • Sac-TMT + pembro demonstrated a statistically significant and clinically meaningful improvement in PFS compared with chemo + pembro. • Sac-TMT + pembro showed a higher deep response rate and longer DOR, reflecting deeper and more durable responses. • OS data were immature, but a favorable trend was observed (HR 0.58; 95% CI, 0.38–0.88). • The safety profile was manageable and consistent with the known profiles of the individual agents, with no new safety signals identified. Median PFS by BICR: Sac-TMT + Pembro 15.0 mo vs Chemo + Pembro 5.7 mo; HR 0.49; 95% CI: 0.36–0.65; P < 0.0001. Median DOR by BICR: 13.6 mo vs 6.8 mo; HR 0.47; 95% CI: 0.29–0.77 Results from OptiTROP-Lung06 study support sac-TMT + pembro as a potential new first-line treatment option for PD-L1-negative advanced nonsquamous NSCLC without EGFR or ALK alterations

Prof Tom John@TommyJohn00

Invited discussant Melissa L. Johnson: toxicity across the sac-TMT trials

Oct 25, 2026 · ESMO 2026 · LBA66

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ESMO 2026 discussant slide by Melissa L. Johnson, MD: sac-TMT 5 mg/kg in OptiTROP-Lung04 vs 4 mg/kg in OptiTROP-Lung06, grade 3 or higher TEAEs 47.6% vs 60.6% in OptiTROP-Lung06 (shared by Tom John, MD)

Slide text (transcribed from the slide images) [Invited discussant slide, Melissa L. Johnson MD, SCRI] Sac-TMT 5 mg/kg, OptiTROP-Lung 04 (vs. carbo/pemetrexed) | Sac-TMT 4 mg/kg, OptiTROP-Lung 06 (vs. carbo/pemetrexed/pembro) OptiTROP-Lung04, Sac-TMT (n = 188) | Chemo (n = 182): Median duration of exposure, months (range) 9.6 (0.5, 35.8) | 4.9 (0.7, 34.1); TRAEs any grade 188 (100) | 179 (98.4); Grade ≥3 110 (58.5) | 98 (53.8); Serious TRAEs 19 (10.1) | 33 (18.1); Leading to dose reduction 57 (30.3) | 41 (22.5); Leading to dose interruption 75 (39.9) | 60 (33.0); Leading to discontinuation 0 | 1 (0.5); Leading to death 1 (0.5)* | 1 (0.5)* OptiTROP-Lung06, Event, n (%), Sac-TMT + Pembro (n = 229) | Chemo + Pembro (n = 226): TEAEs 228 (99.6) | 225 (99.6); Grade ≥3 TEAEs 109 (47.6) | 137 (60.6); Serious TEAEs 82 (35.8) | 82 (36.3); Leading to dose reduction(a) 11 (4.8) | 45 (19.9); Leading to any dose discont. 13 (5.7) | 32 (14.2); TEAEs leading to death 5 (2.2) | 14 (6.2); TRAEs leading to death 1 (0.4) | 3 (1.3) (Note: the OptiTROP-Lung04 column reports treatment-related AEs; the OptiTROP-Lung06 column reports treatment-emergent AEs.)

Nirmal Raut@oncologician

Invited discussant Melissa L. Johnson: ADCs and checkpoint inhibitors

Oct 25, 2026 · ESMO 2026 · LBA66

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ESMO 2026 discussant slide by Melissa L. Johnson, MD: ADCs rise in NSCLC, the HER2 ADC story from DESTINY-Lung01 to DESTINY-Lung04 (shared by Nirmal Raut, MD)

ESMO 2026 discussant slide by Melissa L. Johnson, MD: ADCs and immune checkpoint inhibitors play complementary roles in the tumor microenvironment (shared by Nirmal Raut, MD)

ESMO 2026 discussant slide by Melissa L. Johnson, MD: conclusions, OptiTROP-Lung06 suggests synergy with checkpoint inhibitors is within reach (shared by Nirmal Raut, MD)

Slide text (transcribed from the slide images) [Image 1, discussant slide: ADCs Rise in NSCLC] Antibody, linker, payload; Smart-Bomb!; "Chemo-Free"; Biomarker selection should be easy → antigen target dependent. The Story Began with HER2 ADC Trastuzumab Deruxtecan for HER2 mutant NSCLC: 2018 DESTINY-Lung01 begins (Phase II; HER2-mutant and IHC-selected cohorts); 2020–21 early activity establishes proof of concept; first U.S. approval in NSCLC (accelerated approval for previously treated HER2-mutant NSCLC; 5.4 mg/kg); 2023 DESTINY-Lung02 confirms dose/benefit (randomized dose finding); Sep 2026 DESTINY-Lung04 positive in 1L (PFS 14.3 vs 8.3 mo; HR 0.63 vs pembrolizumab + chemotherapy). Melissa L. Johnson MD, SCRI [Image 2, discussant slide] ADCs and ICIs play complimentary roles in the TME; Tip efficacy/safety towards tumor; Identify biomarkers that will aid in patient selection (maybe); Manage irAEs. (Mechanism diagram; Yin et al. Antibody Therapeutics 2025, 8 (3), 262-274.) [Image 3, discussant slide: Conclusions: Do ADCs have what it takes to BEAT chemotherapy??] • Maybe not in an all-comers trial …. (Sig-Vie-002) • Opti TROP-Lung 04 shows it can be done! ➢ Find the right patient population ➢ ADC toxicity shouldn't be underestimated ➢ Dose attenuation, even pulsatile administration will be part of ADC adoption into NSCLC paradigms • Opti TROP-Lung 06 suggests synergy with checkpoint inhibitors is also within reach. ➢ Likely the primary exposure to IO will be best chance for success Melissa L. Johnson, MD, SCRI

Elvina Almuradova@Dr_ElvinaA

NEJM publication: progression-free survival figure

Oct 25, 2026 · ESMO 2026 · LBA66

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NEJM original article title page: Sacituzumab Tirumotecan plus Pembrolizumab in PD-L1-Negative Advanced NSCLC, F. Zhou et al. (shared by Elvina Almuradova, MD)

NEJM Figure 1, PFS by blinded independent central review, 12-month PFS 51.1% vs 22.8%, hazard ratio 0.49 (shared by Elvina Almuradova, MD)

Same slides also posted by @ilyassahinMD, @HHorinouchi, @dr_yakupergun, @RManochakian.

Slide text (transcribed from the slide images) [NEJM, Original Article, Meeting of the European Society for Medical Oncology] Sacituzumab Tirumotecan–Pembrolizumab for NSCLC. F. Zhou and Others. Among patients with PD-L1–negative advanced nonsquamous non–small-cell lung cancer, progression-free survival was longer with sacituzumab tirumotecan plus pembrolizumab than with chemotherapy plus pembrolizumab (15.0 vs. 5.7 months). NEJM Figure 1 (PFS by BICR): 12-month PFS 51.1% (95% CI, 41.5–59.9) vs 22.8% (95% CI, 15.3–31.3); events 79/229 (34.5) vs 126/226 (55.8); median 15.0 (9.9–NE) vs 5.7 (5.5–7.4) months; hazard ratio for disease progression or death, 0.49 (95% CI, 0.36–0.65). NEJM OS figure: 12-month OS 77.6% (95% CI, 69.5–83.8) vs 66.4% (95% CI, 57.6–73.8); events 36/229 (15.7) vs 55/226 (24.3); median NE (NE–NE) vs NE (15.6–NE); hazard ratio for death, 0.58 (95% CI, 0.38–0.88).

Dr Rishabh Jain@DrRishabhOnco

NEJM publication: overall survival figure

Oct 25, 2026 · ESMO 2026 · LBA66

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NEJM overall survival figure for OptiTROP-Lung06, 12-month OS 77.6% vs 66.4%, hazard ratio for death 0.58 (shared by Rishabh Jain, MD)

Yakup Ergün@dr_yakupergun

Abstract LBA66 (released before the presentation)

Oct 25, 2026 · ESMO 2026 · LBA66

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OptiTROP-Lung06 ESMO 2026 abstract LBA66 screenshot: background, methods, results and conclusions (shared by Yakup Ergün, MD)

Same slides also posted by @HHorinouchi.

Slide text (transcribed from the slide images) LBA66 - Sacituzumab tirumotecan (sac-TMT) plus pembrolizumab (P) versus chemotherapy (chemo) plus pembrolizumab (P) as first-line (1L) treatment for PD-L1-negative advanced non-squamous (nsq) NSCLC: Randomized phase 3 OptiTROP-Lung06 study Speakers: Caicun Zhou (Shanghai, China) Authors: Caicun Zhou (Shanghai, China) Fei Zhou (Shanghai, China) Xiangjiao Meng (Jinan, China) Qingqing Ding (Nanjing, China) Peng Zhang (Shanghai, China) Wenhua Liang (Guangzhou, China) Sanxing Guo (Zhengzhou, China) Yan Yu (Harbin, China) Wenxiu Yao (Chengdu, China) Yun Fan (Hangzhou, China) Xingxiang Pu (Changsha, China) Chunling Liu (Urumqi, China) Jiuwei Cui (Changchun, China) Peng Chen (Tianjin, China) Hua Zhong (Shanghai, China) Li Yin (Chengdu, China) Yan Qing (Chengdu, China) Xiaoping Jin (Chengdu, China) Junyou Ge (CHENGDU, China) Background Pembrolizumab plus chemotherapy is the standard 1L treatment for PD-L1-negative advanced nsq-NSCLC without actionable genomic alterations, but outcomes remain suboptimal. Sac-TMT, a TROP2-directed ADC, previously showed encouraging activity with PD-1 blockade in 1L PD-L1-positive NSCLC (Xiong et al., Lancet, 2026). We report the results from the preplanned interim PFS analysis of OptiTROP-Lung06 (NCT06711900). Methods Eligible patients (pts) had treatment-naïve, locally advanced or metastatic nsq-NSCLC without EGFR/ALK alterations and PD-L1 tumor proportion score (TPS) <1% using the 22C3 assay. Pts were randomized 1:1 to receive sac-TMT 4 mg/kg Q2W + P 400 mg Q6W or chemo + P. The primary endpoint was PFS per RECIST 1.1 assessed by blinded independent central review (BICR); OS was secondary. Results A total of 455 pts (median age 63 yrs; 72.1% male; 82.4% ECOG 1; 91.6% stage Ⅳ) were randomized to receive sac-TMT + P (n=229) or chemo + P (n=226). As of Jun 9, 2026, median follow-up was 9.7 mo. Sac-TMT + P showed a highly statistically significant and clinically meaningful improvement in PFS by BICR compared with chemo + P (median: 15.0 vs 5.7 mo; HR, 0.49; 95% CI 0.36-0.65; p<0.0001). OS data were immature, but a favorable trend was observed in the sac-TMT + P group (HR, 0.58; 95% CI 0.38-0.88). ORR by BICR was 50.2% vs 47.3%, and median DoR was 13.6 vs 6.8 mo (HR 0.47, 95% CI 0.29-0.77). Grade ≥3 TEAEs were less frequent with sac-TMT + P than with chemo+ P (47.6% vs 60.6%), including neutrophil count decreased (19.7% vs 28.8%), white blood cell count decreased (9.6% vs 16.4%), anemia (6.1% vs 20.4%), and platelet count decreased (3.9% vs 14.6%). Sac-TMT-associated AESIs were manageable; grade ≥3 stomatitis occurred in 2.2%. Conclusions Sac-TMT+ P significantly prolonged PFS versus chemo + P, with longer response duration and a manageable safety profile. To our knowledge, this is the first randomized phase 3 study showing superior PFS with a TROP2-directed ADC plus PD-1 blockade versus an immunotherapy-plus-chemo standard therapy in NSCLC, supporting sac-TMT +P as a potential 1L treatment option for this population. Clinical trial identification: NCT06711900; first posted on Dec 02, 2024. Legal entity responsible for the study: Sichuan Kelun-Biotech Biopharmaceutical Co., Ltd., Chengdu, China. Funding: Sichuan Kelun-Biotech Biopharmaceutical Co., Ltd., Chengdu, China. Disclosure (excerpt): L. Yin, Y. Qing, X. Jin, J. Ge: full-time employment, Sichuan Kelun-Biotech. C. Zhou: invited speaker incl. MSD, others.

KOL-Made Infographics

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Summary card on OptiTROP-Lung06: design, efficacy by BICR and safety (made by Aakash Desai, MD)

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NEJM article header for OptiTROP-Lung06 (shared by Aakash Desai, MD)

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MV Onco infographic on OptiTROP-Lung06: the great partner swap, PFS, ORR and DoR (made by MV Chandrakanth, MD)

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MV Onco infographic on OptiTROP-Lung06 part 1: the clinical question and trial design (made by MV Chandrakanth, MD)

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MV Onco infographic on OptiTROP-Lung06 part 2: PFS soars, but what about OS (made by MV Chandrakanth, MD)

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MV Onco infographic on OptiTROP-Lung06 part 3: less toxicity, safety trade-off and TROP2 expression (made by MV Chandrakanth, MD)

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MV Onco infographic on OptiTROP-Lung06: China-only phase 3, PFS curves, ORR and DoR (made by MV Chandrakanth, MD)

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Infographic on OptiTROP-Lung06: PFS, OS at 12 months, response and safety (shared by Estela Rodriguez, MD)

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Hebrew-language summary card on OptiTROP-Lung06: PFS 15.0 vs 5.7 months, DoR and grade 3 or higher events (made by Dr. Poetic, MD)

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Summary card comparing the OptiTROP-Lung06 arms: median PFS 15.0 vs 5.7 months, OS HR 0.58 immature (made by Jeff Ryckman)

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Discussion Threads · ESMO 2026

OptiTROP-Lung06 conversations on X

Full reply chains, in order, each post shown verbatim under its own author. Physicians also raised access (Tom John, MD), the China-only population (Ilyas Sahin, MD; Gilberto Lopes, MD; Adam Januszewski, MD), smaller benefit in women (Riyaz Shah, MD), stomatitis and ocular toxicity, and the need for longer follow-up to judge OS (Alfredo Addeo, MD; Nurullah İlhan, MD); their posts are in Physician Reactions.

“I wouldn’t call this a ‘chemo-free’ regimen”

2 posts · 2 physicians · 935 views

Dr. Estela Rodriguez @Latinamd · Oct 25, 2026

🇪🇸 #ESMO26 | Top Lung Abstracts 🫁 🚨 OPTITROP-Lung06: Phase III trial in PD-L1–negative, driver-negative nonsquamous NSCLC: 🔥 Median PFS: 15.0 vs 5.7 months 📉 HR 0.49 — 51% reduction in risk of progression/death 🎯 DOR: 13.6 vs 6.8 months 📊 12-mo OS: 77.6% vs 66.4% (immature data) ▶️ I wouldn’t call this a “chemo-free” regimen because the toxicity of an ADC is similar to chemo—> but this many be a potential option for this hard to treat PDL1 neg population. ▶️Could this change the 1L landscape? 👀maybe? but I would hope for a bigger survival advantage….data immature … #LungCancer #LCSM #ADC

gilberto lopes @GlopesMd · Oct 25, 2026 replying in thread

Main issue - shouldn’t really be, as the trial population is relatively homogenous and we and others have shown that results are similar in Asian and other populations - China-only study.

Physician Reactions · ESMO 2026

Physician reactions to OptiTROP-Lung06

Full, verbatim posts, newest first, linked to the originals; posts that are part of a reply chain are in Discussion Threads above. In all, 40 posts from 29 physicians, including four from July 15, when the topline was announced. Where a post’s figures differ from the presentation, a note sits under it.

Aya Mohamed | MSc, MD 🎗@Dr_Oncologista

OptiTROP-Lung06:🫁 Sac-TMT + pembrolizumab improved median PFS in PD-L1–negative advanced nonsquamous NSCLC (15.0 vs 5.7 months; HR 0.49), with fewer grade 3 or higher adverse events. OS remains immature; follow-up is key. @OncoAlert #ESMO26 #LungCancer #ESMOcommunity @myESMO https://t.co/nIAg7uYbdI

315 views 13 likes7 RT 2026-10-26

gilberto lopes@GlopesMd

OptiTROP-Lung06: 1L PD-L1-negative, EGFR/ALK-negative nonsquamous NSCLC. Sac-TMT + pembro vs chemo + pembro (N=455): PFS 15.0 vs 5.7 mo HR 0.49 (95% CI 0.36–0.65) OS encouraging but immature. Median follow-up only 9.7 mo. The major limitation: China-only populations.

118 views 1 likes1 RT 2026-10-26

Dr. Poetic 🩺 Oncology 🇮🇱@Dr_Doc_

#תשובות_לשאלות הסבר מופרט על המשמעות הקלינית של מחקר OptiTROP-Lung06 לבקשת @the_drow אז מה היה לנו עד עכשיו... בסרטן ריאות NSCLC לא-קשקשי עם PD-L1 מתחת ל-1%,ללא מוטציות מטרה ברות טיפול כגון EGFR או ALK, כבר שנים אנחנו תקועים באותו מקום: כימותרפיה + קיטרודה זה עובד, אבל לא חלקית... ה-PFS החציוני בדרך כלל סביב 5–7 חודשים, והחולים משלמים מחיר לא קטן ברעילות המטולוגית. בעיקר בגלל שהגידול לא מבטא מספיק PD-L1 ועד עכשיו לא היה לנו משהו טוב יותר להציע לחולים האילו כאן מחקר נכנס לתמונה OptiTROP-Lung06 במקום להוסיף עוד תרופה לכימותרפיה ה״רגילה״, הם שאלו שאלה אחרת: מה יקרה אם נחליף את אותה בתרופה חדישה ממשפחת ה-ADC? כלומר sacituzumab tirumotecan (TROP2 ADC) + קיטרודה, מול הסטנדרט הרגיל של כימותרפיה + קיטרודה. ובניתוח תוצאות הביניים במעקב של כ-9.7 חודשים, 455 חולים (בסין): PFS: 15 חודשים מול 5.7 חודשים (HR 0.49). זה לא שיפור קטן, זה יותר מכפול. אחוז התגובות היה כמעט זהה (50% מול 47%), אבל משך התגובה היה הרבה יותר ארוך 13.6 חודשים מול 6.8. היו גם יותר תגובות עמוקות. ב-OS עדיין מוקדם, אבל כבר רואים מגמה חיובית (HR 0.58), וב-12 חודשים 77.6% מול 66.4% עדיין חיים. כשהבטיחות/תופעות הלוואי של הטיפול החדש מפתיעו לטובה. פחות Grade ≥3 (47.6% מול 60.6%), ופחות רעילות המטולוגית משמעותית. יש יותר סטומטיטיס, אבל ברוב המקרים זה קל-בינוני. בקיצור לא רק יעיל יותר, אלא גם פחות "כבד" מבחינה המטולוגית מהכימו. אז מה זה אומר מבחינה קלינית? עד עכשיו, בחולים עם PD-L1 <1% לא באמת היה לנו משהו טוב יותר מכימותרפיה פשוטה + אימונתרפיה. מחקר OptiTROP-Lung06 מראה, שאפשר להחליף את הכימותרפיה ב-ADC ולקבל שליטה ארוכה יותר במחלה, עם פרופיל בטיחות סביר יותר מבחינת ספירת דם.

366 views 8 likes0 RT 2026-10-25

Elvina Almuradova@Dr_ElvinaA

#ESMO26 | OptiTROP-Lung06 @NEJM Sac-TMT + pembrolizumab challenges first-line chemo-IO in PD-L1–negative nonsquamous NSCLC: • mPFS: 15.0 vs 5.7 mo; HR 0.49 • Grade ≥3 AEs: 47.6% vs 60.6% Impressive PFS benefit. OS remains immature—longer follow-up will be key. @OncoAlert @Larvol #esmo26

338 views 6 likes4 RT 2026-10-25

Uğur Özkerim@UOzkerim

🚨 Could ADCs replace chemotherapy in first-line NSCLC? Exciting results from Phase III OptiTROP-Lung06 at #ESMO26! Sacituzumab tirumotecan + pembrolizumab vs chemo + pembrolizumab in PD-L1-negative NSCLC: 📊 PFS: 15.0 vs 5.7 months ✅ Grade ≥3 AEs: 47.6% vs 60.6% OS data remain immature, but these results could change first-line treatment! #LungCancer @OncoAlert @weoncologists @OpenMedKate @StephenVLiu @GlopesMd @ManuelDomine

343 views 5 likes2 RT 2026-10-25

Jeff Ryckman@jryckman3

Big PFS gain in PD-L1-negative NSCLC. OptiTROP-Lung06 (LBA66): Randomized phase 3, 455 pts, 1L advanced nonsquamous NSCLC (PD-L1 TPS<1%, EGFR/ALK-negative): sac-TMT + pembro vs platinum/pemetrexed + pembro. mPFS 15.0 vs 5.7 mo (HR 0.49 (0.36–0.65), and OS HR 0.58 (0.38–0.88), still immature, but extremely promising! #ESMO26 #LCSM #OncTwitter https://t.co/ssgUKkif6S @OncoAlert @BalazsHalmosMD @ADesaiMD

1.1K views 12 likes2 RT 2026-10-25

MV Chandrakanth@ChandrakanthMv

🐼 THE GAP IS SO WIDE, EVEN A PANDA FITS! OptiTROP-Lung06 | ESMO 2026 | LBA66 🇨🇳 China-only Phase III | 455 patients First-line PD-L1–negative nonsquamous NSCLC. 📈 PFS: 15.0 vs 5.7 mo | HR 0.49 🎯 12-mo PFS: 51.1% vs 22.8% 🔬 ORR: 50.2% vs 47.3% — similar! ⏳ DoR: 13.6 vs 6.8 mo — twice as long! Similar response rates. Far more durable disease control. ⚠️ OS remains immature (HR 0.58). Longer follow-up and broader validation needed. KM curves adapted for illustration; refer to the original publication for exact trajectories. Zhou F et al. NEJM, 2026. https://t.co/71dlz6CwnZ @myESMO @OncoAlert @larvol #ESMO26 #NSCLC #ADC #MVOnco

358 views 3 likes0 RT 2026-10-25

Aakash Desai@ADesaiMD

OptiTROP-Lung06 #ESMO26: 1L sac-TMT+pembro vs chemo-IO, PD-L1-neg nsq NSCLC ➡️ mPFS 15.0 vs 5.7 mo, HR 0.49 ➡️ ORR 50.2 vs 47.3%, mDOR 13.6 vs 6.8 mo ➡️ OS HR 0.58, immature ➡️ G≥3 TEAEs 47.6 vs 60.6% What must ADCs show to replace platinum? @LungCancerRx @OncoAlert @oncodaily https://t.co/5CoJUw2OIp

532 views 10 likes5 RT 2026-10-25

MV Chandrakanth@ChandrakanthMv

💍 THE GREAT PARTNER SWAP! OptiTROP-Lung06 | ESMO 2026 | LBA66 Pembrolizumab stays. Sac-TMT replaces chemotherapy! 🎯 PFS: 15.0 vs 5.7 mo | HR 0.49 📊 ORR: 50.2% vs 47.3% — similar! ⏳ DoR: 13.6 vs 6.8 mo — twice as long! ⚖️ Grade ≥3 AEs: 47.6% vs 60.6% 🔍 OS: HR 0.58 — immature; formal benefit unproven. The story? Similar responses, much longer disease control — with a different toxicity profile. Zhou F et al. NEJM. 2026. DOI: 10.1056/NEJMoa2611280 @myESMO @OncoAlert #ESMO26 #NSCLC #ADC #MVOnco

632 views 9 likes1 RT 2026-10-25

ilyas sahin, MD@ilyassahinMD

Another major #ESMO26 paper, published in @NEJM today. In PD-L1-negative advanced nonsquamous lung cancer, sacituzumab tirumotecan (a TROP2-targeted ADC) plus pembrolizumab improved median PFS (time without progression) from 5.7 to 15 months, replacing chemotherapy rather than adding to it. OS is immature, and these China-only results need global confirmation.

3.2K views 43 likes9 RT 2026-10-25

Aya Mohamed | MSc, MD 🎗@Dr_Oncologista

OptiTROP-Lung06 🫁 Sac-TMT + pembrolizumab: A substantial PFS benefit in 1L PD-L1-negative advanced NSCLC, with OS data still immature. @OncoAlert #ESMO26 #LungCancer #Lcsm #ESMOAmbassadors #ESMOcommunity @myESMO https://t.co/XTv3FAFHOZ

752 views 15 likes11 RT 2026-10-25

Rami Manochakian MD, FASCO@RManochakian

🔥🚨@OncoAlert Hot off the press. Just published @NEJM in conjunction with presentation @myESMO #ESMO26 results of: ⭐️#OptiTROP-#Lung06 phase 3 trial of: ❇️#Sacituzumab Tirumotecan (Sac-TMT)+ #Pembrolizumab Vs #Chemotherapy + #Pembrolizumab 🎯For #1stLine Tx of #PDL1 #negative (PD-L1 < 1%) advanced #NonSquamous non-small-cell #LungCancer (#NSCLC) WITHOUT genomic alterations. Study showed: ‼️Statistically significant & clinically meaningful ⬆️#ProgressionFreeSurvival Benefit. ✅ #mPFS 15.0 vs 5.7 mo (HR 0.49, p<0.001) ✅#ORR 50.2% and 47.3% ✅Immature #OS data; #HR: 0.49 P<0.001 ✅≥ Grade 3 #AEs: 47.6% vs 60.6% 👇🏻 https://t.co/SbNKX2ZOPm

Context: per the NEJM abstract, the hazard ratio for death was 0.58 (95% CI 0.38–0.88), with OS immature; HR 0.49 (P<0.001) is the PFS result.

1.1K views 31 likes13 RT 2026-10-25

Abdullah Mohammed@AMohammedAM1

🚨 #ESMO26 | OptiTROP-Lung06 (Phase III) Impressive PFS with sacituzumab tirumotecan + pembrolizumab vs chemotherapy + pembrolizumab in PD-L1-negative advanced non-squamous NSCLC: 📈 Median PFS: 15.0 vs 5.7 months 📈 12-month PFS: 51.1% vs 22.8% Could ADC + IO redefine first-line NSCLC treatment? Awaiting mature OS and safety data. #LungCancer #NSCLC

137 views 0 likes0 RT 2026-10-25

Nirmal Raut@oncologician

Melissa Johson doing an excellent job discuuing those lung studies and ADC #ESMO2026 https://t.co/3Piy2Re2GH

344 views 2 likes1 RT 2026-10-25

Prof. Dr. Ahmet Dirican@dr_dirican

Could OptiTROP-Lung06 change first-line treatment in PD-L1-negative NSCLC? At #ESMO26, Prof. Caicun Zhou presented striking Phase III results: Sac-TMT + pembrolizumab vs chemo + pembrolizumab: PFS: 15.0 vs 5.7 months (HR 0.49) A potential practice-changing result. @OncoDaily @OncoAlert @myESMO #ESMO2026 #LungCancer #ADC

178 views 1 likes1 RT 2026-10-25

Prof Tom John@TommyJohn00

Johnson: explains the differences in toxicity in the SacTMT trials as likely dose related. Asks if there is a synergy with SacTMT and Pembro? #LCSM #ESMO26 https://t.co/VB568NRg3K

325 views 5 likes2 RT 2026-10-25

Nurullah İlhan,MD@drnurullahilhan

The response rates are close. The durability is not. OptiTROP-Lung06: first-line, PD-L1-negative, EGFR/ALK-negative nonsquamous NSCLC. Sac-TMT + pembrolizumab vs chemotherapy + pembrolizumab: • Primary BICR-PFS: 15.0 vs 5.7 months; HR 0.49; P<0.0001 • ORR: 50.2% vs 47.3% • Median response duration: 13.6 vs 6.8 months • Grade ≥3 TEAEs: 47.6% vs 60.6% OS is immature, and median follow-up is only 9.7 months. Could replacing conventional chemotherapy with a TROP2 ADC improve the durability of first-line disease control? Longer follow-up will be crucial. @StephenVLiu @CharuAggarwalMD @myESMO @OncoAlert #OptiTROPLung06 #ESMO26 #LCSM

195 views 2 likes1 RT 2026-10-25

Nirmal Raut@oncologician

Sacituzumab tirumotecan (sac-TMT) plus pembrolizumab (P) versus chemotherapy (chemo) plus pembrolizumab (P) as first-line (1L) treatment for PD-L1-negative advanced non-squamous (nsq) NSCLC: Randomized phase 3 OptiTROP-Lung06 study Caicun Zhou (CN) #ESMO2026 https://t.co/p4dZoOiEGI

344 views 6 likes2 RT 2026-10-25

Balazs Halmos@BalazsHalmosMD

Can we be Opti-mists about improving the outcome of the poorest prognosis subset of our patients w PD-L1 negative advanced NSCLC? Based on OptiTROP-Lung06 we should be! Sac-TMT/pembro sacked chemo/IO easily with much improved PFS, clear OS trends, better/different tox- only 5% discontinuation rate! (But note mucositis as common AE)

684 views 9 likes2 RT 2026-10-25

Dr. Antonio Calles 🫁🚭@Tony_Calles

A new SoC in a patient population with negative PD-L1 expression NSCLC. Sac-TMT + Pembro >>> Chemo + Pembro #ESMO26 #LCSM https://t.co/GDvUjtOldv

1.7K views 8 likes2 RT 2026-10-25

Dr Rishabh Jain@DrRishabhOnco

🚨 ESMO 2026 × NEJM: Is chemotherapy losing its place in first-line lung cancer? 🔥 OptiTROP-Lung06 delivers a striking Phase III result in PD-L1–negative advanced nonsquamous NSCLC! Sacituzumab tirumotecan + pembrolizumab vs chemo + pembrolizumab: 📊 Median PFS: 15.0 vs 5.7 months 🔥 51% lower risk of progression/death (HR 0.49) ✅ Grade ≥3 AEs: 47.6% vs 60.6% ⚠️ OS remains immature. The big question: Could TROP2-ADC + immunotherapy replace platinum chemotherapy in first line? Published simultaneously in NEJM during #ESMO26. @my_esmo @ESMO_open @ASCO @oncoalert #LungCancer #NSCLC #ESMO26

2.5K views 47 likes13 RT 2026-10-25

RyosukeTsugitomi@Rtsugitom

Another impressive set of results with sac-TMT! #ESMO26 https://t.co/DbdSusbS6f

111 views 0 likes0 RT 2026-10-25

Stephen V Liu, MD@StephenVLiu

OptiTROP-Lung06 now @NEJM after #ESMO26 presentation showing Sac-TMT (TROP2 ADC) + pembro superior to standard chemotherapy + pembro. #ESMOAmbassadors @myESMO https://t.co/AWr8vi6VvR

3.4K views 37 likes7 RT 2026-10-25

Prof Tom John@TommyJohn00

Zhou: Optitrop-Lung06 chemo/io vs sacTMT/Pembro in PDL1 neg. Impressive PFS difference. Similar second line use. Deeper responses and double duration of response. Less tox except more stomatitis. Access is a major issue! #LCSM #ESMO26 https://t.co/Rqm8vvYalR

430 views 5 likes3 RT 2026-10-25

Dr Riyaz Shah@DrRiyazShah

OptiTROP-Lung06; sacTMT v chemoIO(KN189); n455; open label; PFS HR 0.49; nearly 10m longer mPFS; females magnitude of benefit less; same ORR but double mDOR; tox profile looks interest in stomatitis + ocular. #ESMO26 https://t.co/ygTCgtwpzJ

269 views 2 likes1 RT 2026-10-25

Alfredo Addeo MD@Alfdoc2

🔥 Impressive results from OptiTROP-Lung06 at #ESMO26! Prof. Zhou presents phase III data in first-line PD-L1 TPS <1% advanced non-squamous NSCLC. 💥 Sac-TMT + pembrolizumab vs chemo + pembrolizumab: ✅ PFS: 15.0 vs 5.7 months HR 0.49 (95% CI 0.36–0.65), p<0.0001 📈 Encouraging OS trend: HR 0.58 (95% CI 0.38–0.88), but OS remains immature and exploratory at this interim analysis. A clearly positive PFS result and a promising OS signal. Longer follow-up and safety data will be essential to define its clinical impact. #ESMOAmbassadors #LungCancer #NSCLC #ADC

736 views 14 likes6 RT 2026-10-25

Dr Adam Januszewski@AdamJanuszewski

🫁 #ESMO2026 OptiTROP-Lung06: sac-TMT + pembro vs chemo + pembro in PD-L1-negative NSCLC in china. High never smoker (30%) and male (60%) popn. Promising PFS: 15.0 vs 5.7m (HR 0.49). OS immature. Global data awaited Sac-TMT is also in clinical trials at @NHSBartsHealth https://t.co/xL5qviAYhn

Context: per the baseline characteristics slide, 72.1% of patients in each arm were male and 34.5% vs 37.2% were never smokers.

136 views 1 likes1 RT 2026-10-25

Stephen V Liu, MD@StephenVLiu

#ESMO26 Dr. Caicun Zhou presents OptiTROP-Lung06: 1L Sac-TMT (TROP2 ADC) + pembro vs chemo + pembro in non-squamous NSCLC. PFS 15m vs 5.7m (HR 0.49). OS immature but 1y rate 78% vs 66% (HR 0.58). mDOR 13.6m vs 6.8m. TEAEs leading to d/c of drug 6% with Sac-TMT 14% with chemoIO. https://t.co/NuvZZ9S3EM

2.7K views 21 likes12 RT 2026-10-25

Hidehito HORINOUCHI@HHorinouchi

🆙#ESMO26 Proffered Paper I: #LCSM Mets 🔥OptiTROP-Lung06: Sacituzumab Tirumotecan (Sac-TMT) Plus Pembrolizumab (P) Versus Chemotherapy (Chemo) Plus Pembrolizumab (P) as First-Line (1L) Treatment for PD-L1-Negative Advanced Non-Squamous (Nsq) NSCLC: Randomized Phase 3 Study 🎙️Dr. Caicun Zhou 🔢LBA66 🎯Met Primary Endpoint: BICR-PFS 15.0 vs 5.7mo (HR 0.49, p<0.0001; n=455) 🎯OS Immature, Favorable Trend (HR 0.58) 🎯Grade≥3 TEAEs 47.6% vs 60.6%; Grade≥3 Stomatitis 2.2% ☑️NCT06711900 🔗 https://t.co/uGHKJfjhvW @OncoAlert @Larvol @myESMO @IASLC

759 views 14 likes7 RT 2026-10-25

Yakup Ergün@dr_yakupergun

#ESMO26 | OptiTROP-Lung06 Concomitant NEJM publication Such a clear benefit over standard chemo-IO in PD-L1-negative NSCLC is impressive, especially with fewer severe AEs. OS is still immature, but sac-TMT + pembro looks like a strong contender to change first-line treatment https://t.co/E3UdsILlyn https://t.co/fayTGhSChB

3.2K views 39 likes9 RT 2026-10-25

Hidehito HORINOUCHI@HHorinouchi

🔥OptiTROP-Lung06: Sac-TMT + pembrolizumab vs chemo + pembrolizumab in PD-L1-negative advanced NSCLC 🆙 @NEJM #ESMO26 ☑Phase 3 RCT; N=455; PD-L1<1% nonsquamous NSCLC; mFU 9.7 mo 🎯mPFS 15.0 vs 5.7 mo (HR 0.49, p<0.001); mOS HR 0.58; grade ≥3 AEs lower with sac-TMT (47.6% vs 60.6%) 🎙Dr. Fei Zhou & Dr. Caicun Zhou #LCSM @OncoAlert @Larvol @IASLC https://t.co/id5CQipESy

2K views 28 likes13 RT 2026-10-25

Yakup Ergün@dr_yakupergun

#ESMO26 | OptiTROP-Lung06 PD-L1 <1% non-sq NSCLC: Sac-TMT + pembro vs platinum/pem + pembro 🔹 PFS: 15 vs 5.7 mo (HR 0.49) 🔹 DoR: 13.6 vs 6.8 mo 🔹 OS: HR 0.58 (immature) 🔹 ≥G3 AEs: 47.6% vs 60.6% Strong results vs contemporary chemo-IO. https://t.co/mT1aoETKPQ

3.4K views 11 likes5 RT 2026-10-25

Tejas Patil@TejasPatilMD

⭐️How do we improve outcomes for #lungcancer patients with PDL1 < 1% in the 1L setting? This may be addressed with the following two approaches 1⃣Sacituzumab tirumotecan (sac-TMT) plus pembrolizumab (P) versus chemotherapy (chemo) plus pembrolizumab (P) as first-line (1L) treatment for PD-L1-negative advanced non-squamous (nsq) NSCLC: Randomized phase 3 OptiTROP-Lung06 study 2⃣First-line (1L) olomorasib + chemoimmunotherapy (chemo-IO) in KRAS G12C-mutant NSCLC: Updated results from the LOXO-RAS-20001 and SUNRAY-01 trials. These are separate strategies (ADC vs TKI), but both address a fundamental need which is combination approaches for certain subsets of 1L NSCLC. @lcsmchat @OncoAlert @OncLive @Onco_Nexus @LungCancerEu @Lung_Cancers @LungCancerRx @MedwatchHQ @YoungLungCancer @KRASKickers

Posted on October 24, before the presentation.

290 views 3 likes1 RT 2026-10-24

Aakash Desai@ADesaiMD

5/ OptiTROP-Lung06 (LBA66), Oct 25, 10:53 CET Sac-TMT + pembro vs chemo + pembro, 1L PD-L1-negative nonsquamous NSCLC. PFS met per Kelun-Biotech. Can a TROP2 ADC replace the platinum doublet alongside IO? @LungCancerRx @OncoAlert @oncodaily https://t.co/XWMc6SJ3gy

Posted on October 23, before the presentation.

116 views 0 likes0 RT 2026-10-23

Stephen V Liu, MD@StephenVLiu

Phase III OptiTROP-Lung06 meets primary endpoint. First-line sacituzumab tirumotecan (sac-TMT, Trop2 ADC) + pembro vs chemo + pembro in PD-L1 negative non-squamous NSCLC. Sac-TMT + pembro had superior PFS with OS trend. Will ADCs push out chemo? https://t.co/kQiRMDEYN9

Posted on July 15, 2026, after Kelun-Biotech's topline announcement and before any numbers were released.

4.8K views 40 likes15 RT 2026-07-15

Hiroaki Akamatsu@AkamatsuHiroaki

ついに肺癌にもADC+ICI時代が到来しますかね…結果が楽しみ😊 https://t.co/bSY2cErwlK

Posted on July 15, 2026, after Kelun-Biotech's topline announcement and before any numbers were released.

2.6K views 10 likes1 RT 2026-07-15

Toni Choueiri, MD@DrChoueiri

JUST IN via @PRNewswire: PhIII trial of OptiTROP-Lung06 with SAC-TMT (Trop-2 @Merck ADC)+ Pembro vs SOC chemo/IO shows PFS and OS superiority for this new regimen in PDL-1 NEGATIVE non-small cell lung cancer. Slowly but surely, convention cytotoxic chemotherapy is being relaced by ADCs... https://t.co/SkbRI7avSM

Context: Kelun-Biotech's July 14 topline release reported that the primary PFS endpoint was met with a positive OS trend. At ESMO 2026, OS data were immature (HR 0.58, 95% CI 0.38–0.88), a descriptive analysis at the PFS interim analysis.

5.9K views 20 likes13 RT 2026-07-15

Balazs Halmos@BalazsHalmosMD

Nothing like a lung cancer World Cup semifinal press release- sac-TMT/pembro beats chemo/IO for st4 PD-L1 neg nonSQ NSCLC (given prior positive studies sac-TMT now has scored 3 spectacular goals!) This sets up a really interesting #lcsm first line World Cup finals match between ivonescimab and sac-TMT! Might need some penalty kicks for a decision.. Which will deliver the trophy of FDA approval/ larger market share - and most importantly improved patient outcomes until the next challenger shows up? Hope we wont need to wait 4 years!

Posted on July 15, 2026, after Kelun-Biotech's topline announcement and before any numbers were released.

5.8K views 44 likes9 RT 2026-07-15

Trial Design

OptiTROP-Lung06 Trial Design

OptiTROP-Lung06 asked whether replacing pemetrexed-platinum chemotherapy with sacituzumab tirumotecan, a TROP2-directed antibody-drug conjugate, improves outcomes when combined with pembrolizumab as first-line treatment for PD-L1-negative nonsquamous NSCLC. Pembrolizumab plus pemetrexed-platinum is the standard first-line regimen in this population. The trial is sponsored and funded by Sichuan Kelun-Biotech (Chengdu, China); Merck (MSD) makes pembrolizumab and holds sac-TMT rights outside Greater China. Results were presented by Caicun Zhou, MD, at ESMO 2026 (LBA66, Proffered paper 1: NSCLC, metastatic, October 25, 2026), with Melissa L. Johnson, MD, as invited discussant, and published in NEJM the same day.

Study Design

Randomized 1:1, open-label, multicenter phase 3 in China (NCT06711900; 81 registered sites); 229 vs 226 patients. Stratified by sex, ECOG PS (0 vs 1) and stage (IIIB/IIIC vs IV).

Population

Untreated locally advanced (IIIB/IIIC) or metastatic nonsquamous NSCLC; PD-L1 TPS <1% by IHC 22C3 (central lab); no sensitizing EGFR or ALK alteration; ECOG PS 0–1. Median age 63; 72.1% male; 91.6% stage IV; never smokers 34.5% vs 37.2%.

Interventions

Sac-TMT 4 mg/kg Q2W + pembrolizumab 400 mg Q6W vs pemetrexed 500 mg/m² + carboplatin AUC 5 or cisplatin 75 mg/m² Q3W (up to 4 doses, then pemetrexed maintenance) + pembrolizumab 400 mg Q6W. Pembrolizumab for up to 18 cycles; treatment until progression or unacceptable toxicity.

Endpoints

Primary: PFS by BICR (RECIST 1.1). Secondary: OS, investigator-assessed PFS, ORR, DCR, DOR, safety.

Presenter & Discussant

Presenter: Caicun Zhou, MD (Shanghai East Hospital, Tongji University), national lead principal investigator. NEJM first author: Fei Zhou, MD. Invited discussant: Melissa L. Johnson, MD (SCRI).

Data Cut

Prespecified interim PFS analysis; data cutoff June 9, 2026; median follow-up 9.7 months. OS reported descriptively at this analysis.

ESMO 2026 programme (LBA66) NEJM article ClinicalTrials.gov Kelun-Biotech release OptiTROP-Lung05 profile

Major Media & Publications

OptiTROP-Lung06 in the News

Publication

Sacituzumab Tirumotecan plus Pembrolizumab in PD-L1–Negative Advanced NSCLC

NEJMOct 25, 2026

Abstract

LBA66: Sacituzumab tirumotecan (sac-TMT) plus pembrolizumab versus chemotherapy plus pembrolizumab as first-line treatment for PD-L1-negative advanced non-squamous NSCLC: randomized phase 3 OptiTROP-Lung06 study

ESMO 2026Oct 25, 2026

Press release

The results of phase III OptiTROP-Lung06 study of sac-TMT presented as an ESMO oral presentation and simultaneously published in NEJM

Kelun-BiotechOct 25, 2026

Press release

Kelun-Biotech announces phase III study of sac-TMT plus pembrolizumab as first-line treatment for PD-L1-negative nonsquamous NSCLC met primary endpoint

Kelun-BiotechJul 14, 2026

Registry

SKB264 plus pembrolizumab vs chemotherapy plus pembrolizumab, first-line PD-L1-negative nonsquamous NSCLC (SKB264-III-14)

ClinicalTrials.govNCT06711900

FAQ

OptiTROP-Lung06 Questions

What is the OptiTROP-Lung06 trial?

OptiTROP-Lung06 (NCT06711900) is a randomized, open-label phase 3 trial run in China by Sichuan Kelun-Biotech. It compared sacituzumab tirumotecan (sac-TMT), a TROP2-directed antibody-drug conjugate, plus pembrolizumab with pemetrexed-platinum chemotherapy plus pembrolizumab as first-line treatment in 455 patients with advanced nonsquamous NSCLC, PD-L1 TPS below 1% and no EGFR or ALK alteration.

What did OptiTROP-Lung06 show at ESMO 2026?

At the prespecified interim PFS analysis (data cutoff June 9, 2026; median follow-up 9.7 months), the primary endpoint was met: median PFS by blinded independent central review was 15.0 vs 5.7 months, HR 0.49 (95% CI 0.36–0.65). ORR was similar (50.2% vs 47.3%) but median duration of response was 13.6 vs 6.8 months. Results were published simultaneously in NEJM.

Did sac-TMT plus pembrolizumab improve overall survival?

Not yet shown. Overall survival is a secondary endpoint and the data are immature: 36 vs 55 deaths, medians not reached, HR 0.58 (95% CI 0.38–0.88), reported as a descriptive analysis at the PFS interim analysis. The 12-month OS rate was 77.6% vs 66.4%.

Is sacituzumab tirumotecan FDA approved?

No. Sacituzumab tirumotecan is not approved by the FDA or the European Medicines Agency for any indication. In China (NMPA) it is approved in four other indications (previously treated triple-negative breast cancer, EGFR-mutant NSCLC after EGFR-TKI in two settings, and pretreated HR+/HER2− breast cancer). First-line sac-TMT plus pembrolizumab for PD-L1-negative NSCLC is investigational everywhere. Merck (MSD) holds sac-TMT rights outside Greater China. It is a different drug from sacituzumab govitecan (TRODELVY).

How did the safety profiles compare?

Grade ≥3 treatment-emergent adverse events occurred in 47.6% vs 60.6% of patients, and 5.7% vs 14.2% discontinued a study drug because of an adverse event. Sac-TMT brought stomatitis (51.1% any grade, 2.2% grade 3) and ocular surface toxicity (13.5%, all grade 1–2); pneumonitis, including ILD, occurred in 10.5% vs 13.7%.

Was the trial conducted only in China?

Yes. All 81 sites listed on ClinicalTrials.gov are in China. Several physicians flagged the China-only population and asked for global data; one noted results have been similar in Asian and other populations (see Discussion Threads and Physician Reactions).

Physician Opinions

Key KOL Sentiments - OptiTROP-Lung06

24 positive, 16 neutral and 0 negative posts from physicians, each shown verbatim.

Physician	Date	Sentiment	Post (verbatim)
Aya Mohamed \| MSc, MD 🎗 @Dr_Oncologista	Oct 26, 2026	● POSITIVE	OptiTROP-Lung06:🫁 Sac-TMT + pembrolizumab improved median PFS in PD-L1–negative advanced nonsquamous NSCLC (15.0 vs 5.7 months; HR 0.49), with fewer grade 3 or higher adverse events. OS remains immature; follow-up is key. @OncoAlert #ESMO26 #LungCancer #ESMOcommunity @myESMO https://t.co/nIAg7uYbdI
Dr. Poetic 🩺 Oncology 🇮🇱 @Dr_Doc_	Oct 25, 2026	● POSITIVE	#תשובות_לשאלות הסבר מופרט על המשמעות הקלינית של מחקר OptiTROP-Lung06 לבקשת @the_drow אז מה היה לנו עד עכשיו... בסרטן ריאות NSCLC לא-קשקשי עם PD-L1 מתחת ל-1%,ללא מוטציות מטרה ברות טיפול כגון EGFR או ALK, כבר שנים אנחנו תקועים באותו מקום: כימותרפיה + קיטרודה זה עובד, אבל לא חלקית... ה-PFS החציוני בדרך כלל סביב 5–7 חודשים, והחולים משלמים מחיר לא קטן ברעילות המטולוגית. בעיקר בגלל שהגידול לא מבטא מספיק PD-L1 ועד עכשיו לא היה לנו משהו טוב יותר להציע לחולים האילו כאן מחקר נכנס לתמונה OptiTROP-Lung06 במקום להוסיף עוד תרופה לכימותרפיה ה״רגילה״, הם שאלו שאלה אחרת: מה יקרה אם נחליף את אותה בתרופה חדישה ממשפחת ה-ADC? כלומר sacituzumab tirumotecan (TROP2 ADC) + קיטרודה, מול הסטנדרט הרגיל של כימותרפיה + קיטרודה. ובניתוח תוצאות הביניים במעקב של כ-9.7 חודשים, 455 חולים (בסין): PFS: 15 חודשים מול 5.7 חודשים (HR 0.49). זה לא שיפור קטן, זה יותר מכפול. אחוז התגובות היה כמעט זהה (50% מול 47%), אבל משך התגובה היה הרבה יותר ארוך 13.6 חודשים מול 6.8. היו גם יותר תגובות עמוקות. ב-OS עדיין מוקדם, אבל כבר רואים מגמה חיובית (HR 0.58), וב-12 חודשים 77.6% מול 66.4% עדיין חיים. כשהבטיחות/תופעות הלוואי של הטיפול החדש מפתיעו לטובה. פחות Grade ≥3 (47.6% מול 60.6%), ופחות רעילות המטולוגית משמעותית. יש יותר סטומטיטיס, אבל ברוב המקרים זה קל-בינוני. בקיצור לא רק יעיל יותר, אלא גם פחות "כבד" מבחינה המטולוגית מהכימו. אז מה זה אומר מבחינה קלינית? עד עכשיו, בחולים עם PD-L1 <1% לא באמת היה לנו משהו טוב יותר מכימותרפיה פשוטה + אימונתרפיה. מחקר OptiTROP-Lung06 מראה, שאפשר להחליף את הכימותרפיה ב-ADC ולקבל שליטה ארוכה יותר במחלה, עם פרופיל בטיחות סביר יותר מבחינת ספירת דם.
Elvina Almuradova @Dr_ElvinaA	Oct 25, 2026	● POSITIVE	#ESMO26 \| OptiTROP-Lung06 @NEJM Sac-TMT + pembrolizumab challenges first-line chemo-IO in PD-L1–negative nonsquamous NSCLC: • mPFS: 15.0 vs 5.7 mo; HR 0.49 • Grade ≥3 AEs: 47.6% vs 60.6% Impressive PFS benefit. OS remains immature—longer follow-up will be key. @OncoAlert @Larvol #esmo26
Uğur Özkerim @UOzkerim	Oct 25, 2026	● POSITIVE	🚨 Could ADCs replace chemotherapy in first-line NSCLC? Exciting results from Phase III OptiTROP-Lung06 at #ESMO26! Sacituzumab tirumotecan + pembrolizumab vs chemo + pembrolizumab in PD-L1-negative NSCLC: 📊 PFS: 15.0 vs 5.7 months ✅ Grade ≥3 AEs: 47.6% vs 60.6% OS data remain immature, but these results could change first-line treatment! #LungCancer @OncoAlert @weoncologists @OpenMedKate @StephenVLiu @GlopesMd @ManuelDomine
Jeff Ryckman @jryckman3	Oct 25, 2026	● POSITIVE	Big PFS gain in PD-L1-negative NSCLC. OptiTROP-Lung06 (LBA66): Randomized phase 3, 455 pts, 1L advanced nonsquamous NSCLC (PD-L1 TPS<1%, EGFR/ALK-negative): sac-TMT + pembro vs platinum/pemetrexed + pembro. mPFS 15.0 vs 5.7 mo (HR 0.49 (0.36–0.65), and OS HR 0.58 (0.38–0.88), still immature, but extremely promising! #ESMO26 #LCSM #OncTwitter https://t.co/ssgUKkif6S @OncoAlert @BalazsHalmosMD @ADesaiMD
MV Chandrakanth @ChandrakanthMv	Oct 25, 2026	● POSITIVE	🐼 THE GAP IS SO WIDE, EVEN A PANDA FITS! OptiTROP-Lung06 \| ESMO 2026 \| LBA66 🇨🇳 China-only Phase III \| 455 patients First-line PD-L1–negative nonsquamous NSCLC. 📈 PFS: 15.0 vs 5.7 mo \| HR 0.49 🎯 12-mo PFS: 51.1% vs 22.8% 🔬 ORR: 50.2% vs 47.3% — similar! ⏳ DoR: 13.6 vs 6.8 mo — twice as long! Similar response rates. Far more durable disease control. ⚠️ OS remains immature (HR 0.58). Longer follow-up and broader validation needed. KM curves adapted for illustration; refer to the original publication for exact trajectories. Zhou F et al. NEJM, 2026. https://t.co/71dlz6CwnZ @myESMO @OncoAlert @larvol #ESMO26 #NSCLC #ADC #MVOnco
MV Chandrakanth @ChandrakanthMv	Oct 25, 2026	● POSITIVE	💍 THE GREAT PARTNER SWAP! OptiTROP-Lung06 \| ESMO 2026 \| LBA66 Pembrolizumab stays. Sac-TMT replaces chemotherapy! 🎯 PFS: 15.0 vs 5.7 mo \| HR 0.49 📊 ORR: 50.2% vs 47.3% — similar! ⏳ DoR: 13.6 vs 6.8 mo — twice as long! ⚖️ Grade ≥3 AEs: 47.6% vs 60.6% 🔍 OS: HR 0.58 — immature; formal benefit unproven. The story? Similar responses, much longer disease control — with a different toxicity profile. Zhou F et al. NEJM. 2026. DOI: 10.1056/NEJMoa2611280 @myESMO @OncoAlert #ESMO26 #NSCLC #ADC #MVOnco
Aya Mohamed \| MSc, MD 🎗 @Dr_Oncologista	Oct 25, 2026	● POSITIVE	OptiTROP-Lung06 🫁 Sac-TMT + pembrolizumab: A substantial PFS benefit in 1L PD-L1-negative advanced NSCLC, with OS data still immature. @OncoAlert #ESMO26 #LungCancer #Lcsm #ESMOAmbassadors #ESMOcommunity @myESMO https://t.co/XTv3FAFHOZ
Rami Manochakian MD, FASCO @RManochakian	Oct 25, 2026	● POSITIVE	🔥🚨@OncoAlert Hot off the press. Just published @NEJM in conjunction with presentation @myESMO #ESMO26 results of: ⭐️#OptiTROP-#Lung06 phase 3 trial of: ❇️#Sacituzumab Tirumotecan (Sac-TMT)+ #Pembrolizumab Vs #Chemotherapy + #Pembrolizumab 🎯For #1stLine Tx of #PDL1 #negative (PD-L1 < 1%) advanced #NonSquamous non-small-cell #LungCancer (#NSCLC) WITHOUT genomic alterations. Study showed: ‼️Statistically significant & clinically meaningful ⬆️#ProgressionFreeSurvival Benefit. ✅ #mPFS 15.0 vs 5.7 mo (HR 0.49, p<0.001) ✅#ORR 50.2% and 47.3% ✅Immature #OS data; #HR: 0.49 P<0.001 ✅≥ Grade 3 #AEs: 47.6% vs 60.6% 👇🏻 https://t.co/SbNKX2ZOPm Context: per the NEJM abstract, the hazard ratio for death was 0.58 (95% CI 0.38–0.88), with OS immature; HR 0.49 (P<0.001) is the PFS result.
Abdullah Mohammed @AMohammedAM1	Oct 25, 2026	● POSITIVE	🚨 #ESMO26 \| OptiTROP-Lung06 (Phase III) Impressive PFS with sacituzumab tirumotecan + pembrolizumab vs chemotherapy + pembrolizumab in PD-L1-negative advanced non-squamous NSCLC: 📈 Median PFS: 15.0 vs 5.7 months 📈 12-month PFS: 51.1% vs 22.8% Could ADC + IO redefine first-line NSCLC treatment? Awaiting mature OS and safety data. #LungCancer #NSCLC
Prof. Dr. Ahmet Dirican @dr_dirican	Oct 25, 2026	● POSITIVE	Could OptiTROP-Lung06 change first-line treatment in PD-L1-negative NSCLC? At #ESMO26, Prof. Caicun Zhou presented striking Phase III results: Sac-TMT + pembrolizumab vs chemo + pembrolizumab: PFS: 15.0 vs 5.7 months (HR 0.49) A potential practice-changing result. @OncoDaily @OncoAlert @myESMO #ESMO2026 #LungCancer #ADC
Balazs Halmos @BalazsHalmosMD	Oct 25, 2026	● POSITIVE	Can we be Opti-mists about improving the outcome of the poorest prognosis subset of our patients w PD-L1 negative advanced NSCLC? Based on OptiTROP-Lung06 we should be! Sac-TMT/pembro sacked chemo/IO easily with much improved PFS, clear OS trends, better/different tox- only 5% discontinuation rate! (But note mucositis as common AE)
Dr. Antonio Calles 🫁🚭 @Tony_Calles	Oct 25, 2026	● POSITIVE	A new SoC in a patient population with negative PD-L1 expression NSCLC. Sac-TMT + Pembro >>> Chemo + Pembro #ESMO26 #LCSM https://t.co/GDvUjtOldv
Dr Rishabh Jain @DrRishabhOnco	Oct 25, 2026	● POSITIVE	🚨 ESMO 2026 × NEJM: Is chemotherapy losing its place in first-line lung cancer? 🔥 OptiTROP-Lung06 delivers a striking Phase III result in PD-L1–negative advanced nonsquamous NSCLC! Sacituzumab tirumotecan + pembrolizumab vs chemo + pembrolizumab: 📊 Median PFS: 15.0 vs 5.7 months 🔥 51% lower risk of progression/death (HR 0.49) ✅ Grade ≥3 AEs: 47.6% vs 60.6% ⚠️ OS remains immature. The big question: Could TROP2-ADC + immunotherapy replace platinum chemotherapy in first line? Published simultaneously in NEJM during #ESMO26. @my_esmo @ESMO_open @ASCO @oncoalert #LungCancer #NSCLC #ESMO26
RyosukeTsugitomi @Rtsugitom	Oct 25, 2026	● POSITIVE	Another impressive set of results with sac-TMT! #ESMO26 https://t.co/DbdSusbS6f
Stephen V Liu, MD @StephenVLiu	Oct 25, 2026	● POSITIVE	OptiTROP-Lung06 now @NEJM after #ESMO26 presentation showing Sac-TMT (TROP2 ADC) + pembro superior to standard chemotherapy + pembro. #ESMOAmbassadors @myESMO https://t.co/AWr8vi6VvR
Prof Tom John @TommyJohn00	Oct 25, 2026	● POSITIVE	Zhou: Optitrop-Lung06 chemo/io vs sacTMT/Pembro in PDL1 neg. Impressive PFS difference. Similar second line use. Deeper responses and double duration of response. Less tox except more stomatitis. Access is a major issue! #LCSM #ESMO26 https://t.co/Rqm8vvYalR
Alfredo Addeo MD @Alfdoc2	Oct 25, 2026	● POSITIVE	🔥 Impressive results from OptiTROP-Lung06 at #ESMO26! Prof. Zhou presents phase III data in first-line PD-L1 TPS <1% advanced non-squamous NSCLC. 💥 Sac-TMT + pembrolizumab vs chemo + pembrolizumab: ✅ PFS: 15.0 vs 5.7 months HR 0.49 (95% CI 0.36–0.65), p<0.0001 📈 Encouraging OS trend: HR 0.58 (95% CI 0.38–0.88), but OS remains immature and exploratory at this interim analysis. A clearly positive PFS result and a promising OS signal. Longer follow-up and safety data will be essential to define its clinical impact. #ESMOAmbassadors #LungCancer #NSCLC #ADC
Yakup Ergün @dr_yakupergun	Oct 25, 2026	● POSITIVE	#ESMO26 \| OptiTROP-Lung06 Concomitant NEJM publication Such a clear benefit over standard chemo-IO in PD-L1-negative NSCLC is impressive, especially with fewer severe AEs. OS is still immature, but sac-TMT + pembro looks like a strong contender to change first-line treatment https://t.co/E3UdsILlyn https://t.co/fayTGhSChB
Yakup Ergün @dr_yakupergun	Oct 25, 2026	● POSITIVE	#ESMO26 \| OptiTROP-Lung06 PD-L1 <1% non-sq NSCLC: Sac-TMT + pembro vs platinum/pem + pembro 🔹 PFS: 15 vs 5.7 mo (HR 0.49) 🔹 DoR: 13.6 vs 6.8 mo 🔹 OS: HR 0.58 (immature) 🔹 ≥G3 AEs: 47.6% vs 60.6% Strong results vs contemporary chemo-IO. https://t.co/mT1aoETKPQ
Stephen V Liu, MD @StephenVLiu	Jul 15, 2026	● POSITIVE	Phase III OptiTROP-Lung06 meets primary endpoint. First-line sacituzumab tirumotecan (sac-TMT, Trop2 ADC) + pembro vs chemo + pembro in PD-L1 negative non-squamous NSCLC. Sac-TMT + pembro had superior PFS with OS trend. Will ADCs push out chemo? https://t.co/kQiRMDEYN9 Posted on July 15, 2026, after Kelun-Biotech's topline announcement and before any numbers were released.
Hiroaki Akamatsu @AkamatsuHiroaki	Jul 15, 2026	● POSITIVE	ついに肺癌にもADC+ICI時代が到来しますかね…結果が楽しみ😊 https://t.co/bSY2cErwlK Posted on July 15, 2026, after Kelun-Biotech's topline announcement and before any numbers were released.
Toni Choueiri, MD @DrChoueiri	Jul 15, 2026	● POSITIVE	JUST IN via @PRNewswire: PhIII trial of OptiTROP-Lung06 with SAC-TMT (Trop-2 @Merck ADC)+ Pembro vs SOC chemo/IO shows PFS and OS superiority for this new regimen in PDL-1 NEGATIVE non-small cell lung cancer. Slowly but surely, convention cytotoxic chemotherapy is being relaced by ADCs... https://t.co/SkbRI7avSM Context: Kelun-Biotech's July 14 topline release reported that the primary PFS endpoint was met with a positive OS trend. At ESMO 2026, OS data were immature (HR 0.58, 95% CI 0.38–0.88), a descriptive analysis at the PFS interim analysis.
Balazs Halmos @BalazsHalmosMD	Jul 15, 2026	● POSITIVE	Nothing like a lung cancer World Cup semifinal press release- sac-TMT/pembro beats chemo/IO for st4 PD-L1 neg nonSQ NSCLC (given prior positive studies sac-TMT now has scored 3 spectacular goals!) This sets up a really interesting #lcsm first line World Cup finals match between ivonescimab and sac-TMT! Might need some penalty kicks for a decision.. Which will deliver the trophy of FDA approval/ larger market share - and most importantly improved patient outcomes until the next challenger shows up? Hope we wont need to wait 4 years! Posted on July 15, 2026, after Kelun-Biotech's topline announcement and before any numbers were released.
gilberto lopes @GlopesMd	Oct 26, 2026	● NEUTRAL	OptiTROP-Lung06: 1L PD-L1-negative, EGFR/ALK-negative nonsquamous NSCLC. Sac-TMT + pembro vs chemo + pembro (N=455): PFS 15.0 vs 5.7 mo HR 0.49 (95% CI 0.36–0.65) OS encouraging but immature. Median follow-up only 9.7 mo. The major limitation: China-only populations.
gilberto lopes @GlopesMd	Oct 25, 2026	● NEUTRAL	Main issue - shouldn’t really be, as the trial population is relatively homogenous and we and others have shown that results are similar in Asian and other populations - China-only study.
Dr. Estela Rodriguez @Latinamd	Oct 25, 2026	● NEUTRAL	🇪🇸 #ESMO26 \| Top Lung Abstracts 🫁 🚨 OPTITROP-Lung06: Phase III trial in PD-L1–negative, driver-negative nonsquamous NSCLC: 🔥 Median PFS: 15.0 vs 5.7 months 📉 HR 0.49 — 51% reduction in risk of progression/death 🎯 DOR: 13.6 vs 6.8 months 📊 12-mo OS: 77.6% vs 66.4% (immature data) ▶️ I wouldn’t call this a “chemo-free” regimen because the toxicity of an ADC is similar to chemo—> but this many be a potential option for this hard to treat PDL1 neg population. ▶️Could this change the 1L landscape? 👀maybe? but I would hope for a bigger survival advantage….data immature … #LungCancer #LCSM #ADC
Aakash Desai @ADesaiMD	Oct 25, 2026	● NEUTRAL	OptiTROP-Lung06 #ESMO26: 1L sac-TMT+pembro vs chemo-IO, PD-L1-neg nsq NSCLC ➡️ mPFS 15.0 vs 5.7 mo, HR 0.49 ➡️ ORR 50.2 vs 47.3%, mDOR 13.6 vs 6.8 mo ➡️ OS HR 0.58, immature ➡️ G≥3 TEAEs 47.6 vs 60.6% What must ADCs show to replace platinum? @LungCancerRx @OncoAlert @oncodaily https://t.co/5CoJUw2OIp
ilyas sahin, MD @ilyassahinMD	Oct 25, 2026	● NEUTRAL	Another major #ESMO26 paper, published in @NEJM today. In PD-L1-negative advanced nonsquamous lung cancer, sacituzumab tirumotecan (a TROP2-targeted ADC) plus pembrolizumab improved median PFS (time without progression) from 5.7 to 15 months, replacing chemotherapy rather than adding to it. OS is immature, and these China-only results need global confirmation.
Nirmal Raut @oncologician	Oct 25, 2026	● NEUTRAL	Melissa Johson doing an excellent job discuuing those lung studies and ADC #ESMO2026 https://t.co/3Piy2Re2GH
Prof Tom John @TommyJohn00	Oct 25, 2026	● NEUTRAL	Johnson: explains the differences in toxicity in the SacTMT trials as likely dose related. Asks if there is a synergy with SacTMT and Pembro? #LCSM #ESMO26 https://t.co/VB568NRg3K
Nurullah İlhan,MD @drnurullahilhan	Oct 25, 2026	● NEUTRAL	The response rates are close. The durability is not. OptiTROP-Lung06: first-line, PD-L1-negative, EGFR/ALK-negative nonsquamous NSCLC. Sac-TMT + pembrolizumab vs chemotherapy + pembrolizumab: • Primary BICR-PFS: 15.0 vs 5.7 months; HR 0.49; P<0.0001 • ORR: 50.2% vs 47.3% • Median response duration: 13.6 vs 6.8 months • Grade ≥3 TEAEs: 47.6% vs 60.6% OS is immature, and median follow-up is only 9.7 months. Could replacing conventional chemotherapy with a TROP2 ADC improve the durability of first-line disease control? Longer follow-up will be crucial. @StephenVLiu @CharuAggarwalMD @myESMO @OncoAlert #OptiTROPLung06 #ESMO26 #LCSM
Nirmal Raut @oncologician	Oct 25, 2026	● NEUTRAL	Sacituzumab tirumotecan (sac-TMT) plus pembrolizumab (P) versus chemotherapy (chemo) plus pembrolizumab (P) as first-line (1L) treatment for PD-L1-negative advanced non-squamous (nsq) NSCLC: Randomized phase 3 OptiTROP-Lung06 study Caicun Zhou (CN) #ESMO2026 https://t.co/p4dZoOiEGI
Dr Riyaz Shah @DrRiyazShah	Oct 25, 2026	● NEUTRAL	OptiTROP-Lung06; sacTMT v chemoIO(KN189); n455; open label; PFS HR 0.49; nearly 10m longer mPFS; females magnitude of benefit less; same ORR but double mDOR; tox profile looks interest in stomatitis + ocular. #ESMO26 https://t.co/ygTCgtwpzJ
Dr Adam Januszewski @AdamJanuszewski	Oct 25, 2026	● NEUTRAL	🫁 #ESMO2026 OptiTROP-Lung06: sac-TMT + pembro vs chemo + pembro in PD-L1-negative NSCLC in china. High never smoker (30%) and male (60%) popn. Promising PFS: 15.0 vs 5.7m (HR 0.49). OS immature. Global data awaited Sac-TMT is also in clinical trials at @NHSBartsHealth https://t.co/xL5qviAYhn Context: per the baseline characteristics slide, 72.1% of patients in each arm were male and 34.5% vs 37.2% were never smokers.
Stephen V Liu, MD @StephenVLiu	Oct 25, 2026	● NEUTRAL	#ESMO26 Dr. Caicun Zhou presents OptiTROP-Lung06: 1L Sac-TMT (TROP2 ADC) + pembro vs chemo + pembro in non-squamous NSCLC. PFS 15m vs 5.7m (HR 0.49). OS immature but 1y rate 78% vs 66% (HR 0.58). mDOR 13.6m vs 6.8m. TEAEs leading to d/c of drug 6% with Sac-TMT 14% with chemoIO. https://t.co/NuvZZ9S3EM
Hidehito HORINOUCHI @HHorinouchi	Oct 25, 2026	● NEUTRAL	🆙#ESMO26 Proffered Paper I: #LCSM Mets 🔥OptiTROP-Lung06: Sacituzumab Tirumotecan (Sac-TMT) Plus Pembrolizumab (P) Versus Chemotherapy (Chemo) Plus Pembrolizumab (P) as First-Line (1L) Treatment for PD-L1-Negative Advanced Non-Squamous (Nsq) NSCLC: Randomized Phase 3 Study 🎙️Dr. Caicun Zhou 🔢LBA66 🎯Met Primary Endpoint: BICR-PFS 15.0 vs 5.7mo (HR 0.49, p<0.0001; n=455) 🎯OS Immature, Favorable Trend (HR 0.58) 🎯Grade≥3 TEAEs 47.6% vs 60.6%; Grade≥3 Stomatitis 2.2% ☑️NCT06711900 🔗 https://t.co/uGHKJfjhvW @OncoAlert @Larvol @myESMO @IASLC
Hidehito HORINOUCHI @HHorinouchi	Oct 25, 2026	● NEUTRAL	🔥OptiTROP-Lung06: Sac-TMT + pembrolizumab vs chemo + pembrolizumab in PD-L1-negative advanced NSCLC 🆙 @NEJM #ESMO26 ☑Phase 3 RCT; N=455; PD-L1<1% nonsquamous NSCLC; mFU 9.7 mo 🎯mPFS 15.0 vs 5.7 mo (HR 0.49, p<0.001); mOS HR 0.58; grade ≥3 AEs lower with sac-TMT (47.6% vs 60.6%) 🎙Dr. Fei Zhou & Dr. Caicun Zhou #LCSM @OncoAlert @Larvol @IASLC https://t.co/id5CQipESy
Tejas Patil @TejasPatilMD	Oct 24, 2026	● NEUTRAL	⭐️How do we improve outcomes for #lungcancer patients with PDL1 < 1% in the 1L setting? This may be addressed with the following two approaches 1⃣Sacituzumab tirumotecan (sac-TMT) plus pembrolizumab (P) versus chemotherapy (chemo) plus pembrolizumab (P) as first-line (1L) treatment for PD-L1-negative advanced non-squamous (nsq) NSCLC: Randomized phase 3 OptiTROP-Lung06 study 2⃣First-line (1L) olomorasib + chemoimmunotherapy (chemo-IO) in KRAS G12C-mutant NSCLC: Updated results from the LOXO-RAS-20001 and SUNRAY-01 trials. These are separate strategies (ADC vs TKI), but both address a fundamental need which is combination approaches for certain subsets of 1L NSCLC. @lcsmchat @OncoAlert @OncLive @Onco_Nexus @LungCancerEu @Lung_Cancers @LungCancerRx @MedwatchHQ @YoungLungCancer @KRASKickers Posted on October 24, before the presentation.
Aakash Desai @ADesaiMD	Oct 23, 2026	● NEUTRAL	5/ OptiTROP-Lung06 (LBA66), Oct 25, 10:53 CET Sac-TMT + pembro vs chemo + pembro, 1L PD-L1-negative nonsquamous NSCLC. PFS met per Kelun-Biotech. Can a TROP2 ADC replace the platinum doublet alongside IO? @LungCancerRx @OncoAlert @oncodaily https://t.co/XWMc6SJ3gy Posted on October 23, before the presentation.

Compiled and reviewed by the KOL Pulse research team, led by Brian Shields, Founder, KOL Pulse. Last updated October 26, 2026. Every quote verbatim; every number checked against the ESMO 2026 LBA66 abstract and presentation slides, the NEJM publication, the Kelun-Biotech releases or ClinicalTrials.gov, with the source labelled.

OptiTROP-Lung06 Trial

OptiTROP-Lung06 Key Takeaways

Primary endpoint met: progression-free survival by BICR

Overall survival: immature, descriptive

Response: similar rate, longer duration

Subgroups

Safety

Regulatory status & clinical implications

Top KOLs Discussing OptiTROP-Lung06

OptiTROP-Lung06 Key Slides & Visuals

ESMO 2026 slides

KOL-Made Infographics

OptiTROP-Lung06 conversations on X

Physician reactions to OptiTROP-Lung06

OptiTROP-Lung06 Trial Design

Study Design

Population

Interventions

Endpoints

Presenter & Discussant

Data Cut

OptiTROP-Lung06 in the News

OptiTROP-Lung06 Questions

What is the OptiTROP-Lung06 trial?

What did OptiTROP-Lung06 show at ESMO 2026?

Did sac-TMT plus pembrolizumab improve overall survival?

Is sacituzumab tirumotecan FDA approved?

How did the safety profiles compare?

Was the trial conducted only in China?

Key KOL Sentiments - OptiTROP-Lung06

OptiTROP-Lung06 Key Takeaways

Primary endpoint met: progression-free survival by BICR

Overall survival: immature, descriptive

Response: similar rate, longer duration

Subgroups

Safety

Regulatory status & clinical implications

Track oncology’s top KOLs in your specialty

Top KOLs Discussing OptiTROP-Lung06

OptiTROP-Lung06 Key Slides & Visuals

ESMO 2026 slides

KOL-Made Infographics

OptiTROP-Lung06 conversations on X

Physician reactions to OptiTROP-Lung06

OptiTROP-Lung06 Trial Design

Study Design

Population

Interventions

Endpoints

Presenter & Discussant

Data Cut

OptiTROP-Lung06 in the News

OptiTROP-Lung06 Questions

What is the OptiTROP-Lung06 trial?

What did OptiTROP-Lung06 show at ESMO 2026?

Did sac-TMT plus pembrolizumab improve overall survival?

Is sacituzumab tirumotecan FDA approved?

How did the safety profiles compare?

Was the trial conducted only in China?

Key KOL Sentiments - OptiTROP-Lung06

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