Researchers of this multicenter randomized trial tested a nurse-led, screening-triggered early specialized palliative care (SPC) program for patients with advanced lung cancer starting first-line chemotherapy. The intervention—delivered by advanced-level nurses—included comprehensive needs assessments, counseling, and coordination of services; controls received usual oncology care. The primary endpoint was change in trial outcome index (TOI) at 12 weeks, with secondary endpoints of TOI at 20 weeks, depression, anxiety, and survival. Screening triggers were used to proactively identify supportive care needs, aiming to integrate SPC alongside active treatment from the outset.

Among 204 patients (102 per arm), the intervention did not significantly improve TOI at 12 weeks vs usual care (mean difference 2.13; one-sided p=0.107) but did show a modest TOI benefit at 20 weeks (3.58; p=0.043). Changes in depression and anxiety were not significantly different at 12 or 20 weeks, and median survival was similar (12.1 vs 11.1 months; p=0.302). Overall, the nurse-led early SPC model was feasible and acceptable, with signals of delayed quality of life improvement despite no early superiority over usual care. These findings suggest that benefits may accrue with sustained engagement, supporting implementation of nurse-led SPC pathways that emphasize ongoing monitoring and timely coordination of supportive services.

Reference: Matsumoto Y, Umemura S, Okizaki A, et al. Nurse-Led Screening-Triggered Early Specialized Palliative Care Program for Patients With Advanced Lung Cancer: A Multicenter Randomized Controlled Trial. Cancer Med. 2024 Nov;13(22):e70325. doi: 10.1002/cam4.70325.

Perioperative checkpoint inhibition is reshaping treatment for resectable early-stage non-small cell lung cancer (NSCLC). Building on prior successes in unresectable stage III (PACIFIC) and in neoadjuvant or adjuvant settings alone (CheckMate 816, IMpower010, KEYNOTE-091), the phase 3 KEYNOTE-671 trial tested a combined approach: neoadjuvant pembrolizumab plus cisplatin-based chemotherapy (4 cycles), surgery, and adjuvant pembrolizumab (up to 13 cycles) vs matched placebo with chemotherapy, surgery, and placebo. Eligible patients had stage II to IIIB (N2) NSCLC, Eastern Cooperative Oncology Group performance status score of 0 to 1, and resectable disease.

Among 797 randomized participants (median follow-up 25.2 months), perioperative pembrolizumab significantly improved event-free survival (24-mo event-free survival 62.4% vs 40.6%; HR 0.58; P<0.001) and deepened pathologic responses (major pathologic response 30.2% vs 11.0%; pathologic complete response 18.1% vs 4.0%; both P<0.0001). Overall survival at this interim analysis favored pembrolizumab (80.9% vs 77.6% at 24 months) but did not cross the prespecified boundary. Surgical feasibility and complication profiles were similar. Grade ≥3 treatment-related adverse events occurred in 44.9% vs 37.3% (grade 5: 1.0% vs 0.8%), consistent with known chemo-immunotherapy risks. Together with other perioperative trials, these data support perioperative immunochemotherapy as a new standard option for resectable stage II to III NSCLC, pending longer-term survival follow-up and refined patient selection.

Reference: Wakelee H, Liberman M, Kato T, et al. Perioperative Pembrolizumab for Early-Stage Non–Small-Cell Lung Cancer. N Engl J Med. 2023;389(6):491-503. doi:10.1056/NEJMoa2302983.

Frontline aumolertinib plus carboplatin/pemetrexed significantly prolonged progression-free survival (PFS) vs aumolertinib alone for EGFR-mutated advanced non-small cell lung cancer (NSCLC) with concomitant tumor suppressor gene (TSG) alterations in the phase 3 ACROSS-2 trial. At 25.3 months median follow-up, investigator-assessed median PFS was 19.8 months with the combination vs 16.5 months with monotherapy (hazard ratio [HR] 0.55; 95% confidence interval [CI], 0.34–0.91; P=.021). Benefit was consistent in key subgroups with TP53 co-mutations (18.7 vs 16.3 months; HR 0.55; P=.024) and numerically favored the combination in EGFR 19del (not reached vs 16.3 months; HR 0.46; P=.055) and L858R (18.7 vs 16.5 months; HR 0.63; P=.154). Overall response rates were similar (70.4% vs 67.2%), and disease control was high in both arms (92.6% vs 98.4%).

Safety reflected added chemotherapy: In the combination arm, common any-grade treatment-emergent adverse events (TEAEs) included anemia (61%), decreased white blood cell count (54%), AST/ALT elevations (52%/48%), and decreased neutrophils (44%). Monotherapy had lower overall TEAE rates, with the most often reported being creatine kinase elevation (42%), transaminase elevations (27%/19%), and rash (20%). These data support aumolertinib-chemotherapy as a feasible option to improve PFS in EGFR-mutated NSCLC with co-occurring TSG alterations, while balancing higher myelosuppression and hepatic laboratory abnormalities associated with chemotherapy.

Reference: DiEugenio J. Aumolertinib Plus Chemotherapy Improves PFS in EGFR-Mutated NSCLC. OncLive. Published September 7, 2025. Accessed September 22, 2025. https://www.onclive.com/view/aumolertinib-plus-chemotherapy-improves-pfs-in-egfr-mutated-nsclc