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Updates in Metastatic NSCLC From ASCO 2025

Updates in Metastatic NSCLC From ASCO 2025

Medscape20-06-2025
Dr Jonathan Goldman, of the University of California, Los Angeles, shares key updates in metastatic non-small cell lung cancer from ASCO 2025.
Dr Goldman reviews findings from TROPION-Lung02, which evaluated datopotamab deruxtecan (Dato-DXd) ± pembrolizumab (pembro) in first-line metastatic NSCLC. The objective response rate (ORR) was 55% for Dato-DXd + pembro vs 56% for chemo. Improved outcomes in TROP2 NMR-positive patients may indicate a predictive biomarker.
Dr Goldman then discusses results from OptiTROP-Lung03, in which sacituzumab tirumotecan (sac-TMT) showed superior efficacy compared to docetaxel in pretreated EGFR-mutated NSCLC. The ORR for sac-TMT was 45% vs 15% for docetaxel.
Next, he highlights updates from KRYSTAL-7 of first-line adagrasib plus pembro in KRASG12C-mutant NSCLC. The combination yielded an ORR of 44% and median duration of response of 26.3 months. In patients with a PD-L1 ≥ 50%, ORR reached 50% vs 34% in those with lower expression.
Dr Goldman also reports on HERTHENA-Lung02, in which patritumab deruxtecan (HER3-DXd) improved progression-free survival (PFS) vs chemo in resistant EGFR-mutated NSCLC, but the lack of overall survival benefit led to application withdrawal.
Finally, Dr Goldman reviews phase 2b findings from REZILIENT1, evaluating zipalertinib in EGFR exon 20-mutant NSCLC. In patients without prior amivantamab, ORR was 40% and PFS was 9.5 months. In those previously treated with amivantamab, zipalertinib resulted in clinically meaningful results: an ORR of 23.5% and PFS of 7.3 months.
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