Thread by @StephenVLiu

#ESMO19 Timely review and discussion of novel therapies in #SCLC by @charlesrudin in a session chaired by @fblackhall Big challenge is unraveling the biology. Need to “subdivide and conquer” #OncoAlert #LCSM

#ESMO19 Subsets certainly exist in #SCLC and efforts to standardize nomenclature is an important first step. Think of some of these as markers, not necessarily drivers. Already implementing at @MSKPathology with sample report here to allow prospective analysis #OncoAlert

#ESMO19 need to translate these subtypes into guiding therapy and may allow us to revisit other “negative” trials which may have just lacked the right selection criteria. Key point. We need smarter studies, not necessarily larger studies. #OncoAlert

#ESMO19 the key genomic events in #SCLC are loss of p53 and Rb, critical checkpoints in the cell cycle. Leaves these cells very dependent on other checkpoints and possibly exposing a context of vulnerability. Promising. SLFN11 possibly as a marker for PARP inhibition. #OncoAlert

#ESMO19 Are all PARPi equal? There are different possible mechanisms and PARL trapping may be even more relevant here. Recurrent themes seem over time. SLFN11 also seems to silences with emergence of acquired chemoresistance. And possibly reversible by targeting EZH2! #OncoAlert

#ESMO19 perhaps most exciting is combining these strategies in rational ways, highlighting key work by Lauren Byers and @triparnasen - the start of a lot of exciting work in this highly lethal subtype of lung cancer. Encourage listening to the session online! #OncoAlert