Thread by @StephenVLiu

#ASCO20 Well balanced review of the #SCLC IO oral abstracts by @teekayowo. Clear and consistent benefit with addition of PD(L)1 therapy to front line chemotherapy with 2y OS rates ~ 22% across studies (prior analyses suggest 2y OS rate ~ 7% with chemo alone). #OncoAlert #LCSM

#ASCO20 Looking at the OS curves, later separation leads some to question value of concurrent IO. @teekayowo cautions against this interpretation, as do I. See CM451 where maintenance IO did not impact OS. Concurrent chemo-IO was the only effective approach. #OncoAlert

#ASCO20 Nivolumab + chemotherapy performed well in EA5161 (@LealTiciana) but a phase II is insufficient to change practice in the current environment. Going forward, similar trials are not justified without plans for confirmatory trials. #LCSM #OncoAlert

#ASCO20 CASPIAN with more follow up confirms benefit of durvalumab but tremelimumab did not improve outcomes and treatment related deaths were 2x as high. Without a defined biomarker, @teekayowo declares further CTLA4 investigation in this setting unwarranted. Agreed. #LCSM

#ASCO20 KEYNOTE 604 did not meet its predefined threshold for OS improvement and has no immediate impact on practice. @teekayowo offers the design as a cautionary tale that sometimes, an uncomplicated study and analytic design is best. Wise words indeed. #OncoAlert #LCSM

#ASCO20 The path forward is biomarkers. PDL1 and TMB were low lying fruit and are not enough to help guide treatment here. Other ongoing efforts are the key to enrich trials properly and deliver the types of benefit we need!