Charu Aggarwal, MD, MPH

Charu Aggarwal, MD, MPH, is a physician leader in Airways Malignancies Research, director of Precision Oncology Innovation at Penn Center for Cancer Care Innovation, section chief of Head & Neck and Thoracic Cancers, Hematology-Oncology, and the Leslye M. Heisler Professor for Lung Cancer Excellence at Penn Medicine in Philadelphia, Pennsylvania.

Articles

Final Reflections: Key Takeaways and Future Opportunities With QCS and TROP2 NMR

September 11th 2025

Panelists discuss the introduction of quantitative cell scoring (QCS) for TROP2 as a significant artificial intelligence (AI)-driven advancement in oncology, emphasizing its ability to provide precise, quantitative biomarker assessment that complements molecular data like EGFR status. The panelists also highlight the importance of pathologists embracing digital pathology tools to enhance diagnostic accuracy and treatment planning while recognizing the technology’s early but promising role in expanding patient identification for targeted therapies and its potential broader impact on precision oncology.

Broader Implications and Future Impact of QCS and AI-Driven Digital Pathology in Precision Oncology

September 11th 2025

Panelists discuss the expanding potential of quantitative cell scoring (QCS) technology beyond TROP2, highlighting its ability to assess not only cell surface expression but also internalization critical for antibody-drug conjugate (ADC) efficacy. They also emphasize how artificial intelligence (AI)-driven pathology advancements promise to streamline lung cancer diagnostics, improve predictive accuracy, and reduce variability in biomarker testing, ultimately enabling more precise patient selection and better integration of complex biomarker data into clinical care.

Forward Perspectives on Integrating QCS and TROP2 NMR Into Future Treatment Approaches

September 11th 2025

Panelists discuss the strategic approach to implementing targeted therapies through advanced biomarker testing, emphasizing the importance of prioritizing next-generation sequencing (NGS) early in diagnostic workflows due to limited tissue availability, the growing role of liquid biopsies, and emerging technologies like multiplex immunohistochemistry (IHC) to maximize tissue use. The panelists also highlight the critical need for close collaboration and clear communication between oncologists and pathologists to streamline testing, reduce redundant procedures, and ensure timely, personalized treatment decisions.

Evolving Multidisciplinary Collaboration in NSCLC: Preparing for QCS and AI-Driven Pathology

September 11th 2025

Panelists discuss how biomarker testing in oncology is evolving beyond genomic sequencing to include complex protein and RNA analyses, highlighting challenges such as limited biopsy tissue, the need for recent samples, and the importance of clear, standardized reporting; they emphasize that effective collaboration between oncologists and pathologists, along with the use of specialized send-out labs, will be critical to streamline workflows and ensure timely, actionable results for personalized patient care.

Looking Toward Potential Future Integration of TROP2 NMR and QCS: Changing Workflows and Anticipated Challenges

September 11th 2025

Panelists discuss the significant changes needed to integrate quantitative continuous scoring (QCS) and TROP2 normalized membrane ratio (NMR) assays into routine clinical practice, emphasizing the current limited adoption of digital pathology, the likely use of artificial intelligence (AI)-based assays as send-out tests initially, and the importance of expanding digital infrastructure and collaboration to enable precise, automated biomarker evaluation that can guide personalized oncology treatment.

Prospective Evaluation of TROP2 NMR in Ongoing Trials: Key Data on the Horizon and Remaining Questions

September 11th 2025

Panelists discuss several ongoing clinical trials, including AVANZAR and TROPION-Lung10, that are investigating the predictive utility of TROP2 normalized membrane ratio (NMR) in guiding treatment with datopotamab deruxtecan combinations in lung cancer while highlighting advances in artificial intelligence (AI)-driven pathology to refine biomarker assessments and emphasizing the need for prospective validation to establish NMR’s role in clinical practice.

TROP2 NMR as a Predictive Biomarker Across Multiple Patient Cohorts: Insights From TR

September 11th 2025

Panelists discuss how data from the TROPION-PanTumor01, TROPION-PanTumor02, and TROPION-Lung02 studies reinforce the predictive value of the TROP2 normalized membrane ratio (NMR) biomarker across diverse patient populations and treatment regimens, highlighting its reproducibility and ability to specifically identify patients likely to benefit from datopotamab deruxtecan–based therapies rather than serving as a general prognostic marker.

TROP2 NMR as a Predictive Biomarker for Dato-DXd: Clinical Insights From TROPION-LUNG01

September 11th 2025

Panelists discuss the TROPION-LUNG01 trial results, highlighting how datopotamab deruxtecan improved progression-free survival (PFS) in nonsquamous non–small cell lung cancer (NSCLC) and the role of the TROP2 normalized membrane ratio (NMR) as a predictive biomarker that helps identify patients most likely to benefit from the therapy.

Expert Perspectives on TROP2 NMR: Preclinical Evidence and Rationale

September 11th 2025

Panelists discuss preclinical findings supporting TROP2 normalized membrane ratio (NMR) as a predictive biomarker for datopotamab deruxtecan, highlighting its ability to quantify functional membrane expression and internalization potential, refine patient selection beyond conventional immunohistochemistry (IHC), and drive broader adoption of artificial intelligence (AI)-powered digital pathology in precision oncology across multiple tumor types.

Defining and Understanding TROP2 Normalized Membrane Ratio (NMR)

September 11th 2025

Panelists discuss the limitations of conventional immunohistochemistry (IHC) in assessing TROP2 expression for targeted therapies in non–small cell lung cancer and highlight how advanced tools such as quantitative continuous scoring (QCS) and normalized membrane ratio (NMR) offer more precise, objective, and functional evaluations of protein expression and internalization, paving the way for improved patient stratification and personalized treatment with antibody-drug conjugates (ADCs).

Quantitative Continuous Scoring (QCS) Explained From a Pathologist’s Perspective

September 5th 2025

Advancing Biomarker Assessment for TROP2: Moving Beyond Conventional IHC

September 5th 2025

Panelists discuss the evolving role of advanced biomarker tools like quantitative continuous scoring (QCS) and normalized membrane ratio (NMR) in non–small cell lung cancer (NSCLC), highlighting their potential to overcome limitations of traditional TROP2 assessment, improve prediction of antibody-drug conjugate (ADC) efficacy, and enhance patient selection through more precise and functional tumor profiling.

Key Takeaways and Future Directions in the Management of EGFR-mutant NSCLC

August 5th 2025

Panelists discussed that despite advances in targeted therapies for EGFR-mutant lung cancer, challenges remain around defining meaningful clinical endpoints, improving access to molecular testing and treatments, expanding trial eligibility for high-risk patients, exploring curative approaches in select cases, and emphasizing personalized strategies with ongoing patient-centered care and education.

EGFR-mutant NSCLC: Future Directions

August 5th 2025

Panelists discussed that consolidation osimertinib after chemoradiation significantly improves progression-free survival in unresectable stage III EGFR-mutant NSCLC, neoadjuvant osimertinib plus chemotherapy shows promise in early-stage disease, and new antibody-drug conjugates offer effective, better-tolerated options after progression on osimertinib and chemotherapy.

Evolving Therapy Options in 2L and Beyond in EGFR-mutant NSCLC

August 5th 2025

Panelists discussed that although a HER3-targeted ADC showed limited benefit and lost FDA approval, emerging therapies like new ADCs, bispecific antibodies, and personalized sequencing based on molecular testing are expanding treatment options for EGFR-mutant NSCLC resistant to TKIs.

Sequencing Approaches for EGFR mutant NSCLC

July 29th 2025

Panelists discuss that when patients progress after frontline osimertinib without histologic transformation or secondary drivers, treatment options include switching to chemotherapy combined with targeted agents like anti-MET antibodies, considering toxicity and patient tolerance, while molecular testing guides sequencing decisions—especially in cases with MET amplification—and that after newer combination regimens, biopsy and personalized approaches remain essential for optimizing therapy and managing side effects.

EGFR mutant NSCLC: Treatment Options upon Progression after 1L Therapy

July 29th 2025

Panelists discuss that after progression on frontline therapy, treatment decisions hinge on prior regimens, progression patterns, and detailed molecular profiling—including tissue biopsy to detect transformations and resistance mechanisms like MET or HER2 alterations—with sequencing strategies tailored accordingly and clinical trial enrollment encouraged for patients without clear targets.

Upon Progression: Impact of Molecular Testing and Identification of MET Amplification

July 22nd 2025

Panelists discuss that managing systemic progression in EGFR-mutant lung cancer requires thorough molecular profiling via tissue and liquid biopsies to identify resistance mechanisms like histologic transformation and MET amplification, with comprehensive testing guiding next-line targeted therapies or clinical trial enrollment to optimize patient outcomes.

Mechanisms of Resistance: FLAURA2 and MARIPOSA

July 22nd 2025

Panelists discuss that resistance to frontline osimertinib is diverse, involving on-target mutations like C797S, MET amplification, and small cell transformation, highlighting the need for tissue biopsies alongside liquid biopsies to guide treatment, and note that newer combination therapies such as Mariposa may reduce certain resistance mutations and alter tumor evolution, offering hope for improved outcomes.

Propylactic Strategies in Managing Dermatologic AEs with Amivantamab: Expert Insights from the COCOON Trial

July 15th 2025

Panelists discuss that the Cocoon trial’s four-part prophylactic regimen—including oral antibiotics, clindamycin topical treatment, nail toxicity prevention, and ceramide-based lotions—significantly reduces skin toxicities like scalp rashes in EGFR inhibitor therapies, emphasizing the importance of patient and provider education to ensure adherence and improve treatment tolerability.