Optimizing Early-Stage NSCLC Management Through Multidisciplinary Strategies: ASCO 2025

Tina Cascone, MD, PhD; Josh Reuss, MD; Wade Iams, MD, MSCI; Aditya Juloori, Tina Cascone, MD, PhD; Josh Reuss, MD; Wade Iams, MD, MSCI; Aditya Juloori, MD; Brendon Stiles, MD; and Mara Antonoff, MD, FACS, discuss how the evolving landscape of early-stage non–small cell lung cancer (NSCLC) treatment has been transformed by neoadjuvant and perioperative chemoimmunotherapy approaches, with recent data presented at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting from CheckMate 816 and CheckMate 77T demonstrating significant overall survival benefits while highlighting the critical importance of multidisciplinary collaboration, biomarker-guided personalization, and managing surgical attrition rates to optimize patient outcomes.

EP. 1: Resectable Early-Stage NSCLC: How the Standard of Care Is Evolving

June 27th 2025

Panelists discuss how the standard of care for resectable early-stage non–small cell lung cancer (NSCLC) has evolved from adjuvant chemotherapy alone to neoadjuvant chemoimmunotherapy and perioperative approaches that combine preoperative treatment with continued immunotherapy after surgery.

EP. 2: CheckMate 816 at ASCO 2025: OS Update and Impact on Early-Stage NSCLC Care

June 27th 2025

Panelists discuss how the CheckMate 816 overall survival data presented at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting demonstrated a significant survival benefit with neoadjuvant chemoimmunotherapy, particularly in patients with higher PD-L1 expression and those achieving pathologic complete responses (pCRs).

EP. 3: CheckMate 77T: Updated Survival and Biomarker Insights Shaping Early-Stage NSCLC Care

July 8th 2025

Panelists discuss how the CheckMate 77T perioperative trial updates showed that even patients receiving fewer than 4 cycles of neoadjuvant therapy still benefited, and circulating tumor DNA (ctDNA) clearance serves as an independent biomarker for predicting outcomes regardless of pathologic response status.

EP. 4: Surgical Perspectives: Who Are the Best Candidates for Neoadjuvant Chemoimmunotherapy?

July 8th 2025

Panelists discuss how surgeons evaluate candidates for neoadjuvant chemoimmunotherapy by emphasizing that all patients with stage II and III disease should be considered regardless of PD-L1 or mutation status, while highlighting the importance of multidisciplinary collaboration in treatment decisions.

EP. 5: ASCO 2025 Real-World Data on Neoadjuvant Therapy in Stage II to III NSCLC: Surgical Outcomes and Clinical Implications

July 15th 2025

Panelists discuss how real-world data from the Flatiron Health database revealed that surgical completion rates after neoadjuvant therapy are lower in community practice (65%) compared with clinical trials, particularly for patients with poor performance status or more advanced stage disease.

EP. 6: Expert Perspectives in Challenging Situations: Progression After Neoadjuvant Chemoimmunotherapy

July 15th 2025

Panelists discuss how to manage patients who cannot proceed to surgery after neoadjuvant chemoimmunotherapy by pivoting to definitive concurrent chemoradiation with reduced-dose chemotherapy, while emphasizing the need to distinguish true progression from inflammatory changes.

EP. 7: MDT Management of Borderline Resectable Early-Stage NSCLC and Delayed Surgery After Neoadjuvant IO

July 22nd 2025

Panelists discuss how borderline resectable patients can be made resectable through neoadjuvant chemoimmunotherapy when surgeons have clear, objective goals for what they aim to achieve rather than vague hopes to make surgery “less scary.”

EP. 8: FDA Green-Lights Subcutaneous Nivolumab: What It Means for Early-Stage NSCLC Care

July 22nd 2025

Panelists discuss how subcutaneous (SQ) nivolumab administration offers patient convenience and potential logistical advantages, particularly in the maintenance setting, though they acknowledge limited current adoption and need for more biological data on efficacy differences.

EP. 9: Optimizing Adjuvant Therapy Decisions in Resectable NSCLC: Integrating Pathologic Response, PD-L1, and Nodal Status

July 29th 2025

Panelists discuss how treatment decisions should integrate multiple factors, including pathologic complete response (pCR), PD-L1 status, and nodal involvement, with particular emphasis on continuing adjuvant therapy for N2 disease and non-PCR patients despite the complexity of using residual viable tumor as a decision-making tool.

EP. 10: Clinical Utility of ctDNA in Guiding Perioperative Treatment Decisions in Early-Stage NSCLC

July 29th 2025

Panelists discuss how circulating tumor DNA (ctDNA) serves as a promising biomarker for identifying patients at higher risk who may benefit from therapy escalation, though they acknowledge the current lack of prospective data on how to act therapeutically on positive ctDNA results.

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