Advances in NSCLC Bring Excitement in the Lung Space

There is a lot to be excited about in the overall treatment of lung cancer care, both for non–small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), according to Jorge Nieva, MD.

CancerNetwork® spoke with Nieva, an associate professor of clinical medicine at the Keck School of Medicine of the University of Southern California, following the FDA’s approval of taletrectinib (Ibtrozi) in ROS1-positive NSCLC. At the end of the conversation, he spoke about the future possibilities of lung cancer care. Bispecific T-cell engagers in SCLC were 1 modality of treatment that has achieved “fantastic gains”, and there is also the possibility of combining targets together. One example Nieva gave was interleukin (IL)-2 and PD-L1.

As of now, however, the current means of treatment remain inhibiting targets, reducing cell division, utilizing consolidation radiation and surgery, and combining these agents with chemotherapy.

Even with all the breakthroughs and advancements, Nieva concluded by emphasizing the need to do more in pursuit of a cure for this disease and others like it.

Transcript:

Bispecific antibodies that harness the immune response are going to be very exciting. There are companies that are bringing forth bispecific T-cell engagers in SCLC. We’ve seen fantastic gains with that category of molecules, and I’m hopeful that a similar gain can be achieved in other subsets of NSCLC. There are folks working on bispecifics of PD-L1 and VEGF. Recently, the excitement around that has diminished slightly, but there are some other possible second targets that can be added [such as] interleukin 2-targeting together with PD-L1-targeting. [That] is one development that may be very exciting. There’s a whole host of approaches that people are taking. The great news is that we have people taking dozens and hundreds of shots on goal as to what’s going to be the best way to turn these cold tumors hot. When that happens, we’ll start to see a lot of excitement.

In the meantime, we’re going to have to focus on inhibiting the targets, reducing cell division, using consolidation radiation and consolidation surgery, and perhaps combining these drugs with chemotherapy. We’ve had very nice results combining tyrosine kinase inhibitors and chemotherapy in EGFR-positive disease—not a cure, but certainly something that extends progression-free survival. We may need to apply that paradigm to ROS1, ALK, and some of the other diseases that can be modified with tyrosine kinase inhibitors.

Reference

FDA approves taletrectinib for ROS1-positive non-small cell lung cancer. News release. FDA. June 11, 2025. Accessed June 23, 2025. https://tinyurl.com/yc4f379m