Conference Insights: Breaking Developments in ALK-Positive NSCLC and ES-SCLC Authors: Solange Peters, MD, PhD; Shirish M. Gadgeel, MD; Rafal Dziadziuszko, MD, PhD

https://www.medscape.org/viewarticle/conference-insights-breaking-developments-alk-positive-nsclc-2025a1000vwn?page=1%3Fsrc%3Dmkmcmr_reeng_recap_mscpedu_activity&uac=148436CN&sso=true thank you for your recent participation in the activity: Conference Insights: Breaking Developments in ALK-Positive NSCLC and ES-SCLC Below are some key learning points to help reinforce the impact of this activity. ☑ Clinical Updates on ALK+ early-stage resectable non-small cell lung cancer (NSCLC): • Alectinib has been approved as the first adjuvant ALK inhibitor for resectable early-stage ALK+ NSCLC based on ALINA, representing a major practice shift from chemotherapy-alone postoperative care. • Updated ALINA results report a 4-year overall survival (OS) rate of 98.4% with alectinib, reinforcing its durable benefit in the adjuvant setting. • Ensartinib has showed promising activity in the adjuvant setting, markedly improving 24-month disease-free survival (DFS) after complete resection 86.4% vs 53.5% with placebo, supporting its use as a postoperative therapy. ☑ Clinical Updates on extensive-stage small cell lung cancer (ES-SCLC): • Lurbinectedin plus atezolizumab is a new approved option for first-line maintenance therapy for ES‑SCLC after completion of platinum‑etoposide with a PD‑L1 inhibitor. • Based on IMforte, the combination improved median PFS (5.4 vs 2.1 months) and median OS (13.2 vs 10.6 months) vs atezolizumab alone, demonstrating a clinically meaningful benefit. • Tarlatamab is moving from relapsed line monotherapy into earlier settings (with chemo-immunotherapy or as maintenance) to deepen and prolong responses. • Tarlatamab in combination with a PD-L1 inhibitor as first-line maintenance after chemo-immunotherapy showed promising OS signals and high early survival, prompting the phase 3 DeLLphi 305 study.