Mini oral session 2

In this video, Prof Dr Thierry Berghmans provides a summary of the second mini-oral session during the 2025 European Lung Cancer Conference (ELCC).

The first 2 abstracts in the session addressed the potential role of artificial intelligence (AI) in the management of lung cancer. A first of these studies validated an AI-based lung nodule malignancy score that was developed to facilitate a better detection of high risk incidental pulmonary nodule/s (IPN) on X-ray. The model proved to be associated with a good negative and postive predictive value and can therefore be used to improve the effectiveness of lung cancer screening in (low-income) countries where low-dose CT-scans are not readily available.¹

The second study used a machine Learning (ML)-based survival analysis to optimize the identification of long-term survival in metastatic non-small-cell lung cancer (NSCLC)  patients treated with immunotherapy. Interestingly, some of the models that were developed, which were solely based on clinical and laboratory data, demonstrated a good alignment with established scoring systems like LIPI and EPSILON.²

The second mini oral session also featured the presentation of the patterns of progression in the ADRIATIC study. In this trial, durvalumab consolidation significantly improved both the overall and progression-free survival compared to placebo in patients with limited-stage small-cell lung cancer (LS-SCLC) without progression after concurrent chemoradiotherapy (cCRT). The presented data show that durvalumab consolidation reduces the rate of extrathoracic metastases and significantly prolonged the time to progression or death for both intrathoracic and extrathoarcic metastases. Importantly, the latter includes a significant delay in the progression of brain or central nervous system (CNS) metastases.³

In recent years, immunotherapy has become the standard of care for patients with pleural mesothelioma. In the presented study, the tumor microenvironment was analysed in an attempt to detect biomarkers that predict a response to immunotherapy in this setting. The study showed that a high sarcomatoid (S)-score and/or a high level of tumour-associated macrophage (TAM) infiltration was associated with a more pornounced clinical benefit to nivolumab-ipilimumab. In contrast, most patients with a low S-score and low TAM infiltration did not derive a benefit from this treatment.⁴

In the next study presented in the mini oral session, a grading system of spread through air spaces (STAS) proved to be an independent predictor of recurrence in patients with stage I invasive non-mucinous adenocarcinoma.⁵

While there is a general consensus on the fact that NSCLC patients should be managed in the context of a multidisciplinary tumor board (MDT), Swiss data presented by Joerger et al. show that the recommendation of the MDT was not followed in 30% of patients with stage III NSCLC. Importantly, non-adherence to MDT recommenations proved to be associated with a significantly worse OS.⁶

The prospective LUNG HEART study investigates the association between the dose delivered to heart substructures and the development of cardiotoxicity in patients with early-stage NSCLC treated with stereotactic ablative body radiotherapy (SABR). The presented analysis showed a statistically significant association between pre-existing cardiac disease (HR: 2.72) and the mean dose to the left anterior descending coronary artery (HR: 1.20) and the development of grade ≥3 cardiac adverse events.⁷

In the SAKK 16/14 study, perioperative durvalumab showed favorable outcomes for patients with resectable stage IIIA(N2) NSCLC. During ELCC 2025 long-term data of this trial were presented showing a 5-year EFS and OS rate of 45.9% and 65.8%, respectively. While these findings are reassuring, they do require further validation in ongoing, randomized-controlled phase III trials.⁸