Multidisciplinary Approaches to Early-Stage Lung Cancer: Insights from TTLC 2026

In this summary of a panel discussion at the 2026 TTLC Meeting, Dr Estelamari Rodriguez highlights key takeaways from a multidisciplinary conversation on early-stage lung cancer management.

The panel—comprising thoracic surgeons, radiation oncologists, and medical oncologists—opened with a discussion on neoadjuvant immunotherapy. Dr Jessica Donington of the University of Chicago noted that while 3 trials have demonstrated improvements in pathologic complete response, neoadjuvant chemoimmunotherapy introduces at least a 12-week delay to surgery and can cause toxicity-related attrition, preventing some patients from ever reaching the operating room. The group emphasized careful patient selection, noting that not all patients are appropriate candidates for perioperative therapy.

On the targeted therapy front, the panel reviewed promising data from the ADAURA trial (perioperative osimertinib in EGFR-positive lung cancer), as well as press releases from the LIBRETTO and ATHENA trials examining RET and ALK inhibition in the adjuvant setting. A survey of surgeons revealed a significant gap: only about 60% reported access to reflex molecular testing prior to surgery, and actionable results were available beforehand for fewer than half of patients, underscoring the need for faster, more integrated diagnostic workflows.

Dr Rodriguez also highlighted a compelling presentation on ctDNA for minimal residual disease (MRD) testing, noting that while the technology is ready, prospective data to guide clinical decisions is still forthcoming. Ongoing trials are working to determine how ctDNA findings can direct next treatment steps.

The session closed with discussion of antibody-drug conjugates—particularly TROP2 inhibitors—as promising agents to incorporate into the perioperative setting, potentially reducing reliance on toxic regimens like cisplatin. Dr Rodriguez stressed the importance of tumor board-style multidisciplinary collaboration, especially for community providers who may lack the infrastructure for these critical conversations.