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ISOPT CONGRESS - JUNE 2026

Day Two: ISOPT Annual Meeting

Jun 13, 2026 Hong Kong
The 2nd Annual ISOPT Congress features world-class speakers discussing: 1) initiatives to reduce cancer mortality in Europe, Korea, and China, 2) the global cancer burden; 3) advances in neoadjuvant therapies for lung, colorectal, breast, and melanoma,; 4) multidisciplinary management of gastrointestinal, breast, and lung cancers; 5) principles for cancer prevention and early detection of colorectal, gastric, and lung cancers, and 6) the cost-effectiveness of nasopharyngeal cancer prevention and early detection.
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Advances in Neoadjuvant Therapies for Primary Cancers

Advances in Targeted Neoadjuvant Therapies for Lung Cancer 16:53

Advances in Targeted Neoadjuvant Therapies for Lung Cancer

Tony S. K. Mok

For a patient with resectable lung cancer, three or four cycles of chemotherapy plus immunotherapy before surgery can leave the surgeon with no visible cancer cells to find. In about one in...

For a patient with resectable lung cancer, three or four cycles of chemotherapy plus immunotherapy before surgery can leave the surgeon with no visible cancer cells to find. In about one in five patients treated this way, the pathologist reports a complete pathological response. Professor Tony Mok walked through why that matters, and where the evidence is still thin.

Mok separates lung cancer into two worlds that call for different management: tumors without a driver oncogene, and tumors driven by EGFR or ALK. For driver-negative disease, neoadjuvant chemoimmunotherapy is now a world standard. He builds the case from the pathological response data through event-free survival and, finally, the long-term overall survival numbers that patients actually care about. He then turns to the harder driver-positive questions, where targeted therapy shrinks tumors reliably but rarely clears them, and closes on a striking new signal in ALK-positive disease.

Key points for clinicians:

  • In driver-negative resectable NSCLC, neoadjuvant chemoimmunotherapy produces a pathological complete response in roughly 20 percent of patients, drawing on CheckMate 816, NEOTORCH, and KEYNOTE-671 among others.

  • Pooled analysis shows chemo-IO markedly raises the odds of a complete pathological response, with a smaller but real gain in major pathological response, and the benefit carries through to event-free survival (hazard ratio about 2.59).

  • CheckMate 816 now has five-year follow-up: overall survival of 65 percent versus 55 percent, an absolute gain near 10 percent that patients should be told about directly.

  • PD-L1 status guides selection. Benefit is clear above 1 percent (one large dataset showed 78 percent versus 50 percent), and marginal below 1 percent, where the overall survival difference is not statistically significant.

  • Multidisciplinary team review before surgery raises the conversion from unresectable to resectable disease. In one European stage 2B/3 series, resectable cases rose from 56 to 72 with neoadjuvant chemo-IO in the discussion.

  • For EGFR-mutant disease, neoadjuvant osimertinib (NeoADAURA) shrinks tumors in about 90 percent of patients and downstages roughly half, but pathological complete response stays near zero, so a survival benefit cannot be assumed. Its clearest use is downstaging to ease surgery.

  • In ALK-positive disease, a small study of a second-generation inhibitor reported a 60 percent major pathological response and 25 percent complete response. A Chinese study presented at ASCO used the third-generation agent lorlatinib in unresectable stage 3 disease and reported 75 percent conversion to resectable, a 47 percent complete pathological response, and 81 percent major pathological response, the strongest targeted-therapy pathological signal to date.

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