Dr. Thomas Marron, a lung cancer specialist, explains how researchers are developing groundbreaking lung cancer therapies—from targeted treatments for rare genetic mutations to next-generation immunotherapies like bispecific antibodies that help the immune system find and attack cancer more effectively. Dr. Marron also discusses how clinical trials can provide patients with early access to cutting-edge treatments and why it’s important to talk to your care team about trial participation.
Dr. Thomas Marron is Director of the Early Phase Trials Unit and Associate Director for Translational Research at the Mount Sinai Tisch Cancer Center. Dr. Marron is also Professor of Medicine and Professor of Immunology and Immunotherapy at the Icahn School of Medicine at Mount Sinai. Learn more about Dr. Marron.
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Transcript
Katherine Banwell:
What clinical trials are showing promise for people with lung cancer?
Dr. Thomas Marron:
So, there are many targeted therapies, oral medicines, for very specific mutations. Many of them are relatively rare. So, EGFR, which is the classic mutation we see in patients that have never smoked before, increasingly we’re seeing new drugs not only for patients who have
EGFR-mutant lung cancer, we have lots of drugs for those patients, but for more rare subsets of EGFR mutations, including Exon-20. We have many different oral therapies that are coming down the line. So, those are definitely exciting on the one end of the spectrum.
With immunotherapies, one of the most exciting things are bispecific antibodies. So, an antibody is basically a protein. It’s a Y-shaped protein that floats around in your body and sticks to cancer. And we have many of these drugs that we’re already giving patients, amivantamab (Rybrevant) is a good example of one. Even the immune therapies like pembrolizumab or Keytruda, that binds a specific target on your immune cells. But we now are making what we call bispecific.
So, a normal antibody basically is Y-shaped, and it has two we call them fab arms.
But these are the parts of the antibody that bind to something. And now we’re able to make a Y-shaped protein where this side binds one thing and this side binds another. For example, small cell lung cancer, which used to be just a terrible diagnosis, patients lived an average of less than a year, now we’re giving patients these bispecific, specifically a drug called tarlatamab-dlle (Imdelltra), and it’s this Y-shaped drug that on one end will grab your immune cell and on the other end grab the cancer. And it kind of drags your immune system over to the cancer so that your immune system recognizes and kills cancer.
And that is significantly prolonging people’s lives with small-cell lung cancer. We are seeing some very durable remissions. That same sort of bispecific approach where you have something that is basically tethering two things together or blocking two things at the same time, we’re also seeing that as a next generation version of the immunotherapies that we use as a standard of care as a first-line treatment for lung cancer.
So, most patients in the United States get a drug called pembrolizumab or Keytruda that binds to something called PD-1, which is just the thing that sees that stop sign I mentioned earlier. So, cancer is putting up PDL-1, which is a stop sign.
So, your immune system comes along and sees that, and you want to tear down that stop sign. Unfortunately, that’s not enough, just tearing down that one stop sign is not enough because cancer has ways of putting up dozens of stop signs. So, you have these bispecifics that can tear down two different stop signs at the same time.
Those drugs are very exciting. The one that’s farthest along that I imagine will be approved at some point is called ivonescimab.
But there are many other very similar compounds that are right on the heels of that drug that are being tested really across tumor types. In non-small cell lung cancer, also in small cell lung cancer, mesothelioma, breast cancer, colon cancer, everything under the sun. So, I think that’s going to be a big game changer.
Katherine Banwell:
Do you have anything you want to add?
Dr. Thomas Marron:
I would just say, lung cancer in 2026 is still a devastating diagnosis, it’s still a terrifying diagnosis, but it’s a radically different diagnosis than in 2016 or even in 2021. The field is moving very quickly. I think it’s super important that patients and their caregivers advocate for themselves. I’m a clinical trialist. I’m helping to develop the next generation of drugs. And I do encourage all patients at any stage of their treatment journey to ask their providers and other providers in the area about clinical trials. Because we’ve made a lot of progress in the last 5 to 10 years. But I’m super excited about the progress that I see us making in the next 5 to 10 years.
Clinical trials really give patients their earliest access possible to the next generation of drugs.