Research

Each year, oncology professionals from around the world gather at the American Society of Clinical Oncology (ASCO) Annual Meeting to explore the latest advances in cancer research and treatment. Our team recently returned from this year’s conference with exciting insights and updates to share.

Updates to precision medicine and targeted therapy

At ASCO 2026, we continued to see advancements made in targeted therapies, including new options for rarer biomarker groups.

• ALK
  Updated data from the CROWN trial underscored long-term progress. The data compared the ALK targeted therapy Lorbrena (lorlatinib) as a first treatment for ALK-positive non-small cell lung cancer (NSCLC) to an earlier generation of ALK targeted therapy, Xalkori (crizotinib). While the trial had previously demonstrated that lorlatinib led to better outcomes, new data showed that even 7 years after the trial started, many patients had still not experienced progression while taking lorlatinib. The median or “middle-ground” benefit of lorlatinib has still not been determined, which could mean a long treatment benefit. This exciting result affirms that with continued research, we are achieving better long-term outcomes than ever before in lung cancer.

• EGFR
  In the WU-KONG 28 trial, we saw promising results from the EGFR Exon 20 targeted therapy Zegfrovy (sunvozertinib) as a first therapy (notable also given that sunvozertinib is a pill and other currently approved EGFR Exon 20 therapies are administered by IV).  

• RET
  The Libretto-432 trial showed that giving the RET targeted therapy Retevmo (selpercatinib) after surgery decreased the chance that the cancer would come back after being removed in people with RET-positive NSCLC. Trials like Libretto-432 serve as a reminder that receiving comprehensive biomarker testing is important for everyone who has lung cancer (regardless of stage) and that we may soon see additional targeted therapy options for early-stage NSCLC, beyond the already approved Tagrisso (osimertinib) (EGFR) and Alecensa (alectinib) (ALK). Data also demonstrated the new RET targeted therapy, lunbotinib, had promising effectiveness and could be an additional option for RET-positive NSCLC.

• ALK
  The LORIN trial showed that giving the ALK-targeted therapy Lorbrena (lorlatinib) before surgery to patients with initially unresectable, early-stage ALK-positive NSCLC led to significant tumor shrinkage. As a result, 75% of participants became eligible for surgical removal of their cancer, highlighting the potential role of targeted therapies in expanding treatment options for patients with early-stage disease.

Immunotherapy innovations

The field of immunotherapy continues evolving in new directions, with several agents advancing in trials and coming closer to entering clinical practice. Two such drugs that were spotlighted at this year's meeting include ivonescimab and pumitamig. These are both bi-specific antibodies that attach to and block PD-1 and VEGF (a special protein that helps blood vessels grow).  

• Invonescimab with chemotherapy
  In the Harmoni-6 trial, invonescimab (with chemotherapy) was compared to a PD-L1 inhibitor called Tevimbra (tislelizumab) (also given with chemo) to see which combination would be a better treatment for people living with squamous cell NSCLC. The ivonescimab group had a 4-month longer period without progression (28 months compared to 24), and people with a positive PD-L1 score (one that is >1%) did better than people with a negative PD-L1 score. This emphasizes the importance of having doctors test the tumor tissue to measure this number.  

• BNT327/BMS-986545 (pumitamig)
  In the RosettaLung-02 trial, people with squamous and non-squamous NSCLC were given this drug in the first line. There was a strong response among both groups, with non-squamous individuals responding 63.6% of the time, and squamous individuals responding 72.7% of the time. For those who did respond, all still showed stable or shrinking disease at 9 months.

• Combination therapies
  The TRITON study showed the benefits of new drug combinations, especially for mutations that are prone to resistance. The study found that a combination of durvalumab Imfinzi (durvalumab), Paraplatin (carboplatin) or Platinol (cisplatin) plus Toposar (etoposide) chemotherapy, and the drug Imjudo (tremelimumab) can provide added benefit when administered in first line NSCLC. This trial found that people who had a STK11, KEAP1, or KRAS mutation were 15% more likely to respond to this combination when compared to the standard of care, chemotherapy plus Keytruda (pembrolizumab), at 48% vs. 33.3%.

Promising research for small cell lung cancer (SCLC)

Researchers continue to work on bridging the gap for people living with SCLC and brought updates on improving both treatment and quality of life.

• SCLC with brain metastasis
  In the DELPHI-304 study of Imdelltra (tarlatamab), people who received it over chemotherapy were more likely to see their brain tumor(s) shrink by 30% or more (56% of people compared to 38%). They also found that a complete response was more likely with Imdelltra (tarlatamab), at 15% compared to 5% for chemotherapy. This offers an additional layer of protection and confidence for the many people with SCLC experiencing brain metastases.  

• Risks and benefits of adding extra treatments
  The TRIPLEX study evaluated whether there was a survival benefit to adding radiation therapy to treatment with chemoimmunotherapy in extensive-stage SCLC. This study found that people given concurrent radiation with their chemotherapy+immunotherapy had higher rates of side effects and mortality when compared to those who were on chemo and immunotherapy alone, but they did not have a longer survival time. Though this study did not find that added radiation was beneficial for these individuals, it teaches us how to optimize cancer care. By balancing the disease control rate of a medication with its side effect profile, we can work to provide care that will be well-tolerated and effective at the same time.

Want to learn more about takeaways and highlights from ASCO 2026? Don’t miss our dedicated Lung Cancer Living Room discussion on Tuesday, July 21. Text "LivingRoom" to 844-871-7558 to receive Living Room text reminders.

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When Misty Shields was 13 years old, her father was diagnosed with small cell lung cancer (SCLC). He was 48. Within 2 years, he was gone.

That loss changed everything for her. While other teenagers were figuring out who they wanted to be, Misty was looking online to find out how to become an oncologist. She had found her purpose, even if it came wrapped in grief.

Today, Misty Shields, MD, PhD, is one of the leading researchers and clinicians working to make SCLC a more treatable disease. She sat down with GO2’s Chief Patient Officer, Danielle Hicks, at a recent Lung Cancer Living Room® to share what’s changing in the world of SCLC and why she believes real hope is finally within reach.

Watch the full Lung Cancer Living Room conversation with Dr. Misty Shields on SCLC below.

A disease that went decades without progress

For most of the last 50 years, the story of SCLC treatment hasn’t changed much. Chemotherapy was the main tool, and it often worked for a little while, but not for long or well enough. Unlike non-small cell lung cancer (NSCLC), which saw a wave of new targeted therapies and immunotherapies reshape outcomes over the past decade, SCLC lagged behind.

That personal history is part of why Dr. Shields pushed into this field. “SCLC has been neglected for a long time,” she said. “That’s not acceptable.”

The treatments that are changing the picture

The first real turning point came in 2018 and 2019, when the Food and Drug Administration (FDA) approved the first immunotherapy drugs for SCLC. Drugs like Tecentriq (atezolizumab) and Imfinzi (durvalumab) work by releasing the brakes on the immune system, helping it recognize and attack cancer cells. They are used alongside or after chemotherapy, depending on the stage of disease, and they are helping some people with SCLC live longer.

Then, in 2025, a new treatment for SCLC was approved by the FDA. Dr. Shields explained that Imdelltra (tarlatamab) is a drug that works in a completely different way. Think of it as a connector. It acts like glue between the immune system’s T-cells and the cancer cells, pulling them together so the immune system can do its job. This approach, called a T-cell engager, is now the standard second-line treatment for extensive-stage (stage 4 (IV)) SCLC. It represents the first major shift in what doctors reach for when cancer stops responding to first-line therapy.

SCLC isn’t one disease anymore

For decades, doctors treated all SCLC the same way. That’s also starting to change. Researchers have discovered that SCLC has distinct subtypes, or different versions of the disease that may behave differently and respond differently to treatment.

This is the same shift that happened in NSCLC years ago, and it opened the door to targeted therapies that dramatically improved outcomes for many people. The hope is that identifying SCLC subtypes will do the same. The work is still in early stages, but the direction is clear: the future of SCLC treatment will likely be more personalized, not one-size-fits-all.

Finding SCLC earlier and understanding it better

SCLC is often caught late, partly because it can grow and spread quickly. Researchers are now looking at new tools that could change that. Liquid biopsies, or blood tests that detect cancer cells or fragments of cells in the bloodstream, may help doctors diagnose SCLC earlier or track how the cancer changes over time. Multi-cancer early detection tests are also being studied to flag cancers such as SCLC before symptoms appear.

For a fast-moving disease like SCLC, finding cancer earlier could dramatically change outcomes.  

Clinical trials: progress requires participation

Every treatment Dr. Shields discussed exists because people with lung cancer agreed to be part of a clinical trial. It’s worth saying that plainly, because trials are still widely misunderstood.

A clinical trial is not a last resort. It often means people gain access to the newest treatments before they are widely available. For people with SCLC, that access can matter enormously, especially because the disease tends to progress quickly.

People with SCLC often face barriers to joining trials, such as strict eligibility requirements, how fast the disease progresses, and the need to act quickly. Researchers know this is a problem. Many are now designing studies with more flexible rules and faster enrollment to make sure more people can participate. More participants mean faster answers, and faster answers mean better treatments for everyone who comes after.

“The nihilism is no longer welcome.”

Dr. Shields closed the conversation with a message she clearly feels deeply: “Never give up hope. The breakthrough might be just right around the corner. This is the new era for small cell lung cancer, and the nihilism is no longer welcome.”

For the 15-year-old who lost her father to this disease, that shift is personal. For the people living with SCLC today, it may be life changing.

If you would like to learn more about SCLC, have questions, or need support, our SCLC program can help. Contact our free HelpLine at 1-800-298-2436 or email support@go2.org.

When we try to characterize small cell lung cancer (SCLC), we typically define it by its stage, either extensive stage or limited stage. We don't often delve further than that; that's about as specific as we'll hear. However, you may be surprised to learn that there are actually 4 unique subtypes of small cell lung cancer, each with its own characteristics. The reason these aren't often discussed, though, is that for a while we weren't certain what this information meant. Yes, there are differences among these 4 types at the cellular level, but what does that really mean for the person living with the disease? In recent years, though, this has begun to change. Scientists have been working to uncover how these small differences can potentially have a great impact on the future of personalized medicine and small cell lung cancer. Here, we'll discuss a little bit about each of these 4 subtypes, and how the treatment landscape may shift to accommodate them in the future.

To differentiate the types of SCLC, we have to look at the different proteins that are inside of the cancer cells. These special proteins can help determine how the genes of the cancer cells express themselves, which in turn can impact how these cells grow, reproduce, and react within the body. By taking a blood sample and looking at the circulating tumor DNA (ctDNA) to examine these factors, doctors and scientists can see what type of subtype a person's SCLC is.

SCLC Subtype-A

These are SCLC type cancers where there is a high expression in the cells of a factor called ASCL1. This is the most common subtype, found in between 40% and 50% of cases. Some early research shows that this subtype might be more susceptible to a type of drug called BL-2 inhibitors. These drugs work by blocking a protein inside of the cells that can then cause the cell to die. Some research suggests that this sub-type, after treatment with chemotherapy, may convert to sub-type I (discussed lower down).  

SCLC Subtype-N

This subtype means that a person's SCLC cells have a lot of the factor NEUROD1. This factor is important to helping certain specialized cells grow and function within the body, and it is found in high levels in many cases of extensive-stage disease. This subtype is found in about 20% of SCLC cancers. While this subtype can mean the cancer is a bit faster in how it grows and spreads, it is also more sensitive to treatment with a type of drug called Aura-Kinase inhibitors. These are still in trials for SCLC, and we are monitoring the progress of this research for future uses.  

SCLC Subtype-P

Having the subtype of SCLC-P indicates that your cancer has higher levels of the POU2F3 factor. This is a factor used by specialized cells that line the respiratory and digestive systems. In healthy cells, this helps them to recognize foreign bodies and protect against them, but when mutated, it can drive the subtype of SCLC. It's a bit rarer than those described above and is in 12% to 15% of cases. Fortunately, research is beginning to show that this type of SCLC may respond better to a class of experimental drugs called PARP inhibitors. These drugs, though still in trial, have been shown to stop the damaged DNA in cancer cells from replicating, preventing the spread of more cancerous cells.  

SCLC Subtype-I

Finally, our last class of SCLC subtypes is SCLC-I. This stands for inflamed SCLC, and indicates that, rather than having higher levels of certain proteins, the cells have a lot of inflammation occurring, and a high level of immune cells within the environment. Because of this, research has shown that this subtype may have a stronger response to immunotherapy agents than other small cell lung cancers. This is a less common class of SCLC, found in about 10-15% of cases.  

It is important to know that, when looking at how these sub-types may affect a person's prognosis, there was no difference noted in the length of a person's overall and progression free survival. This means that having one subtype over another doesn't seem to have an impact on how long they will live, or how serious their disease might be. As shown above though, it can impact what treatment types may be more effective, and can help oncologists think about which types of treatment they should try first. It can also useful when a person is considering clinical trials that they may want to join.

If you want to learn more about managing small cell lung cancer and what options are available, please reach out to us. GO2’s HelpLine is a free, one-on-one service that connects patients and caregivers with experienced staff who can provide guidance, resources, and, most importantly, hope!  

References:

1. Baine MK, Febres-Aldana CA, Chang JC, Jungbluth AA, Sethi S, Antonescu CR, Travis WD, Hsieh MS, Roh MS, Homer RJ, Ladanyi M, Egger JV, Lai WV, Rudin CM, Rekhtman N. POU2F3 in SCLC: Clinicopathologic and Genomic Analysis With a Focus on Its Diagnostic Utility in Neuroendocrine-Low SCLC. J Thorac Oncol. 2022 Sep;17(9):1109-1121. doi: 10.1016/j.jtho.2022.06.004. Epub 2022 Jun 24. PMID: 35760287; PMCID: PMC9427708.

2. Dahlstrom, Erin. “Advances in Small Cell Lung Cancer Classification.” MD Anderson Cancer Center, 25 Nov. 2024, www.mdanderson.org/cancerwise/advances-in-small-cell-lung-cancer-classification.h00-159702279.html.

3. Schwendenwein A, Megyesfalvi Z, Barany N, Valko Z, Bugyik E, Lang C, Ferencz B, Paku S, Lantos A, Fillinger J, Rezeli M, Marko-Varga G, Bogos K, Galffy G, Renyi-Vamos F, Hoda MA, Klepetko W, Hoetzenecker K, Laszlo V, Dome B. Molecular profiles of small cell lung cancer subtypes: therapeutic implications. Mol Ther Oncolytics. 2021 Feb 6;20:470-483. doi: 10.1016/j.omto.2021.02.004. PMID: 33718595; PMCID: PMC7917449.

4. The Asco Post Staff. “Study Identifies Four Unique Subtypes of Small Cell Lung Cancer.” Ascopost.com, 2026, ascopost.com/news/january-2021/study-identifies-four-unique-subtypes-of-small-cell-lung-cancer/. Accessed 30 Apr. 2026.

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At the 2026 GO2 for Lung Cancer Voices Summit in Washington, DC, Christine M. Lovly, MD, PhD, FASCO, Division Chief of Thoracic Medical Oncology at City of Hope, shared a powerful message: the future of lung cancer care is being rewritten, and real progress is being made faster than ever before.

In her keynote, “Precision, Progress, Partnerships, and Possibility in Lung Cancer,” Dr. Lovly highlighted how science, advocacy, and collaboration are transforming outcomes for people living with lung cancer. “Every person in this room has a lung cancer story,” she said, recognizing those living with lung cancer, caregivers, advocates, and researchers working together to drive change.

That shared purpose is what continues to move the field forward.

A turning point in lung cancer treatment

Not long ago, non-small cell lung cancer (NSCLC) treatment options were limited. In the early 2000s, people with advanced NSCLC lived an average of about 8 months.

Today, we are in a different era.

Advances in precision medicine, which is treatment that is tailored to the individual person, have transformed NSCLC care. It was once thought that lung cancer was a single disease, but through biomarker testing, we can now identify subtypes of NSCLC. When a person is found to have certain biomarkers such as EGFR, ALK, KRAS, and others, targeted therapies are available. These treatments target specific biomarkers and stop lung cancer from growing and spreading.

The impact is profound. Many people with advanced lung cancer are now living for years with good quality of life and outcomes that once felt out of reach.

But Dr. Lovly emphasized that continued progress depends on ongoing investment in federal research. She expressed concern about how funding reductions and uncertainty at the National Institutes of Health (NIH) could affect the pace and stability of cancer research. When studies are paused or clinical trials are delayed, progress can slow for patients who are waiting for new treatment options. Sustained federal investment in research plays a critical role in supporting clinical trials, which drive continued advances in lung cancer care.

The role of immunotherapy in lung cancer progress

In addition to targeted therapies, immunotherapy has reshaped what’s possible for many people living with lung cancer.

These treatments work by helping the immune system recognize and attack cancer. A type of immunotherapy called a checkpoint inhibitor has greatly improved outcomes and has expanded treatment options across lung cancer stages.

Still, Dr. Lovly emphasized that progress cannot be measured by numbers alone.

“Life lived is equally as important,” she said, a reminder that quality of life must remain central to every advance.

At GO2, we know this is what matters most. It means more time, better days, and meaningful moments for people living with lung cancer and their families.

Ongoing challenges in lung cancer care

Despite this progress, too many people are still diagnosed at later stages, when treatment options are more limited.

Dr. Lovly outlined several key challenges that continue to impact outcomes:

• Low lung cancer screening rates, leading to late diagnoses

• Limited access to biomarker testing and expert care

• Health differences based on location and income

• Drug resistance, as cancer cells adapt and survive treatments  

• Gaps in research funding that limit progress

Despite causing more deaths than many other cancers, lung cancer research has historically received less funding. Dr. Lovly highlighted this as a major barrier to continued progress as it requires urgent action from all of us.

The future of lung cancer research

There is also real momentum and reason for hope.

New treatments, including next-generation KRAS inhibitors and antibody-drug conjugates, are expanding options for people.

Emerging tools like liquid biopsy are making it easier to detect and monitor cancer through a simple blood test, helping bring precision medicine to more people.

At the same time, AI and new clinical trial designs are helping people access new treatments faster.

The science is moving forward quickly, but as Dr. Lovly made clear, discovery alone isn’t enough.

Impact through advocacy

“Innovation is not our barrier. Implementation is,” Dr. Lovly said.

We already have many of the tools needed to save lives. The challenge is making sure every person with lung cancer, no matter who they are or where they live, can access them.

Where we go from here: More resources, more action

To continue progress, Dr. Lovly emphasized the need for more resources. Top priorities include:

• Expand access to lung cancer screening  

• Increase research funding  

• Improve clinical trial participation  

• Ensuring a variety of people join research studies

• Support research on survivorship

• Strengthen the cancer care workforce  

These priorities reflect where the lung cancer community must focus next and where we can make the greatest impact.

The story is still being written

Dr. Lovly closed with a powerful reminder that reflects the heart of the lung cancer community:

“Every treatment we use today exists because people chose hope over fear and participated in research that helped all of us learn.”

The story of lung cancer is still being written. And as Dr. Lovly emphasized, people with lung cancer and advocates are not simply part of that story. They are helping lead it.

The lung cancer community can continue to make a difference by contacting lawmakers and supporting policies that accelerate research, expand access to care, and improve outcomes. Take action today.

For Amita Jain, MD, lung cancer is not just a diagnosis. It’s a lived experience that has shaped her life across multiple roles as a physician, a patient, a daughter, a caregiver, and an advocate.

Her family’s lung cancer story spans generations. In July 2018, her mother, Usha Jain, a retired UC Berkeley professor, was diagnosed with stage 4 (IV) non-small cell lung cancer (NSCLC) despite having no smoking history. Just 6 months later, Amita herself would receive the same diagnosis.

While both women faced advanced disease, their treatment paths diverged. Usha underwent chemotherapy and immunotherapy for nearly 2 years before stopping treatment and transitioning to routine scans. That period (often described clinically as “watch and wait”) felt anything but passive to her family.

“It was hard to feel as though we were ‘doing nothing,’” Amita recalls.

Turning to navigation for answers

As both a physician and a caregiver, Amita understood medicine, but even she found the complexity of lung cancer care overwhelming.

Navigating next steps after treatment, understanding emerging options, and keeping up with rapidly evolving research can feel like a full-time job, especially for families already carrying the emotional weight of a diagnosis.

So, Amita reached out to GO2's LungMATCH navigation program.

“I called the navigators and furnished my mom’s tumor’s genetic profile,” she says. “They reached out a day later with information on some trials for which she might qualify.”

Although her mother ultimately chose not to pursue clinical trials, the impact of that interaction was profound.

“While we did not take action on the options that the navigator provided, the information was empowering,” Amita explains. “It really helped us understand the ‘lay of the land’ in her particular situation.”

Bridging the gap between information and understanding

Even for someone with medical training, the experience revealed an important truth.  Access to information is not the same as understanding it.

“Navigating is complex and scary, and getting all the information is difficult if you are not an oncologist,” Amita says. “The navigator that I spoke with was both professional and prompt. That information made me feel as though we understood our options—and that was extremely reassuring.”

For patients and families, that reassurance can be transformative.

A lung cancer diagnosis often brings not only fear, but also a sense of powerlessness. Decisions feel urgent; stakes are high, and the volume of information can be paralyzing.

“The navigator can serve as a bridge to knowledge,” Amita says. “Knowledge is power. Having a diagnosis of lung cancer can be shocking, but more importantly you do feel a bit powerless and overwhelmed. The navigators serve as a resource and lifeline.”

The invisible work of navigation

What many patients don’t see is the depth of work happening behind the scenes.

Navigators are constantly reviewing evolving research, identifying clinical trials, interpreting biomarker data, and translating complex medical information into something patients can actually use to discuss with their care teams.

“Keeping up on the information is a full-time job that most of us are not trained to do,” Amita says.

That expertise becomes especially critical at moments of uncertainty, like when treatment ends, and the path forward is unclear.

In those moments, navigation doesn’t just guide decisions; it restores a sense of control.

Strengthening navigation for the future

Stories like Amita’s mother’s underscore the critical role navigators play, not just in coordinating care, but in empowering patients and families with clarity, confidence, and connection.

To support and strengthen this role, GO2 for Lung Cancer partnered with leading experts to develop a comprehensive resource for those on the front lines of patient care.

The Lung Cancer Navigator: A Guide for Nurses and Allied Health Professionals textbook is designed to equip health professionals with the knowledge and tools they need to guide patients through every step of the lung cancer experience, from diagnosis to survivorship.

By investing in navigator education, we can ensure that more patients and families experience what Amita describes so clearly: the shift from feeling overwhelmed and uncertain to being informed and empowered.

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The absence of tobacco use suggests alternative carcinogenic mechanisms may contribute to lung cancer development in younger individuals.

SAN CARLOS, Calif., April 17, 2026 — The Addario Lung Cancer Medical Institute (ALCMI) and GO2 for Lung Cancer today announced results from a new study presented at the 2026 American Association for Cancer Research annual meeting showing that lifestyle patterns and dietary exposures could play a role in tumor mutations among young adults with lung cancer. The results, drawn from the ongoing Epidemiology of Young Lung Cancer study, may help uncover modifiable risk factors in a population where lifestyle behaviors traditionally associated with lung cancer, such as smoking, fail to explain disease onset.  

This project is conducted by researchers from California Northstate University College of Medicine, the Dana-Farber Cancer Institute, The Ohio State University Comprehensive Cancer Center, and USC Norris Comprehensive Cancer Center, part of Keck Medicine of USC. The work is supported by AstraZeneca, the Beth Longwell Foundation, Genentech, GO2 for Lung Cancer, and Upstage Lung Cancer.  

There is growing concern that lung cancer is biologically distinct in adults under 40, with 84% of patients carrying targetable mutations. These historically younger patients are predominantly female and have no smoking history, which raises questions about other potential environmental contributors.  

The new analysis examined data from 187 patients, assessing dietary patterns and food exposure in conjunction with mutation subtypes. Key findings include:  

• Diet quality and pesticide-linked foods. Patients with EGFR and fusion mutations reported better overall diet quality than the U.S. population average. However, their higher intake of fruits, vegetables, and whole grains, which are often associated with elevated pesticide residue, may represent an overlooked environmental risk factor.  

• Unexpected tobacco associations. In the fusion pathway group (ALK, ROS1, RET, NTRK), 55.6% were people with no smoking history, challenging conventional links between these mutations and tobacco exposure. Conversely, one-third of EGFR pathway patients reported a smoking history, higher than anticipated.  

• Potential connection to oral contraceptives. Oral contraceptive use was consistently elevated across all biological pathway groups. Although most patients reported 1-5 years of use, the median duration was 10 years due to a subset of long-term users. This matters because the pesticides can act as endocrine disruptors that interact with estrogen receptors seen in the lung cancers most prevalent in the young lung cancer population.  

The study team notes that further research is needed to clarify how dietary pesticide exposure interacts with genetic pathways and whether reducing exposure could lower risk.  

“These findings demonstrate that there is still so much to learn about this terrible disease, particularly as it occurs in young people,” said ALCMI Executive Director and COO Richard Erwin. “Our hope is that this is just the beginning of this research and that others will join us in exploring how and why lung cancer is presenting in the younger patient population.”  

“This work represents a critical step toward identifying modifiable environmental factors that may contribute to lung cancer in younger adults,” said Jorge J. Nieva, MD, a thoracic oncologist with USC Norris Comprehensive Cancer Center. “Our hope is that these insights can guide both public health recommendations and future research into prevention.”  

“Too many young people diagnosed with lung cancer are left asking, ‘how did this happen?’ especially when they have no known risk factors,” said Chief Patient Officer and Co-Interim CEO of GO2 for Lung Cancer Danielle Hicks. “This research reflects what patients have long suspected. There may be risk factors beyond their control. It’s a critical step toward understanding risk, improving early detection, and giving patients clearer answers.”  

These findings would not be possible without the vision of ALCMI Co-Founder Bonnie J. Addario, who passed away in 2025. She long suspected an unknown environmental link could be contributing to this disease and was steadfast in her determination to search for answers for lung cancer patients.  

“While more research is needed to confirm these findings, this is the first clear evidence that lung cancer in younger patients may develop through a different biological pathway,” said Tony Addario, ALCMI co-founder and husband of the late Bonnie Addario. “This discovery is both scientific and deeply personal. Bonnie’s vision has guided this research from the very beginning, and her legacy continues in the hope we bring to every person facing lung cancer, and in the lives we may one day prevent from ever being touched by it.”  

Disclosure:

Dr. Nieva has received consulting payments from AstraZeneca and Genentech.

Small cell lung cancer (SCLC) is 1 of the 2 main types of lung cancer and accounts for about 15 out of 100 (15%) cases. For decades, treatment for SCLC included chemotherapy, radiation therapy, or surgery if diagnosed in early stages.

It wasn’t until 2018 that the first immunotherapy for SCLC was approved by the Food and Drug Administration (FDA). This was an important advancement in treating SCLC, as immunotherapy works very differently from other treatment types. In October 2025, another breakthrough occurred in the field of immunotherapy when a new type of immunotherapy, a T-cell engager, was approved for SCLC.

These advancements bring hope and optimism to SCLC and expand treatment options. Understanding immunotherapy, how it works, and when it may be used helps you have informed conversations with your healthcare team and stay involved in decision-making. This is important because being knowledgeable allows you to advocate for what matters most to you.

What is immunotherapy?

Your immune system defends your body against germs and diseases that can cause illness. Most of the time, it can tell which cells are healthy and which are not. This enables the immune system to target disease and germ cells without harming healthy cells.

When your immune system detects cancer cells, it goes to work destroying them. Sometimes, it has trouble finding cancer cells because they can appear like healthy cells. Immunotherapy helps your immune system find and attack cancer cells.

Types of immunotherapy

Currently, there are 2 main types of immunotherapies used in SCLC: checkpoint inhibitors and T-cell engagers. They each work in very different ways and are used in different points in treatment.

Checkpoint inhibitors

How do they work?

Cancer cells can hide from the immune system by attaching themselves to immune cells. Cancer cells can attach to immune cells at an area called a checkpoint. This sends a signal to your immune system that the cancer cell is healthy, which prevents the immune system cell from attacking it. A checkpoint inhibitor works by blocking cancer cells from attaching to immune system cells, allowing the immune system to better attack the cancer.

When are they used to treat SCLC?

Imfinzi (durvalumab) and Tecentriq (atezolizumab); however, recent clinical trials have broadened their approved uses in different ways.

• Limited-stage SCLC (stages 1, 2, 3): Imfinzi (durvalumab) can be used after chemotherapy and radiation treatments are complete and may be continued for up to 2 years.
• Extensive-stage SCLC (stage 4): Imfinzi (durvalumab) or Tecentriq (atezolizumab) can be used in combination with chemotherapy. Imfinzi may be continued alone after chemotherapy is completed for as long as it is effective and well-tolerated. This is called maintenance therapy. Tecentriq (atezolizumab) may also be used as maintenance therapy either alone or combined with the chemotherapy drug Lurbinectedin.

T-cell engagers

How do they work?

T-cell engagers, such as Imdelltra (tarlatamab), work like a matchmaker. They attach to a T-cell (a type of immune cell that fights germs and diseases) and a cancer cell, bringing them close together. This connection helps your immune system find and attack cancer cells.

When are they used to treat SCLC?

T-cell engagers are FDA-approved for use in extensive-stage SCLC that has spread during or after chemotherapy.

Immunotherapy side effects

The side effects you may experience from immunotherapy will be unique to you. Some common side effects are mild, while others can be more severe. Immunotherapy boosts your immune system's activity, which can sometimes impact healthy cells and organs, leading to inflammation. This requires prompt medical attention.

Ask a member of your healthcare team what common and more serious side effects may occur with your specific type of immunotherapy and know when you should seek immediate medical care.

The future of immunotherapy in SCLC

Immunotherapy is not 1 single treatment; it’s a growing toolbox of therapies. In fact, there are many clinical trials currently underway that focus on:

• Expanding how the currently approved immunotherapies are used to improve outcomes, including using them in earlier stages or combined with other treatments
• Developing new immunotherapy treatments that work differently from the current options
• Exploring ways to boost the body’s immune system and impact the tumor to make it easier to target and attack Questions for your healthcare team

It’s important to talk to your healthcare team about all your treatment options, including immunotherapy. The following questions may be helpful to ask in your conversation:

• Is immunotherapy right for me?
• What side effects should I be aware of with the type of immunotherapy recommended for me?
• Are there any clinical trials that may be right for me?

By the time many people with cancer begin treatment, the barriers they face, including confusing medical information, fragmented care, transportation challenges, and financial strain, have often been building for weeks or even months.

This is why patient navigation programs were created. Navigators help patients schedule appointments, understand treatment options, coordinate care among multiple providers, and connect with resources that address financial or logistical barriers. For people facing complex healthcare systems, navigation can make the difference between timely treatment and dangerous delays.

But there is a question we rarely ask: Are these programs being designed around the needs of the people most affected by cancer disparities?

A recent scoping review conducted by researchers at GO2 for Lung Cancer and published in an ASCO journal examined cancer navigation studies across the United States and Canada. The goal was simple: to understand what kinds of support patients say they need and whose voices are shaping the research guiding these programs.

The findings revealed several consistent challenges. Across the studies reviewed, patients most often reported difficulties with communication with their healthcare providers, emotional and psychological support following diagnosis, and basic access to care. Many patients described struggling to understand complex medical information, coordinate appointments across multiple specialists, or manage the emotional toll of a cancer diagnosis.

Yet the most striking finding was not the needs themselves. It was who was missing from the research.

Despite experiencing some of the highest cancer mortality rates in North America, African American and American Indian or Alaska Native populations were rarely represented in the studies reviewed. Only a small portion of the research included these groups, even though they face well-documented barriers to screening, diagnosis, and treatment.

At the same time, many studies failed to report key factors that strongly influence cancer care experiences, including whether patients lived in rural or urban areas or whether they faced financial hardship. Without this context, it becomes difficult to fully understand the barriers patients encounter while navigating cancer care.

The timing of these findings is critical. Health systems across North America are increasingly investing in patient navigation programs to reduce disparities and improve outcomes. But if the research guiding these programs does not reflect the communities most affected by cancer disparities, there is a risk that well-intentioned solutions will miss the barriers that matter most.

Some critics may argue that expanding navigation programs should be the priority, regardless of who is represented in the research. Navigation programs have indeed shown tremendous promise in improving care coordination and helping patients move through complex healthcare systems.

But expanding programs without ensuring that the evidence reflects the experiences of the most vulnerable populations at risk, reinforcing the very disparities these programs are meant to solve.

Cancer care does not always require complicated solutions. Sometimes the first step is simpler: making sure the people most affected by the problem are the ones guiding the conversation about the solution.

Until cancer navigation research consistently reflects the voices of the communities most affected by cancer disparities, the healthcare system will continue trying to solve problems without fully understanding them.

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Did you know? HER2 is a gene found in cells that are important for cell growth and survival. You may also sometimes see HER2 referred to as ERBB-2. In some people, the HER2 gene begins to mutate or change, which can be a driving cause of cancer. HER2 mutations occur in about 2 out of every 100 cases (2%) of non-small cell lung cancers (NSCLC).

On February 26, 2026, the U.S. Food and Drug Administration (FDA) expanded its accelerated approval of Hernexeos (zongertinib) for people with advanced non-squamous non-small cell lung cancer (NSCLC) that has a HER2 activating mutation. This exciting update marks the first HER2-targeting therapy approved for use as the initial treatment for this population.

The previous approval allowed individuals to receive Hernexeos (zongertinib) only after a person had already received systemic treatment, such as chemotherapy. With this expanded approval, Hernexeos (zongertinib) can now be used as the first treatment for people with advanced non-squamous NSCLC that has a HER2 activating mutation.

This latest approval is based on the results of the Beamion LUNG-1 study, which evaluated the safety and effectiveness of Hernexeos (zongertinib) in people:

• Whose cancer could not be removed by surgery (unresectable)
• Whose cancer has spread (metastatic) and has a HER2-activating mutation
• Who had not previously received systemic therapy

The study showed participants in the trial experienced both a promising response rate and, for those who responded, benefits lasted for a meaningful period of time.

Hernexeos (zongertinib) is a type of treatment known as a tyrosine kinase inhibitor (TKI), which works by blocking the activity of mutated HER2 in cancer cells and may help to slow down or stop their growth.

Please speak with your healthcare team for more information about Hernexeos (zongertinib) and to see if it may be a good option for you. If you have questions about treatment, trials, or biomarker testing, contact our LungMATCH team at support@go2.org or 1-800-298-2436.   

Read the full FDA announcement.