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Evolving Paradigms in Lung Cancer: Clinical Integration of PD-(L)1 × VEGF Bispecific Therapy - Expert Podcast

Medical oncology

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Description

This program is supported by an independent educational grant from the BioNTech-BMS Alliance.

This expert-led CME podcast features Dr. Edward Garon and Ann Fish-Steagall, who explore the evolving role of PD-(L)1 × VEGF bispecific therapies from both clinical and patient-care perspectives. Dr. Garon discusses the biological rationale for dual-pathway inhibition, emerging clinical evidence, and considerations for integrating bispecific therapies into the lung cancer treatment paradigm. Ann Fish-Steagall brings a patient services and clinical operations perspective, addressing access to clinical trials, shared decision-making, patient education, financial toxicity, and the practical challenges of monitoring and managing novel treatment-related toxicities.

Through a practical, conversational discussion, the podcast highlights the importance of individualized patient selection, multidisciplinary coordination, proactive toxicity monitoring, and clear communication with patients and caregivers. Listeners will gain practical insights into how emerging evidence can be translated into day-to-day lung cancer care while supporting patients through treatment transitions and maintaining quality of life.

This podcast has two segments:

Segment 1: Why Novel Therapies Are Needed

Explore the limitations of current lung cancer treatments, the rationale for dual PD-(L)1 and VEGF pathway inhibition, and the potential role of bispecific antibodies in addressing immune suppression, angiogenesis, and treatment resistance. The segment also incorporates the patient perspective, including unmet needs, access to clinical trials, shared decision-making, and communicating complex treatment concepts with patients.

Segment 2: Practical Integration of Novel Bispecifics into the Treatment Paradigm

Examine practical considerations for patient selection and the integration of emerging clinical evidence into treatment decisions, alongside proactive multidisciplinary monitoring and management of immune-mediated and VEGF-related toxicities.

Who Should Listen?

This program is designed for healthcare professionals involved in the treatment and monitoring of patients with lung cancer, including:

Medical Oncologists
Pulmonologists
Nurses
Nurse Practitioners
Physician Associates
Pharmacists
Other healthcare professionals involved in the multidisciplinary care of patients with lung cancer

Faculty

Edward Garon, MD is Director of the Thoracic Oncology Program at the Jonsson Comprehensive Cancer Center at UCLA and Associate Professor at UCLA. A leading thoracic oncologist, his clinical and research interests focus on lung cancer, biomarker development, and clinical trial innovation. Dr. Garon has led numerous national and international phase I–III clinical trials, including studies that contributed to the approval of multiple cancer therapies and a companion diagnostic.

Ann Fish-Steagall, BSN, RN, is the Senior Vice President of Patient Services, at LUNGevity Foundation. Ann is an experienced healthcare professional and patient advocate with a background in nursing, social work, and thoracic oncology. Before joining LUNGevity Foundation, she served as a research nurse and thoracic nurse navigator at the University of North Carolina and as Director of Clinical Operations at Biologics by McKesson, where she led patient management initiatives. Ann brings a strong patient-centered perspective to her work supporting people affected by lung cancer.

Disclosures

Partners for Advancing Clinical Education (Partners) requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated according to Partners policies. Others involved in the planning of this activity have no relevant financial relationships.

Ann Fish-Steagall faculty for this educational activity, has no relevant financial relationships

Prof. Edward Garon faculty for this educational activity, has the following relevant financial relationships: Consultant and/or Advisor for Abbvie; AstraZeneca; Arrivent; Bayer; Bicycle; Black Diamond Therapeutics; BridgeBio; Boehringer Ingelheim; Bristol Myers Squibb; Daiichi-Sankyo; GSK; Gilead; Hexagon; I-Mab; IO Biotech; iTeos; Merck; Nuvalent; Oxford Bio; Pfizer; Regeneron; Samsung; Sanofi; Servier; Strata; Synthekine, Transcode; Verastem. Grant/Research Support (inst) from ABL-Bio; Arrivent; AstraZeneca; Bayer; BridgeBio; Bristol Myers Squibb; Daiichi Sanko; Eli Lilly; Genentech; Gilead; Iovance Biotherapeutics; Merck; Novartis; Prelude; Regeneron; Synthekine; TILT Biotherapeutics. Intellectual Property for Motif Neoepitopes for Cancer Immunotherapy

Joint Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by Partners for Advancing Clinical Education (Partners) and MedAll. Partners is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physician Continuing Education

Partners designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nursing Continuing Professional Development

The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 0.5 ANCC contact hours.

Pharmacy Continuing Education

Partners designates this continuing education activity for 0.5 contact hour(s) (0.05 CEUs) of the Accreditation Council for Pharmacy Education.

Universal Activity Number - JA4008073-9999-26-289-H01-P

Type of Activity: Knowledge

For Pharmacists: Upon successfully completing the post-test with a score of 75% or better and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.

PA Continuing Medical Education

Partners has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 0.5 AAPA Category 1 CME credits. Approval is valid until July 14th 2027. PAs should only claim credit commensurate with the extent of their participation.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Instructions for Credit

Participation in this self-study activity should be completed in approximately 0.5 hour(s). To successfully complete this activity and receive CE credit, learners must follow these steps during the period from September 8th 2026 through to July 14th 2027.

Review the objectives and disclosures
Study the educational content
Successfully complete activity post-test(s)
Complete the activity evaluation

For Pharmacists: Upon successfully completing the post-test with a score of 75% or better and the online evaluation, your credit will be submitted to CPE Monitor. Please check your NABP account within thirty (30) days to make sure the credit has been posted.

This continuing education activity is active starting September 8th 2026, and will expire on July 14th 2027.

Estimated time to complete this activity: 30 Minutes

Learning objectives

Explain the biological mechanisms underlying PD−(L)1×VEGF bispecific antibodies and how this approach may address immune suppression, angiogenesis, and resistance to PD-(L)1 monotherapy in lung cancer
Interpret emerging global Phase 2/3 clinical evidence for PD−(L)1×VEGF bispecific antibodies, including efficacy and safety outcomes in NSCLC and SCLC, and differential responses in squamous versus non-squamous disease
Apply evidence-based multidisciplinary toxicity monitoring and management strategies for adverse event profiles associated with PD−(L)1×VEGF bispecifics, including both immune-mediated and VEGF-related toxicities
Integrate clinical and biomarker data to identify patients most likely to benefit from PD−(L)1×VEGF bispecific antibody therapy while applying patient selection algorithms to real-world scenarios.

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Computer generated transcript

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The following transcript was generated automatically from the content and has not been checked or corrected manually.

Welcome to Evolving Paradigms in Lung Cancer Forum, a CME accredited podcast series brought to you by Partners for Advancing Clinical Education and Medal. I'm your host. Today we're gonna dive into the rationale for novel treatment mechanisms in thoracic oncology, specifically examining how emerging PDL-1 VEGF by specific antibodies may address long-standing barriers in lung cancer management. Joining us is Doctor Edward Gowan, Professor of Medicine and Director of the Thoracic Oncology Program at the David Geffen School of Medicine at UCLA. Doctor Garran, thank you for being with us. Thank you very much. Before we dive in, please note that this independent educational activity is supported by an independent educational grant from the Biontech BMS Alliance. Faculty disclosures and full accreditation details are available on the activity landing page. Colleagues looking to claim CME CNE or CPE credit for this episode, or to access additional micro-learning modules, interactive flashcards, and board style question banks in this series, can visit MedalEducation.com. Doctor Garon, to set the stage. Immune checkpoint inhibitors targeting the PD1 PDL1 axis have revolutionized advanced non-small cell lung cancer treatment. However, many patients either do not respond or eventually develop resistance. From a biological perspective. What are the primary limitations of PDL one monotherapy, and why is dual inhibition with VEGF such a compelling strategy? So, in many respects, it is not surprising that there are some patients that are, are really not, their tumors are not primed to be responsive to immune checkpoint blockade. And, um, immune checkpoint blockade, of course, it's important that you have a T cell receptor that's going to recognize uh an antigen presented on, on the cancer cells MHC molecules that's foreign. And um there are a, a few different things that, that can drive that. Um, but one of the important ones is, uh, having a high number of mutations makes it more likely that there will be mutations that, uh, when the mutant peptide is presented, um, that the, the T cells recognize it is foreign. And presumably, there are some people who do not have sufficiently immunogenic, um, peptides, uh, to mount an, uh, uh, an immune response against it. Also, the most commonly used immune checkpoints are inhibitors of the interaction between PD1 and PDL1. And Um, the There are some patients with lung cancer who have particularly high expression of PDL one. And we know, um, from years of research that these patients are more likely Um, to, uh, be able to mount an effective immune response when there is, uh, an approach that basically blocks the interaction between PD1 and PDL one. so those end up being made biomarkers we use and predict who, who stands to benefit, but they also are not perfect predictors. Um, And so, we just know, um, empirically that there are many patients who do not, um, have these long-term benefits with inhibition of the PD1. PDL one access. And um this is a group where there are many different treatment strategies that have been evaluated. Um, really to date, none of them has convincingly shown, at least in, um, in a broad population, that it is superior to, um, to checkpoint inhibition with the exception of adding checkpoint inhibition to standard therapies, um, like chemotherapy, for instance. Uh, which clearly shows, uh, uh, that, that one might anticipate the progression-free survival will be longer with that approach. There are questions to date whether or not overall survival will be longer, and at least in cross-trial comparison, the long-term, uh, benefit, um, appears not to be particularly greater when chemotherapy is added, um, to immunotherapy as compared to immunotherapy in cross-trial comparisons. We don't really have randomized data for that question. Of novel treatment approaches, um, that would add to this, um, really the, the approach that I think is generating the most enthusiasm currently are approaches that would add, uh, inhibition of angiogenesis, uh, to PD1 inhibition. Uh, this is an approach that has been tried previously. Um, largely with a combination of chemotherapy along with bevacizumab, uh, a monoclonal antibody that targets, uh, VGF, uh, as well as otezalizumab. Um, but recently, there have been several molecules that combine an inhibitor of, uh, uh, an antibody really directed against VGF. Uh, with on the same molecule and antibody directed against either PD1 or PDL1. That cross talk between angiogenesis and immune evasion is fascinating. Historically, we have tried combining anti-VEGF monoclonal antibodies like bevacizumab or ramusirumab with chemotherapy or immunotherapy. How do novel PDL-1 VEGF by specific antibodies like ivernesimab or pumitimib differ structurally and mechanistically from simply combining separate monoclonal antibodies? So the question you ask is a real one, and I think that that's one that the field is grappling with is what is the advantage of combining um basically the two antibodies into one engineered molecule. And um I think in many respects, potentially the most obvious of those. Um, is, is a safety one, really. And that, uh, if you are able to have uh an antibody that targets VEGF that is acting locally, um, for instance, in the area of, uh, high levels of PD1 or PDL1. There is a possibility that you would, uh, have a better therapeutic index, meaning that you would not have such high rate of systemic VEGF effects, which would include, um, things like hypertension, uh, which is something we, we frequently see. Also, potentially, uh, things like bleeding risk, which is also a complication, uh, potentially of VEGF inhibition. There also is some thought that, um, That basically targeting local angiogenesis would be a more effective approach as well rather than, than sort of globally affecting uh angiogenesis. Although there, I would say that the, the, the data is a little harder to be confident of. There's been some talk about About basically cross-linking things. I, I think it's a, it, it tends to be a little bit more of an unclear argument, whereas, um, it is a much clearer argument from a safety perspective if you could deploy a, a, a therapy locally to a greater extent than just uh sort of systemically throughout the body. That's really interesting, Doctor Gowan, thank you for that. So let's talk about the clinical evidence. From what you've seen, how do you feel the biospecifics will translate into real world efficacy? So in the United States, it's going to be very difficult to uh sort of talk about, about cases. Um, where, where this is clearly proven beneficial because these approaches are not approved in the United States. Um, uh, there are approvals in China, and so there, uh, patients clearly have had access to these drugs. In the United States, in general, when these drugs have been evaluated, Uh, it has been adding on a global population to studies that were, uh, primarily Chinese or looking to replicate data that was generated largely in China. The reason this is important is that these studies really, um, Really, as a result, are are typically randomized and and and placebo controlled because these are, are, are generally large phase three trials. Um. Interestingly, while we used to, in, for instance, the bevacizumab era, be pretty clear whether somebody was receiving the, the, the, the study arm versus the control arm, largely based on the hypertension, because these agents have had a better safety profile, in general, it is not.