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Grand RoundsWeekly Evidence Brief

Oncology

Edition

30-Second Takeaway

  • Perioperative chemoimmunotherapy improves survival and pathological response versus chemotherapy alone in resectable NSCLC.
  • Comprehensive genomic profiling (CGP) identifies more actionable alterations than small-panel testing across multiple advanced cancers.
  • Socioeconomic and geographic trial reporting remains insufficient, limiting generalizability assessments.

Week ending June 27, 2026

Equity, genomic testing, and perioperative immunotherapy in resectable and advanced lung cancer — actionable findings and gaps

Perioperative chemoimmunotherapy improves survival and pathologic response in resectable NSCLC.

CANCERSJun 26, 2026

A systematic review of 16 studies (n=4646) found perioperative immunotherapy plus chemotherapy increased survival and pathological response versus chemotherapy alone. The pooled evidence consistently favored chemoimmunotherapy for these outcomes across heterogeneous trial designs. Studies variably reported adverse events, but the combination tended toward a higher risk of treatment-related adverse events. Heterogeneity in endpoints and study conduct limits precise magnitude estimates and warrants cautious interpretation.

Atypical EGFR and non‑G12C KRAS mutations are common in a diverse resected lung adenocarcinoma cohort.

JOURNAL OF RACIAL AND ETHNIC HEALTH DISPARITIESJun 21, 2026

In 292 resected lung adenocarcinomas, 40.8% were Black and 28.1% Hispanic, and EGFR positivity was independently associated with Hispanic ethnicity (aOR 3.88). Among EGFR-positive tumors, 26% were atypical, with higher numerical proportions in Black (37%) and Hispanic (27%) patients versus White (14%). KRAS mutations were predominantly non‑G12C (58%) and showed no racial/ethnic association. These findings highlight the need for comprehensive NGS and inclusive trial enrollment to avoid leaving underserved patients without targeted options.

Geographic and socioeconomic trial variables are rarely reported in US cancer RCTs.

JAMA NETWORK OPENJun 23, 2026

Systematic review of 441 US randomized cancer trials found age and sex nearly universal, and race/ethnicity reporting rose from 62.3% (2020) to 93.9% (2025). No trials reported rurality, income, or area deprivation; only 2 reported education and 1 reported insurance. This sparse reporting prevents robust assessment of trial generalizability across socioeconomic and geographic subgroups. Clinicians and guideline panels should note this gap when applying trial results to diverse practice settings.

References

Numbered in order of appearance. Click any reference to view details.

Additional Reads

Optional additional studies from this edition.

Edition context

Clinical signal

  • Anticipate higher treatment-related adverse events with perioperative chemoimmunotherapy and counsel patients accordingly.
  • Use broad NGS/CGP when feasible to maximize actionable target detection and trial eligibility.
  • Screen for atypical EGFR and non-G12C KRAS subtypes in diverse populations; ensure access to appropriate testing.