The International Association for the Study of Lung Cancer (IASLC), founded in 1974, has grown into a global organization with over 10,000 members from more than 100 countries and regions. In 2023, Dr. Caicun Zhou from Shanghai Pulmonary Hospital, Tongji University School of Medicine was elected as the IASLC President-Elect for 2023-2025 and will serve as IASLC President for 2025-2027. He is the first IASLC President from mainland China in the organization’s 50-year history. This year marks the 50th anniversary of IASLC, and at the 2024 World Conference on Lung Cancer (WCLC), Oncology Frontier had the opportunity to speak with Dr. Caicun Zhou about IASLC’s remarkable journey over the past five decades in leading the fight against thoracic cancers.

Oncology Frontier：As the President-Elect of IASLC, can you share your thoughts on IASLC’s 50-year journey and its impact on lung cancer care in China?

Dr. Caicun Zhou: At the 2024 WCLC, IASLC celebrated 50 years of international collaboration and education in thoracic oncology. Since its inception, IASLC has championed a multidisciplinary approach to combating lung cancer, emphasizing global collaboration and the importance of diversity, equality, and inclusion. Over the last five decades, IASLC has played a leading role in advancing both basic and clinical research in lung cancer worldwide.

IASLC has continuously evolved, just as global lung cancer care has progressed, including in China. The association’s work has greatly influenced global efforts in thoracic oncology, such as the lung cancer staging project, which has helped refine the staging system by collecting data worldwide in collaboration with the Union for International Cancer Control (UICC) and the American Joint Committee on Cancer (AJCC). Moreover, IASLC has issued several guidelines to guide clinical practice in thoracic oncology and has conducted surveys to better understand global strengths and gaps in areas like lung cancer incidence, biomarker testing, molecular diagnostics, and smoking cessation.

IASLC’s platform has had a positive impact on the development of lung cancer care in China, and Chinese experts have been active participants in its work. My role as the President-Elect of IASLC reflects China’s progress in lung cancer care, drug research, and our overall economic development. It is an honor that recognizes the contributions of multiple generations of Chinese experts whose efforts have brought our research to the global stage. The achievements we’ve made together are being recognized, and it’s a collective honor.

IASLC views all workers in the field of thoracic oncology as comrades because we share a common enemy—thoracic cancer. The association is committed to uniting the world in its fight against lung cancer and other thoracic malignancies, and together, we strive to conquer this common foe.

Oncology Frontier：At the 2024 WCLC, you presented the primary analysis of the HARMONi-2 clinical trial, which compared Ivonescimab with Pembrolizumab as a first-line treatment for PD-L1 positive locally advanced or metastatic non-small cell lung cancer (NSCLC). What are the highlights of the data presented?

Dr. Caicun Zhou: The HARMONi-2 study is a landmark clinical trial, a product of close collaboration among Chinese experts. This study is particularly significant because many previous trials, both in China and internationally, comparing new therapies (including combination therapies) to the Pembrolizumab regimen have failed. However, HARMONi-2 is the first study to show superior progression-free survival (PFS) and objective response rate (ORR) compared to Pembrolizumab, offering chemo-free treatment options for advanced lung cancer patients.

Currently, only patients with targetable gene mutations or those with high PD-L1 expression can benefit from chemo-free treatment regimens. Most NSCLC patients still rely on chemotherapy, which, although effective, carries significant toxicity. The ability of HARMONi-2 to change current treatment protocols hinges on its efficacy. According to the interim analysis presented at the 2024 WCLC, Ivonescimab extended median PFS from 5.82 months in the Pembrolizumab group to 11.14 months (HR=0.51), nearly doubling PFS—a significant result.

The study analyzed patients based on disease stage (IIIB/C vs. IV), histology (squamous vs. adenocarcinoma), and PD-L1 TPS expression (≥50% vs. 1-49%), finding that Ivonescimab outperformed Pembrolizumab across all subgroups, regardless of PD-L1 expression or histology. Further follow-up and analysis of subgroup data are needed, but if all subgroups show benefits similar to these results, Ivonescimab will naturally become a new first-line standard for treating advanced NSCLC.

Looking ahead, the next research direction is exploring whether combining Ivonescimab with chemotherapy can elevate treatment outcomes further. Another avenue for exploration is the potential use of Ivonescimab as neoadjuvant therapy in early-stage NSCLC. Moreover, if Ivonescimab proves effective, the search for biomarkers to guide clinical practice will be essential. The HARMONi-2 study has opened a new era by introducing a bispecific antibody targeting both PD-1 and VEGF in lung cancer treatment. However, there are still many questions left unanswered, and much work remains ahead.

Oncology Frontier：What are your impressions of the 2024 WCLC?

Dr. Caicun Zhou: The 2024 WCLC was a large-scale event, with over 6,000 in-person attendees and 7,000 online participants. One notable change this year was the introduction of two “Presidential Symposia,” which highlights the increasing number of important research findings. Many of these reports came from China, which would have been unimaginable just a few years ago. In the past, Chinese research at international conferences like WCLC was often presented as posters. This year, several studies were featured in the Presidential Symposia and oral presentation sessions, reflecting the significant improvement in the quality of research.

Looking forward, we must continue to push forward, and I hope that more groundbreaking research will come from China, with Chinese experts leading major studies that contribute even more to the global fight against lung cancer.

Dr. Caicun Zhou

Professor, Chief physician, Doctoral supervisor Director of Oncology Department, Shanghai East Hospital Director of Cancer Institute, Tongji University School of Medicine President-elect of the International Association for the Study of Lung Cancer (IASLC) Chairman of Thoracic Oncology Branch of China Medical Promotion Association Chairman of Non-small Cell Lung Cancer Committee of Chinese Society of Clinical Oncology Chairman of Clinical Research Professional Committee on Cancer Drugs of China Anti-Cancer Association Chairman of Molecular Targeted and Immunotherapy Committee for Lung Cancer of Shanghai Anti-Cancer Association Member of the Standing Committee of Oncology Branch of Chinese Medical Doctor Association Vice chairman of Shanghai Anti-Cancer Association Vice chairman of Oncology Branch of Shanghai Medical Doctor Association Vice chairman of Oncology Branch of Shanghai Medical Association