The third annual Bridging the Gaps in Lung Cancer consensus meeting is convening approximately 30 global thoracic oncology experts to tackle the most pressing unresolved challenges in clinical practice, as the field grapples with rapidly emerging biomarkers and evolving treatment paradigms.
Unlike traditional medical conferences that focus on established standards of care, this meeting takes a distinctive approach by exclusively addressing areas of clinical uncertainty and ambiguity. Edward S. Kim, MD, MBA, vice physician-in-chief at City of Hope National Medical Center, emphasized the meeting's forward-thinking nature: "At this meeting, we expect the unexpected. We know the field is changing so quickly. We know that new biomarkers are being reported, and I think we just see where more people in the room are bringing in more thoughts of where their scientific expertise is."
Persistent Clinical Challenges
Several critical knowledge gaps continue to challenge clinicians in 2025. Narjust Florez, MD, associate director of the Cancer Care Equity Program and thoracic medical oncologist at Dana-Farber Cancer Institute, highlighted key areas where consensus remains elusive. The optimal duration of adjuvant targeted therapy in biomarker-selected non-small cell lung cancer remains undefined, representing a significant clinical uncertainty.
Management strategies for patients achieving a complete pathologic response following neoadjuvant chemoimmunotherapy continue to generate debate among experts. Additionally, leptomeningeal disease—a rare but challenging manifestation—lacks robust, evidence-based treatment guidelines, creating difficulties for clinicians treating these complex cases.
Dynamic Consensus Building
The meeting's structure reflects the rapidly changing nature of lung cancer care. Florez noted that consensus recommendations are inherently dynamic: "Every year, our consensus changes because the data are coming so fast. It's truly a unique meeting because we are focused on answering questions that probably haven't been answered until today."
Some knowledge gaps identified in 2024 have since been resolved by newly available trial results, while others persist or have expanded. This iterative approach to consensus building is essential for maintaining high-quality care as phase 3 trial readouts, biomarker validation studies, and real-world data continuously redefine optimal practice.
Addressing Practice Variability
The forum brings together experts to work toward alignment in areas of clinical ambiguity, with participants reviewing the latest evidence, considering regional practice variations, and integrating multidisciplinary perspectives. The aim is to reach consensus that is both globally relevant and adaptable to different healthcare systems.
Without these structured discussions, Florez cautioned that variability in practice patterns could widen, potentially affecting patient outcomes. The meeting creates a welcoming environment for sharing expert opinions and scientific uncertainties, encouraging participants to raise controversial or unresolved questions they face in real-world practice.
Enhanced Engagement and Reach
New features this year include livestreaming and integrated social media engagement to share polling results and discussion points in real time. These additions aim to broaden the meeting's reach and illustrate the variability of expert perspectives across different healthcare systems.
Kim noted that the rapid emergence of new biomarkers and the complexity of molecular testing have expanded discussions to include rare alterations and areas lacking clear clinical guidance. The meeting's open format encourages exploration of these challenging topics.
Practical Impact
A manuscript published in a peer-reviewed journal following the meeting will be shared broadly with the international lung cancer community, serving as a practical guide for oncologists navigating situations where randomized clinical trial evidence is either limited or absent.
Although recommendations and consensus from the meeting will never be unanimous, they will illuminate the "gray areas" in lung cancer care and prepare the field for future advancements, according to Kim. This approach ensures that the lung cancer community remains prepared for the continuous evolution of treatment standards in this rapidly advancing field.
