By: Kyle Doherty
Key Takeaways Exceptional-responder profiling identified TAM gene upregulation (e.g., CD206, CD163) in long-term responders, paired with interferon-γ, TNF-α/NF-κB, and antigen-presentation enrichment across tumor and immune compartments. Cancer-cell CD24 expression was consistently higher in primary progressors and independently associated with poorer outcomes across validation TMAs, while CD47 expression did not correlate with PD-1 resistance. Spatial and multiplex analyses showed increased CD14+ TAM density proximate to tumor cells in long-term responders, suggesting macrophage contexture and function, not simply abundance, may predict durable benefit. In advanced RET+ NSCLC, ~41% required RET-TKI dose reductions (≤75% FDA dose), most often for laboratory toxicities, without statistically significant detriment in PFS, CNS progression, or time to next therapy. Real-world dosing patterns and chronic low-grade toxicity burden highlight the rationale for Project Optimus–aligned development toward optimal biological dosing rather than maximum tolerated dose. SHOW MORE