About

Charu Aggarwal, MD, MPH, FASCO, is the Leslye M. Heisler Professor for Lung Cancer Excellence at the University of Pennsylvania’s Perelman School of Medicine. She specializes in the management of patients with lung cancer, with a specific focus on developing personalized therapeutic approaches and discovering and applying biomarkers to guide treatment. Dr. Aggarwal is a world-renowned expert in the application of plasma-based gene sequencing in the management of patients with metastatic lung cancer. Her work involves the implementation of comprehensive testing, early detection, detection of resistance mutations, and disease monitoring. She serves as the Associate Director of the Penn Center for Cancer Care Innovation (PC3I) and the Director of Precision Medicine Innovation at the Penn Center for Cancer Care Innovation. In these roles, she is actively involved in developing, implementing, and advancing strategic and operational initiatives related to precision medicine, with a focus on integrating new technologies and approaches into clinical care to realize the potential of personalized cancer therapy. Dr. Aggarwal is also an active member of the Abramson Cancer Center, where she leads the clinical research program for Airways Malignancies. Her clinical trials focus on novel immunotherapy approaches, aiming to make a tangible impact and enhance understanding of immunotherapy in lung cancer patients.

Research topics

• Oncology
• Medicine
• Internal medicine
• Political Science
• Pathology
• Biology
• Bioinformatics
• Psychology
• Family medicine
• Law

Selected publications

• Carboplatin plus pemetrexed versus pemetrexed alone in advanced thymoma and thymic carcinoma: a retrospective cohort study

  Frontiers in Oncology · 2026-04-22

  articleOpen access

  Introduction: Pemetrexed is approved as a single agent for advanced and metastatic thymoma and thymic carcinoma. In practice, pemetrexed is often given with carboplatin, but the safety and effectiveness of this combination has not been established in either of these rare diseases. Methods: We identified patients with unresectable, recurrent, or metastatic thymoma or thymic carcinoma who were treated with carboplatin/pemetrexed or pemetrexed alone from 2006-2024. Time to disease progression and objective response were determined retrospectively using RECIST 1.1. Median progression-free survival (mPFS) and median overall survival (mOS) were estimated using Kaplan-Meier methodology. Results: We identified 24 patients (14 thymoma; 10 thymic carcinoma), including 8 treated with carboplatin/pemetrexed and 16 with pemetrexed alone. For our combined cohort, mPFS was not reached (NR) with carboplatin/pemetrexed vs. 14.7m with pemetrexed (p=0.27). Among patients with thymoma, mPFS with carboplatin/pemetrexed was NR vs. 15.6m for pemetrexed (p=0.09), while among patients with thymic carcinoma mPFS was 10.9m vs. 14.7m (p=0.88), respectively. At a median follow-up of 49.0m (37m for carboplatin/pemetrexed; 107m for pemetrexed), mOS was NR across all groups. The objective response rate (ORR) was 1/8 (12.5%) vs. 5/16 (31%), and the disease control rate (DCR) was 7/8 (87.5%) vs. 11/16 (69%) with carboplatin/pemetrexed and pemetrexed respectively. Discussion: Carboplatin/pemetrexed was well tolerated and not associated with statistically significant differences in PFS compared to pemetrexed monotherapy in our combined cohort or thymic carcinoma and thymoma subgroups. Carboplatin/pemetrexed demonstrated a numerically longer PFS with encouraging disease control rates particularly in patients with thymoma.

  PublisherDOI

• Illusion of Comprehensive Testing in Non–Small Cell Lung Cancer: Why Coverage, Sensitivity, and Reporting Matter

  JCO Oncology Practice · 2026-04-22

  articleSenior author
  PublisherDOI

• Outcomes Following First-Line Immune Checkpoint Inhibitors With or Without Chemotherapy Stratified by KRAS Mutational Status—A Real-World Analysis in Patients With Advanced NSCLC

  Clinical Lung Cancer · 2025-05-28 · 2 citations

  articleSenior author
  PublisherDOI

• Clinician perspectives on digital and computational pathology in oncology: Opportunities and challenges.

  Journal of Clinical Oncology · 2025-05-28

  article1st authorCorresponding

  e15172 Background: Digital and computation pathology (DCP) is a rapidly emerging testing technology seeking to address both workflow constraints in the pathology lab and support clinician decisions. As oncology targets become more complex and nuanced, more sophisticated technologies like DCP will be increasingly required to accurately identify patients eligible for specific targeted therapies. DCP technologies historically focused on improving pathology lab workflows and centered on pathologists as the primary stakeholder to drive adoption. However, novel DCP algorithms to support diagnoses and inform specific treatment decisions are on the horizon. With the emergence of these algorithms, clinicians’ perspectives on the benefits and concerns surrounding these technologies are increasingly important to understand if widespread adoption is to become a reality. Methods: We conducted a double-blinded survey in December 2024 of oncologists (n = 101) to evaluate current awareness, perceived benefits, concerns, and willingness to order DCP tests. This evaluation was assessed both generally and with a specific theoretical FDA approved DCP-based companion diagnostic test. Ultimately, this data would help identify what concerns need to be addressed to drive future adoption of DCP algorithms for supporting clinical decisions. Results: Awareness of DCP was highly varied across clinicians surveyed, with 17% knowingly using a DCP-based test today (e.g., Paige Prostate, uPATH HER2, etc.) 26% reporting little to no knowledge of DCP, and 58% having a modest or moderate awareness of the technology. However, when introductory level information on DCP was provided, consensus formed among the majority of clinicians around the potential benefits. As such, 62% of clinicians reported being comfortable or very comfortable ordering an FDA-approved DCP-based test included in NCCN guidelines. Anticipated barriers for DCP-based tests match traditional systemic barriers to novel testing (e.g., insurance coverage concerns, patient out-of-pocket costs, etc.). However, full adoption will also require addressing skepticism around the perceived “black box” of DCP algorithms causing 10-12% of clinicians to be unwilling to adopt DCP-based tests without additional oversight or regulations. Conclusions: Our survey results revealed a positive outlook for DCP tests among clinicians with potential for consensus around the benefits. However, ensuring widespread adoption will require additional education efforts to both broaden awareness and alleviate the concerns of “black box” approaches in a subset of clinicians. These findings help further elucidate the necessary steps for successful adoption of DCP tests into the clinical paradigm.

  PublisherDOI

• Supplementary Tables S1-S3 from Safety and Efficacy of MEDI0457 plus Durvalumab in Patients with Human Papillomavirus–Associated Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma

  2025-11-25

  articleOpen access1st authorCorresponding

  <p>Supplementary Table S1. Representativeness of Study Participants Supplementary Table S2. Disease response as assessed by RECIST v1.1 by PD-L1 tumor cell expression (response-evaluable population). Supplementary Table S3. Disease response as assessed by RECIST v1.1 in prior line of therapy subgroups (response-evaluable population) and survival (as-treated population).</p>

  PublisherDOI

• Clinical utility and cost-effectiveness of a molecular biomarker for immune checkpoint inhibitor response monitoring and treatment decisions.

  Journal of Clinical Oncology · 2025-05-28

  articleSenior author

  e23338 Background: Clinical validation studies have shown that response using ctDNA may detect treatment response following immune checkpoint inhibitor therapy (ICI) earlier and more accurately than radiologic imaging. However, there is no clinical utility evidence to determine if molecular response monitoring-based treatment decisions can improve clinical outcomes compared to imaging-based standard of care (SOC). Here, we simulate an interventional clinical study to explore the potential clinical utility and cost-effectiveness (CE) of molecular response monitoring-based therapy decisions using realistic assumptions based on real-world (rw) and clinical trial data. Methods: We updated a patient-level microsimulation model of a cohort of patients with advanced solid tumors. We compared molecular-response monitoring-based decision-making (intervention) to scan-based treatment decision-making (control). We evaluated progression-free survival (PFS) and overall survival (OS) over a two-year period. We assume all patients receive ICI as first-line therapy, chemotherapy as second-line therapy, and then were placed on best supportive care if they progress on second-line. We incorporate cancer-specific rates of imaging and adverse events from real-world data. Cancer-specific PFS and OS rates were taken from published clinical trials. In the base case, we assume molecular non-responders (nMRs) have 80% longer PFS and OS on therapy after first-line in the intervention arm. We also assume that nMRs that stay on ICI therapy have 80% shorter PFS and OS while on ICI therapy in the control arm. We conducted a sensitivity analysis, varying this parameter from 40% to 120%, or 2-5 months. Imaging, treatment, and adverse event costs were calculated from Medicare’s 2023 perspective (USD). Results: In the base case model, we observed a median OS of 23.6 months in the molecular-response monitoring driven intervention arm compared to 15.4 months in the SOC arm. This was driven by longer PFS in second-line chemotherapy in the intervention arm (median PFS of 10.3 months in the intervention arm vs. 5.3 months in the SOC arm). This resulted in an average total cost of $101,300 in the intervention arm vs. $132,400 in the SOC arm due to early discontinuation of ineffective ICI therapy. When we varied the clinical benefit of therapy switching in the intervention arm, the clinical benefit and CE of the intervention arm remained. Conclusions: Using data-driven, realistic assumptions, we show that use of molecular response monitoring based treatment decision-making may improve OS and may be cost-effective compared to CT scan-based treatment decision-making. Data-driven simulation studies are a useful tool for evaluating the potential clinical utility and CE of emerging technologies, and can be used as a blueprint for design of clinical utility studies.

  PublisherDOI

• Real World Radiographic Response Rates and Preoperative Attrition in Patients With Non–Small Cell Lung Cancer (NSCLC) Treated With Neoadjuvant Chemoimmunotherapy

  American Journal of Clinical Oncology · 2025-11-07

  article

  OBJECTIVES: To evaluate real-world rates of radiographic response and surgery in patients treated with neoadjuvant chemoimmunotherapy for stage II to III NSCLC. METHODS: We evaluated a prospectively maintained single-institution database of patients of stage II to III NSCLC treated with neoadjuvant chemoimmunotherapy from January 2022 to July 2024. Rates of radiographic response, surgery, and reasons for abandoning surgery were recorded. Toxicity was graded according to the Common Terminology Criteria for Adverse Events for systemic treatment and the Clavien-Dindo Scale for surgery. RESULTS: Overall, 1243 patients were screened: 323 had stage II-III NSCLC that could be treated with curative intent, of whom 111 were considered eligible for surgery and 36 were treated with neoadjuvant chemoimmunotherapy, which will reflect the remainder of this report. The overall response rate (ORR) was 53% and median radiographic change in the sum of tumor diameter was -34% (IQR -44 to -11). In patients with PD-L1 ≥50%, the ORR was 76%. Most patients had evidence of radiographic downstaging after neoadjuvant treatment. The rate of surgical intervention was 58% (n=21). No patient thought to require a pneumonectomy before neoadjuvant therapy underwent surgery. Pathologic complete response rate was seen in 5 of the 21 patients (24%). There were 42 adverse events from chemoimmunotherapy and 19 from surgery, of which 12% and 11% were grade 3 or higher, respectively. CONCLUSIONS: At a tertiary care center, the rate of surgical intervention after neoadjuvant chemoimmunotherapy was 58%. These results require further validation in additional external cohorts and highlight the need for optimal patient selection to ensure the use of curative surgery.

  PublisherDOI

• MA10.02 CAN-2409 With Continued Immune Checkpoint Inhibitor (ICI) in Patients With Stage III/IV NSCLC With Inadequate Response to ICI

  Journal of Thoracic Oncology · 2025-10-01

  article1st authorCorresponding
  PublisherDOI

• 1856P Pembrolizumab (pembro) plus investigational agents as first-line therapy for treatment-naive PD-L1–positive advanced non–small-cell lung cancer (NSCLC): Results from KEYMAKER-U01 substudy 01B

  Annals of Oncology · 2025-09-01

  articleOpen accessSenior author
  PublisherOA PDFDOI

• More Frequent than Annual Administration of COVID-19 Vaccination May Be Appropriate for Patients With Cancer

  JCO oncology advances. · 2025-05-29 · 1 citations

  articleOpen accessSenior author
  PublisherDOI

Frequent coauthors

• Corey J. Langer

  University of Pennsylvania

  146 shared

• Roger B. Cohen

  University of Pennsylvania

  145 shared

• Joshua Bauml

  91 shared

• Melina E. Marmarelis

  University of Pennsylvania

  66 shared

• Christine Ciunci

  University of Pennsylvania

  56 shared

• Lova Sun

  University of Pennsylvania

  54 shared

• Aditi P. Singh

  University of Pennsylvania

  51 shared

• Jeffrey C. Thompson

  University of Pennsylvania

  50 shared

Labs

• Charu Aggarwal LabPI

Education

• M.D.

  Lady Hardinge Medical College

  2003

• Other, Health Care Organization and Policy

  University of Alabama at Birmingham

  2005

Awards & honors

• Leslye M.. Heisler Professor for Lung Cancer Excellence
• Associate Director, Penn Center for Cancer Care Innovation (…
• Director of Precision Medicine Innovation at the Penn Center…