Clinical lung cancer最新文献

{"title":"Genomic Profiling of Driver Gene Alterations in Patients With Non-Small Cell Lung Cancer, Patterns of Treatment and Impact on Survival Outcomes: A Single Center Experience of More Than 1200 Patients.","authors":"Minit Shah, Vanita Noronha, Vijay Patil, Ajay Kumar Singh, Nandini Menon, Supriya Goud, Srushti Shah, Sucheta More, Akhil Kapoor, Bal Krishna Mishra, Pratik Chandrani, Anuradha Chougule, Vinod Gupta, Priyanka Pange, Omshree Shetty, Trupti Pai, Rajiv Kaushal, Subhash Yadav, Moitrri Basu, Deep Vora, Arvind Vaidyanathan, Prashant Kumar, Rohan Jacob, Anjali Shah, Rashmi Ranjan Pradhan, Debdeep Samaddar, Vallish Shenoy, Bhanupratap Singh, Raveendranath Puviarasan, Saurabh Bagra, Rachit Desai, Elveera Saldanha, Disha Poojary, Akash Pathak, Shivangi Ray, Himanshu Bhardwaj, Ujwal Shetty, Ramya Iyer, Richa Das, Neha Mer, Hetakshi Shah, Yuvraj Kaushal, Ananya Singh, Hrutika Panmand, Ganesh Gosavi, Ahmad Ubharay, Anusha Iyer, Ushaan Turel, Ankush Shetake, Kamesh Maske, Amit Janu, Nilendu Purandare, Akash Pawar, Madhvi Mandhania, Kumar Prabhash","doi":"10.1016/j.cllc.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.02.001","url":null,"abstract":"<p><strong>Background: </strong>The utility of Next-Generation-Sequencing (NGS) in patients of non-small-cell-lung-cancer (NSCLC) has led to an exponential increase in the identification of driver-gene alterations, however, Indian NGS data was lacking.</p><p><strong>Materials and methods: </strong>This retrospective study conducted between May'2019 and Dec'2023 included histologically confirmed NSCLC cases with NGS testing done on tissue and/or liquid biopsy samples prior to treatment initiation. We reported the frequency of driver-gene alterations, clinicopathological profile, treatment patterns, and outcomes [Overall-Survival (OS)].</p><p><strong>Results: </strong>Data of 1230 patients was analyzed. Median age was 59 years (IQR,51-66), 65.3% (n = 803) were males, 34.6% (n = 426) had a history of smoking, and 78.1% (n = 961) had an adenocarcinoma histology. NCCN-recommended driver-gene alterations were seen in 64.8% (n = 797) cases. EGFR, ALK, ROS1, ERBB2, MET, RET, NTRK, BRAF and KRAS gene alterations were seen in 33.7% (n = 414), 7.6% (n = 94), 2.4% (n = 29), 6.1% (n = 75), 1.9% (n = 23), 2.2% (n = 22), 0.7% (n = 8), 3.3% (n = 40), and 9.6% (n = 118) cases respectively. 62.1% (n = 495/797) driver-positive patients could receive targeted therapy, and 21.7% (n = 94/433) driver-negative patients could receive immunotherapy. With the receipt of targeted therapy, median-OS of driver-positive patients was 26.7 months (95%CI, 23.3-32.7) versus 9.3 months (95%CI, 7.3-12.2, P < .001) without. Similarly, in driver-negative patients, median OS with the receipt of immunotherapy was 16.4months (95%CI, 14.7-24.4) versus 11.5 months (95%CI, 9.0-13.4, P = .006) without.</p><p><strong>Conclusion: </strong>All eligible NSCLC patients must undergo molecular testing by appropriately chosen and cost-effective methods at diagnosis. Wherever possible, this should be done by NGS. Efforts should focus on improving access to targeted agents in India, and developing cost-effective alternatives.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supraclavicular Lymph Node Metastases in Advanced Lung Cancer: Prevalence and Analysis of Demographic, Clinical and Molecular Characteristics.","authors":"Rocco Trisolini, Valeria Cetoretta, Giovanni Sotgiu, Alessandra Cancellieri, Mariangela Puci, Marta Viscuso, Vanina Livi, Massimiliano Cani, Giovanni Scambia, Federico Cappuzzo, Emilio Bria, Silvia Novello","doi":"10.1016/j.cllc.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.02.003","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of supraclavicular lymph nodes metastases (SNM) in advanced lung cancer has not been systematically evaluated, nor has then been a comparison of demographic, clinical, or molecular characteristics between patients with and without SNM.</p><p><strong>Methods: </strong>In this prospective cohort study, the presence of SNM was evaluated using imaging studies (CT, PET, neck ultrasonography) in patients with suspected advanced lung cancer referred for biopsy aimed at diagnosis and molecular profiling. Ultrasound-guided biopsy confirmed or excluded metastatic involvement when suspicious supraclavicular nodes were identified. We assessed the prevalence of SNM and compared the demographic, clinicopathologic and molecular characteristics of patients with and without SNM.</p><p><strong>Results: </strong>Among the 348 patients with advanced lung cancer, 94 (27%) had SMN. SMN was more common in small cell lung cancer (24/48, 50%) and adenocarcinoma (61/248, 24.6%) than in squamous cell carcinoma (4/35, 11.4%). Compared to patients without SMN, those with SMN were more likely to have small-cell lung cancer, N2/3 disease (97.9 vs. 83.9%, P < .0001), liver metastases (29.8% vs. 16.1% P = .006), and metastases to less common sites (33.7% vs. 14.1%, P < .0001). The prevalence of genomic alterations and PD-L1 expression did not differ between biopsy samples obtained from SNM and those from the primary tumor or other metastatic sites.</p><p><strong>Conclusion: </strong>SNM is common in patients with advanced small-cell lung cancer and adenocarcinoma. Ultrasound-guided biopsy of SNM is a simple and relatively inexpensive method for obtaining adequate tissue samples for diagnosis and comprehensive molecular profiling.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor Immunophenotypic Correlates in Patients Aged 80 Years or Older With Non-Small Cell Lung Cancer and Outcomes to First-Line Pembrolizumab in PD-L1 High (≥50%) Patients.","authors":"Adriana P C Barrichello, Arielle Elkrief, Biagio Ricciuti, Teja Ganta, Thomas U Marron, Xinan Wang, William Lotter, James Lindsay, Valentina Santo, Alessio Cortellini, Bijaya Sharma, Kristen Felt, Kathleen Pfaff, Giuseppe Lamberti, Federica Pecci, Alessandro Di Federico, Maisam Makarem, Malini M Gandhi, Tom Nguyen, Danielle Haradon, Victor R Vaz, Bruce E Johnson, Neha Debnath, Yinghong Wang, Andrew G Kuang, Anwaar Saeed, Maluki Radford, Christine M Lovly, Caroline A Nebhan, David J Pinato, Scott J Rodig, Adam J Schoenfeld, Mark M Awad, Joao V Alessi, Abdul Rafeh Naqash","doi":"10.1016/j.cllc.2025.01.014","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.01.014","url":null,"abstract":"<p><strong>Background: </strong>Non-small cell lung cancer (NSCLC) patients aged ≥80 years [y] are underrepresented in clinical trials. We evaluated whether age correlates with a distinct immunophenotype or impacts outcomes to first-line pembrolizumab in patients with advanced NSCLC, PD-L1 Tumor Proportion Score (TPS) of ≥50%, and aged ≥80y.</p><p><strong>Methods: </strong>Three NSCLC cohorts were retrospectively analyzed to assess the impact of age (<80y versus ≥80y) on pembrolizumab efficacy and the tumor microenvironment (TME). Cohort A encompassed patients receiving first-line pembrolizumab for advanced NSCLC with PD-L1 ≥50%. Cohort B comprised patients with tumor profiling using multiplexed immunofluorescence (ImmunoPROFILE). Cohort C included The Cancer Genome Atlas (TCGA) and Stand Up to Cancer (SU2C) databases for gene expression analysis.</p><p><strong>Results: </strong>In Cohort A (N = 669), patients ≥80y (N = 111) showed no significant differences in objective response rate or median progression-free survival compared to younger patients (N = 558), but had shorter median overall survival and were less likely to receive second-line therapy after progression on pembrolizumab. In Cohort B (N = 567), tumors from patients ≥80y (N = 45) exhibited higher intratumoral FOXP3+ T cells and closer vicinity of PD-1+ immune cells to tumor cells compared to <80y (N = 522). Cohort C revealed a distinct immunophenotype in samples from patients ≥ 80y, with elevated specific immune cell subsets and up-regulated immune checkpoint proteins.</p><p><strong>Conclusion: </strong>Patients ≥80y with PD-L1-high NSCLC displayed a distinct immunophenotype in the TME but achieved similar ORR and mPFS with first-line pembrolizumab compared to younger patients. OS was shorter in older patients, who were less likely to receive second-line therapy.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients With Advanced Non-small Cell Lung Cancer Harboring MET Alterations: A Descriptive Cohort Study.","authors":"Dina Oksen, Emmanuelle Boutmy, Yuexi Wang, Christopher Stroh, Andreas Johne, Alnecia R Nisbett, Alex Ryder","doi":"10.1016/j.cllc.2025.01.013","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.01.013","url":null,"abstract":"<p><strong>Purpose: </strong>Mesenchymal-epithelial transition factor (MET) alterations are rare oncogenic drivers in patients with non-small cell lung cancer (NSCLC). This study characterized patients with advanced NSCLC harboring MET exon 14 (METex14) skipping and MET amplification (METamp) in routine clinical practice in the United States.</p><p><strong>Patients and methods: </strong>Using electronic medical record data from the ConcertAI Oncology Dataset (2004-2022), 2 patient cohorts were identified: 1 with METex14 skipping with or without METamp, and 1 with METamp without METex14 skipping. A subgroup with METamp and concomitant epidermal growth factor receptor (EGFR) mutations who had received EGFR-tyrosine kinase inhibitors (TKIs) was also analyzed. Patient characteristics, treatment patterns and outcomes were described.</p><p><strong>Results: </strong>93 patients with advanced NSCLC harboring METex14 skipping and 164 with advanced NSCLC harboring METamp were identified. Established oncogenic drivers other than MET were less frequent in the METex14 skipping cohort than the METamp cohort. In both cohorts, first-line chemotherapy use decreased over time while immune checkpoint inhibitor (ICI) and MET inhibitor use increased. Treatment patterns were heterogeneous, with patients receiving multiple drug classes across therapy lines. Outcomes were better for patients with METex14 skipping NSCLC who received targeted therapies or ICIs versus chemotherapy. Subgroup analyses of EGFR-TKI-treated patients with METamp indicated poor outcomes.</p><p><strong>Conclusion: </strong>Patients with METex14 skipping and/or METamp NSCLC require targeted and personalized treatment approaches to optimize treatment effect and have an unmet medical need. With targeted therapies recently available and others under exploration, treatment outcomes could significantly improve for patients with NSCLC harboring these rare drivers.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Induction Immunochemotherapy Followed by Hypo-Fractionated Radiotherapy in Unresectable Stage III Non-Small Cell Lung Cancer.","authors":"Zihao Zhu, Jianfeng Wu, Lijun Zhao, Ning Jiang, Yu Chen, Xue Song, Ming Li, Ming Jiang, Meiqi Shi, Shaorong Yu, Binhui Ren, Rong Yin, Feng Jiang, Li Wang, Cheng Kong, Xiangzhi Zhu","doi":"10.1016/j.cllc.2025.01.012","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.01.012","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and safety of induction immunochemotherapy followed by hypo-fractionated radiotherapy (Hypo-RT) for locally advanced unresectable non-small cell lung cancer (LA-NSCLC).</p><p><strong>Methods: </strong>This retrospective analysis involved the data of 35 patients with unresectable stage III LA-NSCLC receiving immunotherapy plus Hypo-RT from January 1, 2019, to December 31, 2023. At least 2 cycles of induction immunochemotherapy were initially administered, followed by a definitive Hypo-RT at 4 Gy per fraction. The primary endpoint was overall survival (OS) and the secondary endpoints were progression-free survival (PFS) and grade ≥ 3 nonhematologic toxicities. Time-to-event outcomes for the entire cohort were calculated using the Kaplan-Meier method.</p><p><strong>Results: </strong>At a median follow-up of 31.5 months (95% confidence interval, 26.1 to 36.9 months), median OS did not reach, with 1, 2, and 3-year OS rates of 100.0%, 82.5%, and 77.3%, respectively. Disease progression or death was recorded in 18 (51.4%) patients, with a median PFS of 28.0 months (95% CI, 9.4 to 46.6 months). The 1, 2, and 3-year PFS rates were 74.3%, 55.7%, and 47.6%, respectively.</p><p><strong>Conclusion: </strong>Induction immunochemotherapy followed by Hypo-RT demonstrated promising efficacy and acceptable toxicity in patients with LA-NSCLC. Studies on Hypo-RT combined with induction and consolidation immunotherapies are warranted in the future.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Atezolizumab in Chinese Patients With Advanced Thymic Carcinoma: A Multicenter, Single-Arm Phase 2 Study.","authors":"Shun Lu, Xuezhen Ma, Lunxu Liu, Qiang Li, Jian Hu, Changli Wang, Jianxing He, Xiufeng Hu, Chun Chen, Zhenzhou Yang, Dandan Hu, Yanjun Shi, Yi Zhou, Mo Chen","doi":"10.1016/j.cllc.2025.01.011","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.01.011","url":null,"abstract":"<p><strong>Introduction: </strong>There are limited treatment options for thymic carcinoma. This study aimed to evaluate the efficacy and safety of atezolizumab for the treatment of advanced thymic carcinoma after failure with prior systemic therapy.</p><p><strong>Patients and methods: </strong>Patients aged ≥ 18 years with advanced thymic carcinoma after failure with prior systemic therapy were enrolled at 10 medical centers in China. Atezolizumab 1200 mg was administered on Day 1 (baseline) every 3 weeks until unacceptable toxicity/loss of clinical benefit. The primary efficacy endpoint was the confirmed objective response rate in the full analysis set.</p><p><strong>Results: </strong>Between 29 July 2020 and 28 December 2022, 34 patients enrolled (median age, 54.5 years), and 16 (47.1%) had received ≥ 2 prior lines of therapy. At the cut-off date (July 16, 2023), the median follow-up duration was 19.1 months. The confirmed objective response rate (ORR) was 14.7% (95% confidence interval, 5.0%-31.1%); disease control rate, 58.8%; median progression-free survival (PFS), 3.2 months; 24-month OS rate, 63.2%; Better ORR and PFS were observed in PD-L1-positive patients versus PD-L1-negative patients (40.0% vs. 0% and 7.4 vs. 1.5 months, respectively). No correlation was observed with TMB. The incidence of adverse events (AEs) was 94.1%; serious AEs, 26.5%; immune-related AEs, 29.4%; and AEs leading to drug withdrawal, 2.9%.</p><p><strong>Conclusions: </strong>In patients with advanced thymic carcinoma who had failed prior systemic therapy, atezolizumab was well-tolerated with a manageable toxicity profile and showed encouraging the antitumor activity, especially in patients with PD-L1-positive tumors.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Sarcopenia With Toxicity and Survival in Patients With Lung Cancer, a Multi-Institutional Study With External Dataset Validation.","authors":"Anurag Saraf, John He, Kee-Young Shin, Jakob Weiss, Mark M Awad, Justin Gainor, Benjamin H Kann, David C Christiani, Hugo J W L Aerts, Raymond H Mak","doi":"10.1016/j.cllc.2025.01.010","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.01.010","url":null,"abstract":"<p><strong>Introduction: </strong>Sarcopenia is associated with worse survival in non-small cell lung cancer (NSCLC), but less studied in association with toxicity. Here, we investigated the association between imaging-assessed sarcopenia with toxicity in patients with NSCLC.</p><p><strong>Methods: </strong>We analyzed a \"chemoradiation\" cohort (n = 318) of patients with NSCLC treated with chemoradiation, and an external validation \"chemo-surgery\" cohort (n = 108) who were treated with chemotherapy and surgery from 2002 to 2013 at a different institution. A deep-learning pipeline utilized pretreatment computed tomography scans to estimate SM area at the third lumbar vertebral level. Sarcopenia was defined by dichotomizing SM index, (SM adjusted for height and sex). Primary endpoint was NCI CTCAE v5.0 grade 3 to 5 (G3-5) toxicity within 21-days of first chemotherapy cycle. Multivariable analyses (MVA) of toxicity endpoints with sarcopenia and baseline characteristics were performed by logistic regression, and overall survival (OS) was analyzed using Cox regression.</p><p><strong>Results: </strong>Sarcopenia was identified in 36% and 36% of patients in the chemoradiation and chemo-surgery cohorts, respectively. On MVA, sarcopenia was associated with worse G3-5 toxicity in chemoradiation (HR 2.00, P < .01) and chemo-surgery cohorts (HR 2.95, P = .02). In the chemoradiation cohort, worse OS was associated with G3-5 toxicity (HR 1.42, P = .02) but not sarcopenia on MVA. In chemo-surgery cohort, worse OS was associated with sarcopenia (HR 2.03, P = .02) but not G3-5 toxicity on MVA.</p><p><strong>Conclusion: </strong>Sarcopenia, assessed by an automated deep-learning system, was associated with worse toxicity and survival outcomes in patients with NSCLC. Sarcopenia can be utilized to tailor treatment decisions to optimize adverse events and survival.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Effectiveness of Nivolumab and Ipilimumab Plus Chemotherapy Versus Pembrolizumab Plus Chemotherapy in PD-L1 Negative Metastatic Non-Small Cell Lung Cancer Patients.","authors":"Marjon V Verschueren, Dagmar T A Hiensch, Peter M J Plomp, Lisanne A Kastelijn, Ewoudt M W van de Garde, Bas J M Peters","doi":"10.1016/j.cllc.2025.01.009","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.01.009","url":null,"abstract":"<p><strong>Background: </strong>Recently, the combination of nivolumab, ipilimumab and chemotherapy (NIC) became available for the treatment of metastatic non-small cell lung cancer (mNSCLC) patients, introducing a new treatment option. This study aimed to compare the treatment response and real-world outcomes of NIC with the current standard of care pembrolizumab plus chemotherapy (PC) in PD-L1 negative mNSCLC patients treated in clinical practice and to compare these outcomes with the results of the Checkmate-9LA trial.</p><p><strong>Methods: </strong>All mNSCLC patients with PD-L1<1% treated with NIC or PC at 2 large teaching hospitals in the Netherlands between 2019 and 2023 were included. The objective response rate (ORR) and progression-free survival (PFS) and treatment characteristics of patients treated with NIC were compared to those of patients treated with PC. Additionally, the real-world outcomes of NIC were compared to the results from the CheckMate 9LA trial. A multivariate Cox regression was used to calculate PFS hazard ratios (HR).</p><p><strong>Results: </strong>PD-L1 negative mNSCLC patients treated with NIC had a higher ORR than those treated with PC (41% versus 27%, P = .08). The PFS was slightly longer for patients treated with NIC versus PC (5.5 vs. 4.5 months, aHR = 0.91 [95% CI 0.59-1.58]), although not statistically significant. The treatment discontinuation rates were comparable between the real-world NIC and PC cohorts (72% vs. 68%), mostly due to disease progression (67% vs. 64%). The outcomes for patients treated with NIC in clinical practice were comparable to the Checkmate-9LA trial.</p><p><strong>Conclusion: </strong>For mNSCLC patients with <1% PD-L1 expression, the treatment responses to NIC were numerically better than to PC. Larger cohorts with longer follow-up periods and overall survival endpoints are needed to further establish the role of NIC in PD-L1 negative patients.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143413623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunotherapy for Early-Stage Non-Small Cell Lung Cancer: A Practical Guide of Current Controversies.","authors":"William J Phillips, Ashley Jackson, Biniam Kidane, Gerald Lim, Vishal Navani, Paul Wheatley-Price","doi":"10.1016/j.cllc.2025.01.006","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.01.006","url":null,"abstract":"<p><p>The role of immunotherapy as systemic therapy for nonmetastatic non-small cell lung cancer (NSCLC) has evolved rapidly over the last decade. There are several well-conducted phase 3 clinical trials evaluating immunotherapy in the neoadjuvant, perioperative, adjuvant and nonoperative setting. In this narrative review, we summarize the data from these studies and discuss ongoing controversies in applying these data to clinical practice. These controversies relate to the value of the adjuvant component of perioperative immunotherapy, treatment of patients with PDL1 negative tumors, defining resectability, optimal use of operative versus nonoperative management, the role of stereotactic radiation therapy for very early lung cancers, and management of tumors with an oncogenic driver.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Evaluation of PD-L1 Expression and Heterogeneity in Early-Stage Non-Small Cell Lung Cancer (REPLICA).","authors":"Eleni C Josephides, Daniel Smith, Andrea Bille, Akshay Patel, Hannah L Rush, Roberta Dunn, Daniel J Hughes, Sarah Hunter, Phillipe Taniere, Danielle Crawley, Maria Monroy-Iglesias, Annie-Rose Henry, Ana Montes, Mieke Van Hemelrijck, James Spicer, Debra Josephs, George Santis, Daisuke Nonaka, Eleni M Karapanagiotou","doi":"10.1016/j.cllc.2025.01.008","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.01.008","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors have improved survival in patients with non-small cell lung cancer (NSCLC). Whilst PD-L1 expression is a useful predictive biomarker, data on concordance of expression between primary tumor and nodal metastases in the surgical setting are sparse.</p><p><strong>Methods: </strong>We assessed PD-L1 expression in paired primary tumor and involved lymph node samples from 451 consecutive patients with stage IIB-IIIB NSCLC who underwent curative lung resection and lymphadenectomy at our institution between 2009 and 2018, to assess intertumor heterogeneity. Clinical records were examined to determine survival outcomes, and relationship to PD-L1 expression was explored.</p><p><strong>Results: </strong>Using PD-L1 expression categories of < 1%, 1% to 49% and ≥ 50% there was heterogeneity of PD-L1 expression between the primary and corresponding lymph node metastases in 24% of cases with only moderate positive correlation (Spearman's coefficient 0.7). 46% of early-stage primary tumors expressed PD-L1, although only 11% demonstrated a high (> 50%) level. It was more common for PD-L1 expression to be higher in the primary tumor than its metastatic lymph node than the converse. PD-L1 expression irrespective of site, had no significant impact on disease-free or overall survival.</p><p><strong>Conclusion: </strong>Our study confirms the heterogeneity of PD-L1 expression in early-stage NSCLC and suggests that a biopsy specimen from a single site may not be a comprehensive representation of PD-L1 expression. The proportion of tumours with high PD-L1 expression appears lower in early-stage NSCLC than in advanced disease.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}