Clinical lung cancer最新文献

{"title":"Common Medical Comorbidities Influence Pneumonitis Risk After Chemoradiotherapy and Durvalumab Maintenance in Stage III Non-small Cell Lung Cancer.","authors":"Kim Ohaegbulam, Christopher Anderson, Reid F Thompson, Timur Mitin","doi":"10.1016/j.cllc.2025.04.012","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.04.012","url":null,"abstract":"<p><strong>Objective: </strong>Approximately 25% of patients with non-small cell lung cancer (NSCLC) present with Stage III disease. The standard treatment for inoperable patients involves definitive chemoradiotherapy (CRT) followed by 12 months of maintenance durvalumab. However, the incidence of pneumonitis-an adverse effect of this regimen-affects a significant proportion of patients. This study aimed to identify predictors of pneumonitis in a large cohort of patients with unresectable Stage III NSCLC receiving CRT and durvalumab, with a focus on common medical comorbidities.</p><p><strong>Methods: </strong>Using data from the Veterans Health Administration's Corporate Data Warehouse, we identified 1,524 patients who received the standard regimen between June 2017 and July 2023. Pneumonitis was assessed via ICD codes and severity determined using National Cancer Institute criteria. We analyzed associations between pneumonitis and various covariates including age, comorbidities, and medication use.</p><p><strong>Results: </strong>Our findings indicated a cumulative pneumonitis incidence of 14.5%, with 7.68% of cases classified as grade 3 or higher. Significant risk factors included advanced age, higher Charlson Comorbidity Index (CCI), prior pneumonia, diabetes, obesity, and antibiotic use, particularly cephalosporins and macrolides. Notably, severe chronic obstructive pulmonary disease (COPD) and uncontrolled diabetes were associated with an increased risk of pneumonitis. In contrast, prior tobacco use and better ECOG performance status (lower score) were protective.</p><p><strong>Conclusion: </strong>These results highlight the complex interplay between comorbid conditions, medication, and pneumonitis risk in patients undergoing CRT and durvalumab therapy. Further research is needed to explore these relationships and potentially inform strategies to mitigate pneumonitis risk.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075916","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":"Comment on: Association of Sarcopenia with Toxicity and Survival in Patients With Lung Cancer, a Multi-Institutional Study With External Dataset Validation.","authors":"Erkan Topkan, Duriye Ozturk, Ugur Selek","doi":"10.1016/j.cllc.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.04.005","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995718","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":"Clinical Sequence Revealed the Prevalence and Biological Significance of Somatic Pathogenic Variants in Thoracic Cancer: Implications for Germline Status.","authors":"Takahiro Fukushima, Kohei Nakamura, Hideki Terai, Keiko Ohgino, Ryutaro Kawano, Marin Ishikawa, Katsura Emoto, Hatsuyo Takaoka, Ayaka Saito, Fumimaro Ito, Shigenari Nukaga, Shinnosuke Ikemura, Ichiro Kawada, Kenta Masuda, Hiroyuki Yasuda, Hajime Okita, Keisuke Asakura, Kenzo Soejima, Kenjiro Kosaki, Hiroshi Nishihara, Koichi Fukunaga","doi":"10.1016/j.cllc.2025.03.012","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.03.012","url":null,"abstract":"<p><strong>Purpose: </strong>Presumed germline pathogenic variants (PGPVs) are occasionally detected in thoracic cancer and their frequency and functional significance remain underexplored. We investigated the prevalence and biological significance of PGPVs identified in comprehensive genomic profiling (CGP) panels in patients with thoracic cancer.</p><p><strong>Patients and methods: </strong>Between January 2021 and August 2023, 204 patients with thoracic cancer were included in this study. A somatic cancer genomic profile system-FoundationOne CDx or an in-house system (Rapid-Neo)-was used for next-generation sequencing-based cancer gene panel tests. Potential PGPVs were identified by evaluating the variant allele frequency (VAF; cutoff > 10%) and pathogenicity based on ClinVar.</p><p><strong>Results: </strong>PGPVs were detected at a frequency of 9.7% from cohort 1 and 8.1% from cohort 2 in thoracic cancer, based on real-world comprehensive genomic profiling panel testing. Copy number plot did not indicate any homologous recombination deficiency patterns in cases with BRCA1, BRCA2, and RAD51D pathogenic variants in thoracic cancer compared with those in hereditary breast and ovarian cancers. Only one hit of MSH6 pathogenic germline variant was observed for lung cancer tissue in the case of Lynch syndrome; therefore, high tumor mutational burden/microsatellite instability or mismatch repair deficiency was not observed, unlike that in endometrial cancer tissue in the same individual.</p><p><strong>Conclusion: </strong>This study underscores the importance of identifying PGPVs through CGP testing conducted in patients with thoracic cancer. Using frequency and functional analysis. Further investigation is warranted regarding the clinical significance of these PGPVs in managing patients with thoracic cancer and their families.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989167","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":"Outcomes and Toxicity following 3 or More Definitive Courses of Thoracic Radiation Therapy for Non-Small Cell Lung Cancer.","authors":"Abigael Odwuor, Percy Lee, Joe Y Chang, Saumil Gandhi, Zhongxing Liao, Steven H Lin, Aileen Chen, Quynh-Nhu Nguyen, Michael S O'Reilly, Stephen G Chun, Julianna Bronk, David Qian, Matthew S Ning","doi":"10.1016/j.cllc.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.04.002","url":null,"abstract":"<p><strong>Purpose: </strong>Salvage re-irradiation is increasingly utilized to manage non-small cell lung cancer (NSCLC) locoregional recurrence or new lung primaries in previously treated areas. There is sparse information on efficacy and toxicity profile. We report a large experience of patients treated with multiple courses of definitive radiation for new and recurrent NSCLC.</p><p><strong>Methods and materials: </strong>Medical records of patients who underwent ≥ 3 definitive thoracic radiation therapy (RT) courses for new or recurrent NSCLC at our cancer center from 2012 through 2021 were retrospectively reviewed following institutional review board approval. Toxicity was graded per Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 and outcomes were estimated using Kaplan-Meier.</p><p><strong>Results: </strong>Among 51 patients meeting inclusion criteria, there were 161 definitive thoracic RT courses (8 received 4 courses). Of these courses, 119 (74%) entailed SBRT for localized lesions; the remaining were conventional fractionation (half included concurrent chemotherapy). Seventeen patients (33%) received SBRT for every thoracic treatment course. There was overlap of treatment fields between separate courses for 38 patients (75%). Following last thoracic RT, median overall survival (OS) was 2.9 years (range, 1.5-4.4) and progression-free survival (PFS) was 14-months (range, 8.5-19). Three-year estimated OS (±standard error) was 81% (± 10%) for patients who received SBRT for every course and 32% (± 9%) among those treated with mixed modality. Overall Grade 3 toxicity incidence was 6%, no Grade 4 or 5 events.</p><p><strong>Conclusion: </strong>Definitive thoracic radiation can be a safe and effective local control modality (despite multiple prior treatments) and should be considered when planning multidisciplinary salvage therapy.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986874","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":"Prognostic Implications of Lymph Node Status in Non-Small-Cell Lung Cancer Patients Before and After Neoadjuvant Chemoimmunotherapy: A Multicenter Retrospective Study.","authors":"Ran Ma, Haitang Yang, Yong Ge, Tianyue Ma, Jiayi Wang, Shuyuan Li, Tianci Feng, Shoujie Feng, Cheng Zhang, Teng Sun, Feng Yao, Jun Yi, Hao Zhang, Pingping Song","doi":"10.1016/j.cllc.2025.04.004","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.04.004","url":null,"abstract":"<p><strong>Background: </strong>In patients with non-small-cell lung cancer (NSCLC) treated with neoadjuvant chemoimmunotherapy, lymph node (LN) status is classified as ypN0 and ypN+. However, ypN0 includes patients who either had LN metastasis before neoadjuvant therapy (cN+/ypN0) or those who never developed LN metastasis (cN0/ypN0). The prognostic implications of these different LN statuses are not well understood.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients with NSCLC who underwent surgery after neoadjuvant chemoimmunotherapy at 4 centers in China from 2019 to 2022. Patients were grouped by their LN status into ``natural'' N0 (cN0/ypN0), ``downstaged'' N0 (cN+/ypN0), and ypN+ (cN+/ypN+).</p><p><strong>Results: </strong>Out of 527 initially enrolled patients, 186 met the inclusion criteria: 34 (18.3%) had ``natural'' N0, 95 (51.1%) had ``downstaged'' N0, and 57 (30.6%) had ypN+. The median follow-up was 24 months (11-64 months). Disease-free survival (DFS) and overall survival (OS) were significantly lower in ypN+ compared to ``natural'' N0 and ``downstaged'' N0 (DFS: P < .001; OS: P < .001). However, no significant difference in either DFS (P = .695) or OS (P = .814) were observed between ``natural'' N0 and ``downstaged'' N0. Subgroup analysis showed that the MPR/ypN0 group had significantly better DFS compared to the non-MPR/ypN0 (P = .008), MPR/ypN+ (P = .028), and non-MPR/ypN+ groups (P < .001). For OS, MPR/ypN0 group was significantly superior to non-MPR/ypN+ (P < .001) and showed a trend toward better OS than non-MPR/ypN0 (P = .067) and MPR/ypN+ (P = .067). Notably, no significant differences were observed in either DFS (P = .908) or OS (P = .943) between non-MPR/ypN0 and MPR/ypN+ groups. The non-MPR/ypN+ group had the poorest survival outcomes in both DFS and OS.</p><p><strong>Conclusions: </strong>Achieving ypN0 status after neoadjuvant chemoimmunotherapy strongly predicts favorable outcomes in patients with NSCLC, regardless of pretreatment cN status. Combining MPR with LN status effectively differentiates patient prognoses.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981224","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":"Assessment of Lung Cancer Risks Related to Family History in Never-Smokers: A Cohort Study.","authors":"Yun-Gyoo Lee, Dayeon Seo, Hyun-Il Gil, Hyunjoo Lee, Young Hwan Kim, Heerim Nam, Soo-Youn Ham, Du-Young Kang","doi":"10.1016/j.cllc.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.04.003","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer in never-smokers is an increasing issue, particularly in East Asia, where nonsmoking-related risk factors, such as genetic predispositions, play a crucial role. This study investigated the association of family history of lung cancer (FHLC) with lung cancer risk among never-smokers and identified when these risks increased.</p><p><strong>Methods: </strong>This prospective cohort study used data from the Kangbuk Samsung Cohort Study, which involved 357,322 Korean adults who underwent health screenings from 2011 to 2021. The 167,883 with a history of smoking or previous cancer diagnoses were excluded from this study. FHLC was evaluated through questionnaires, and incident lung cancer cases were determined through the Korea National Cancer Incidence Database.</p><p><strong>Results: </strong>Of the 189,439 study population, 11,678 reported FHLC. Incident lung cancer was observed in 25 (0.21%) participants with FHLC and 148 (0.083%) without FHLC, yielding an unadjusted hazard ratio (HR) of 1.76 (95% confidence interval [CI]: 1.15-2.69, P = .009). FHLC remained a significant risk factor after adjusting for sex, body mass index, alcohol consumption, exercise, and medical history (HR: 1.93, 95% CI: 1.24-3.01, P = .004). The risk of incident lung cancer based on FHLC significantly diverged after 45 years of age. Propensity score matching confirmed a higher lung cancer risk in nonsmokers with FHLC compared with those without FHLC.</p><p><strong>Conclusions: </strong>Never-smokers with FHLC demonstrated a significantly higher risk of developing lung cancer, which risks start to increase after 45 years of age. Integrating FHLC into lung cancer screening models has the potential to enhance early detection.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957261","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":"Brief Report: The Genomic Landscape of Small Cell Lung Cancer in Never-Smoking Patients.","authors":"Michael S Oh, Edward B Garon, Aaron E Lisberg, Amy L Cummings, Alex Barrett, Arya Ashok, Elizabeth Mauer, Binyam Yilma, Jonathan W Goldman","doi":"10.1016/j.cllc.2025.03.011","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.03.011","url":null,"abstract":"<p><strong>Background: </strong>Small cell lung cancer (SCLC) predominantly develops in patients with significant smoking history, and patients who have no history of tobacco exposure remain understudied. Prior reports have suggested that SCLC in never-smoking patients may have unique genomic traits.</p><p><strong>Methods: </strong>We retrospectively analyzed records from the Tempus clinicogenomic database to identify SCLC patients reporting \"never smoking\" (NS, n = 54) or \"current/former smoking\" (C/FS, n = 608) status. Tumors were sequenced with the Tempus xT assay, including a targeted 648-gene DNA panel and whole exome capture RNA-seq. Tumor immune cell infiltration was estimated from RNA expression data and PD-L1 expression status was determined by immunohistochemistry.</p><p><strong>Results: </strong>Compared with CF/S patients, NS patients were more likely to be female (70% vs. 55%). Tumors of NS patients had a lower prevalence of TP53 mutations (59% vs. 85%) but no significant difference in RB1 mutations (57% vs. 63%). NS patients had a higher prevalence of EGFR (26% vs. 2.6%), PIK3CA (15% vs. 3.6%), and OS9 (5.6% vs. 0.0%) mutations. Similar findings were observed even after removing cases of transformation from non-small cell lung cancer (NSCLC) or combined SCLCNSCLC presentations. In addition, tumors of NS patients had a lower tumor mutation burden and decreased immune cell infiltration, including by CD4+ and CD8+ T cells.</p><p><strong>Conclusion: </strong>The mutational landscape of SCLC in NS patients significantly differs from that of C/FS patients, suggesting that the occurrence of SCLC in NS patients may represent a distinct genomic entity.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989250","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":"First Report of NSCLC With IDH1 Mutation: A Case Report.","authors":"Yuyue Zhang, Yanmei Liu, Ganghui Ye, Yan Ding, Shixiu Wu, Shenpeng Ying","doi":"10.1016/j.cllc.2025.03.007","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.03.007","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981963","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":"Real-World Outcomes of Tarlatamab in Small Cell Lung Cancer, Including Patients With Untreated Brain Metastases.","authors":"Fabian J Bolte, Sean C Dougherty, Abigail O Danos, Alia C Lynch, Yaroslav Shvorak, Sarah Statler, Ryan D Gentzler, Richard D Hall","doi":"10.1016/j.cllc.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.03.006","url":null,"abstract":"<p><strong>Background: </strong>Tarlatamab, a bispecific T-cell engager, has shown promising results in previously treated small cell lung cancer (SCLC) patients in the DeLLphi-300 and DeLLphi-301 trials. However, reports on outcomes in more diverse, real-world patient populations are limited.</p><p><strong>Methods: </strong>We retrospectively evaluated safety and efficacy outcomes of all patients who were treated with tarlatamab at the University of Virginia between May and October 2024.</p><p><strong>Results: </strong>Our analysis included 21 patients with SCLC and 1 patient with DLL-3 positive atypical carcinoid. The median age of patients was 66 years (range, 41-80 years), with 59.1% being females. Most patients (85.7%) had extensive stage SCLC at diagnosis. Brain metastases were present in 9 (40.9%) patients and liver metastasis in 14 (63.8%) patients. A total of 18 (81.8%) patients would not have met the DeLLphi-301 inclusion and exclusion criteria. Cytokine release syndrome (CRS) occurred in 16 (72.7%) patients; the median time of onset was 15.8 hours (9.1-18.8) after tarlatamab infusion. Immune effector cell-associated neurotoxicity syndrome (ICANS) occurred in 9 (40.9%) patients, with higher rates and grades observed in patients with untreated brain metastases. The median time of onset was 14.8 h ([IQR] 7.7-22.1) after tarlatamab infusion. After a median follow-up of 6.7 months, the overall response rate (ORR) was 42.9% in SCLC patients.</p><p><strong>Conclusions: </strong>Tarlatamab is a promising treatment option for heavily pretreated small cell lung cancer patients. We observed higher rates of CRS and ICANS during the first treatment cycle suggesting that real-world safety outcomes may differ from clinical trial data.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982080","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":"The Toxicity Profile of Pemetrexed in Non-Small Cell Lung Cancer Patients With Moderate Renal Impairment: A Retrospective Cohort Study.","authors":"Mart P Kicken, Rob Ter Heine, Intissar Azarfane, Nikki de Rouw, Fenna de Vries, Bas J M Peters, Nienke A G Lankheet, Frank Eektimmerman, Tim Beerden, Eric J F Franssen, Lisanne L Krens, Cor H van der Leest, Arthur A J Smit, Albert J Polman, Laura C Vermeer, John W G van Putten, Ben E E M van den Borne, Michel M van den Heuvel, Maarten J Deenen","doi":"10.1016/j.cllc.2025.03.010","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.03.010","url":null,"abstract":"<p><strong>Purpose: </strong>Pemetrexed is a key drug in the immunochemotherapy of non-small cell lung cancer (NSCLC). However, its use is contraindicated in patients with renal impairment due to severe toxicity risks. As renal impairment is common in lung cancer patients, healthcare professionals face a dilemma between withholding effective treatment and risking toxicity. Real-world data on pemetrexed toxicity may aid in this decision. The primary objective of this study was to describe the toxicity profile of pemetrexed treatment in NSCLC patients with renal impairment.</p><p><strong>Patients and methods: </strong>This multicenter, descriptive, retrospective study was conducted across 9 hospitals in the Netherlands between 2015 and 2024. Patients included had a diagnosis of NSCLC, received ≥ 1 cycle of standard dose pemetrexed, and had a baseline creatinine clearance (CrCL)<45 mL/min. Data were collected on patient and treatment characteristics, hematological and nonhematological toxicity incidences, treatment discontinuation, dose reduction, and treatment-related hospitalization.</p><p><strong>Results: </strong>Forty-four patients were included, with median CrCL 41.1 mL/min (interquartile range: 35.0-43.9). Thirty-one patients (70%) did not finish 4 cycles of pemetrexed treatment, with 14 patients (45%) discontinuing due to pemetrexed-associated toxicity. More than half of patients (n = 28; 64%) were hospitalized due to treatment-related toxicity. Seventeen patients (39%) developed grade 3-4 neutropenia and leukopenia. Gastro-intestinal toxicity grade 3 to 4 occurred in fifteen (34%) patients.</p><p><strong>Conclusion: </strong>Pemetrexed treatment of NSCLC patients with moderate renal impairment was associated with high incidence of hematological toxicity, hospitalization, dose reduction, and treatment discontinuation. These results highlight the necessity of developing new treatment regimens to enable safe pemetrexed-based immunochemotherapy in NSCLC patients with renal impairment.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143957448","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}