Clinical lung cancer最新文献

{"title":"Osimertinib as First-Line Treatment for Patients With Advanced EGFR Mutation-Positive Non-Small Cell Lung Cancer in a Real-World Setting: Updated Overall Survival Data (OSI-FACT-OS).","authors":"Yoshihiko Sakata, Go Saito, Shinya Sakata, Teppei Yamaguchi, Motohiro Tamiya, Hidekazu Suzuki, Ryota Shibaki, Asuka Okada, Toshihide Yokoyama, Hirotaka Matsumoto, Taiichiro Otsuki, Yuki Sato, Junji Uchida, Yoko Tsukita, Megumi Inaba, Hideki Ikeda, Daisuke Arai, Hirotaka Maruyama, Satoshi Hara, Shinsuke Tsumura, Jun Morinaga, Takuro Sakagami","doi":"10.1016/j.cllc.2025.05.015","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.05.015","url":null,"abstract":"<p><strong>Background: </strong>Previously, we reported on osimertinib (OSI) as a first-line treatment for EGFR mutation-positive non-small cell lung cancer (EGFRm+ NSCLC) in a real-world setting. However, owing to the limited observation period, data on overall survival (OS) and long-term safety were not reported. Therefore, in this study, we aimed to assess the long-term efficacy and safety of OSI in patients with EGFRm+ NSCLC.</p><p><strong>Patients and methods: </strong>We extended the observation period until July 2023 for 538 patients with EGFRm+ NSCLC who received OSI between August 2018 and December 2019.</p><p><strong>Results: </strong>The median observation period was 37 months. The number of events was 392 (72.9%) for progression-free survival (PFS) and 285 (53%) for OS. The median PFS was 20.1 months (95% CI: 17.1-22.1) and median OS was 42.0 months (95% CI: 37.7-48.4). Safety data showed incidences of the following adverse events: pneumonitis (all grades/grade ≥ 3/grade 5), 90 (16.7%)/28 (5.2%)/5 (0.9%); grade ≥ 3 nonhematologic toxicity, 69 (12.8%); grade ≥ 3 hematologic toxicity, 34 (6.3%); QT prolongation (all grades/grade ≥ 3), 25 (4.6%)/8 (1.3%); and ejection fraction decrease and heart failure (all grades/grade ≥ 3), 14 (2.6%)/10 (1.9%). Regarding late adverse events manifesting after 1 year of treatment, 17 cases of pneumonitis and 7 cases of cardiotoxicity were recorded.</p><p><strong>Conclusion: </strong>This study supports the long-term efficacy of OSI, with PFS and OS comparable to those in the FLAURA trial in a Japanese real-world setting. However, it highlights the need for careful and long-term safety monitoring throughout the treatment period.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526724","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":"Activity of Brigatinib in Patients With Crizotinib-Resistant ALK-positive Non-Small-Cell Lung Cancer According to ALK Fusion and Mutation Status.","authors":"Lyudmila Bazhenova, J G Hodgson, D Ross Camidge, Corey J Langer, Rudolf M Huber, Dong-Wan Kim, Karen L Reckamp, Myung-Ju Ahn, Daniel S W Tan, Jyoti D Patel, Sylvie Vincent, Cong Li, Michael J Humphries, Pingkuan Zhang, Victor M Rivera, Scott Gettinger","doi":"10.1016/j.cllc.2025.05.016","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.05.016","url":null,"abstract":"<p><strong>Background: </strong>Brigatinib, a selective ALK inhibitor, demonstrated preclinical activity against a range of crizotinib-resistant ALK alterations in NSCLC. We examined associations between brigatinib efficacy and tumor- and plasma-detected driver mutations in crizotinib-resistant ALK fusion-positive NSCLC.</p><p><strong>Patients and methods: </strong>Tumor tissue and plasma circulating tumor DNA (ctDNA) from patients with crizotinib-exposed ALK-positive NSCLC receiving brigatinib in phase 1/2 and phase 2 ALTA trials were analyzed by next-generation sequencing. Objective response rate (ORR) and progression-free survival (PFS) were assessed by mutation status.</p><p><strong>Results: </strong>Ninety-three patients were molecularly profiled at baseline (tumor, 26; ctDNA, 59; 8 with both). Patients received a range of doses, most commonly 90 mg QD. For patients with baseline tumor samples, ORR was 78% (7/9) and median PFS was 11.1 months in patients with secondary ALK mutations co-occurring with ALK fusion, compared with 89% (17/19) and 12.9 months, respectively, in those without ALK mutations. For patients with ctDNA-detectable ALK fusion, ORR was 60% (6/10) and median PFS was 9.2 months in those with secondary ALK mutations, and 50% (10/20) and 21.4 months, respectively, without secondary ALK mutations. The 1 patient with baseline G1202R responded. Six patients had baseline alterations in non-ALK secondary drivers (EGFR, KRAS, NRAS, BRAF, MET); none had response. Emergent G1202R was noted in 3 patients and ALK amplification in 3 patients.</p><p><strong>Conclusion: </strong>Brigatinib showed substantial activity in crizotinib-pretreated ALK-positive NSCLC with ALK-dependent mechanisms of resistance. Patients with non-ALK canonical drivers did not respond to brigatinib, suggesting alternative therapeutic approaches in that cohort.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526723","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":"Maximizing Lung Cancer Screening in High-Risk Population Leveraging ML-Developed Risk-Prediction Algorithms: Danish Retrospective Validation of LungFlag.","authors":"Margrethe Bang Henriksen, Ole Hilberg, Christian Juul, Rasmus Thomsen, Sara Witting Christensen Wen, Morten Borg, Andreas Fanø, Alon Lanyado, Itamar Menuhin-Gruman","doi":"10.1016/j.cllc.2025.05.017","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.05.017","url":null,"abstract":"<p><strong>Background: </strong>Early detection of lung cancer (LC) is crucial for curative treatment, but current screening methods face challenges due to high costs and poor adherence. Artificial intelligence tools, such as the LungFlag model, uses routine clinical data for innovative risk stratification. This study validates LungFlag in Danish high-risk populations to assess its potential in LC screening.</p><p><strong>Methods: </strong>This retrospective study included data from 2 populations in Southern Denmark (2013-2021): (A) LC fast-track clinic patients (∼25% LC incidence) and (B) outpatients followed with chronic obstructive pulmonary disease (COPD) (∼6% LC incidence). Data included laboratory results, comorbidities, body mass index (BMI), and smoking history from up to 3 years prior to the index date. LungFlag's performance was compared to the PLCOm2012 model. Model interpretation was conducted using Shapley additive explanation (SHAP) values, and risk stratification was analyzed by age.</p><p><strong>Results: </strong>In Population A, 5271 LC cases were identified from 18,600 patients, with a stable LC incidence of 28%. In Population B, LC incidence varied by index-date approach: 6.6% using the diagnosis date and 2.1% using the first visit approach. LungFlag outperformed PLCOm2012 in Population A (AUC: 0.63 vs. 0.60) and showed slightly higher sensitivity in Population B, though differences were minor. Key predictors included smoking, age, and COPD. High-risk individuals identified by LungFlag were generally younger compared to using PLCOm2012.</p><p><strong>Conclusion: </strong>LungFlag demonstrates promise as a decision-support tool in detecting LC, particularly for COPD patients, who lack systematized screening. However, prospective real-world studies are needed to confirm its effectiveness and clinical value.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539181","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":"Osimertinib Dose Optimization Guided by Therapeutic Drug Monitoring in Patients With EGFR-Mutated Advanced Non-Small Cell Lung Cancer: A Case series.","authors":"Paul D Kruithof, Anita J W M Brouns, Juliette H R J Degens, Lizza E L Hendriks, Dennis R Wong, Robin M J M van Geel, Sander Croes","doi":"10.1016/j.cllc.2025.05.012","DOIUrl":"10.1016/j.cllc.2025.05.012","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332570","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":"Predictors of Multidisciplinary Tumor Board Adherence in Stage III Non-Small-Cell Lung Cancer Patients From a Large Multicenter Study.","authors":"Kira-Lee Koster, Sarvaganthasenay Yohasenan, Ahmet Samil Pakmak, Michael Mark, Yannis Metaxas, Carolin Lips, Felicitas Hitz, Pawel Leskow, Corinna Ludwig, Paul Martin Putora, Markus Glatzer, Tino Schneider, Claudio Caviezel, Thomas Mader, Mohsen Mousavi, Marcel Blum, Martin Früh, Markus Joerger","doi":"10.1016/j.cllc.2025.05.010","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.05.010","url":null,"abstract":"<p><strong>Background: </strong>While formalized treatment recommendations for non-small cell lung cancer (NSCLC) by a multidisciplinary tumor board (MDT) have been associated with improved patient care and potentially improved survival, there is no data on the prognostic impact of individual adherence to initial MDT treatment recommendations in patients (pts) with stage III NSCLC.</p><p><strong>Patients and methods: </strong>Multimodal treatment data for stage III NSCLC pts between 2014 and 2020 were collected from 3 Swiss referral centers. All pts underwent MDT before treatment. MDT-adherence was defined as implementation of the initially recommended treatment modalities and their sequence. Event-free survival (EFS) (primary endpoint) and overall survival (OS) were subjected to Kaplan-Meier analysis, MDT adherence to multivariable Cox regression analysis.</p><p><strong>Results: </strong>Adherence to initial MDT recommendations was found in 385/547 (70.4%) eligible pts. Treatment de-escalation was the prominent feature in 109/162 (67.3%) non MDT-adherent pts, resulting in 89/547 (16.3%) pts receiving non-curative treatment. Pts ≥ 65 years of age had an increased risk for MDT nonadherence (32.8% vs. 23.0%, P = .02), as had pts with a higher tumor stage (19.8% for IIIA, 38.5% for IIIB, 43.3% for IIIC, P < .001) and frail (ECOG ≥ 2) pts (53.7% vs. 22.8%, P < .001). Median EFS was higher in MDT-adherent pts (11.9 months vs. 8.6 months (mo), P = 0.003), as was OS (20.3 mo vs. 9.4 mo, P < .001).</p><p><strong>Conclusions: </strong>One third of stage III NSCLC pts is unable to adhere to initial MDT recommendations even in tertiary referral centers. Nonadherence was associated with worse outcome. Treatment strategies for vulnerable pts should critically be reviewed.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495030","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 Following First-Line Immune Checkpoint Inhibitors With or Without Chemotherapy Stratified by KRAS Mutational Status-A Real-World Analysis in Patients With Advanced NSCLC.","authors":"David J Cantor, Halla Nimeiri, Leora Horn, Matthew West, Rotem Ben-Shachar, Iker Huerga, Jyoti D Patel, Charu Aggarwal","doi":"10.1016/j.cllc.2025.05.007","DOIUrl":"10.1016/j.cllc.2025.05.007","url":null,"abstract":"<p><strong>Introduction: </strong>Prior studies evaluating the efficacy of first line (1 L) immune checkpoint inhibitor (ICI) monotherapy or combined chemoimmunotherapy in advanced NSCLC found improved outcomes with chemoimmunotherapy independent of PD-L1 and KRAS mutation status. As such, combined chemoimmunotherapy was proposed as the preferred comparator arm for 1 L trials in KRAS mutated (KRAS mt) NSCLC. Herein, we report a multimodal, real world data (RWD) analysis for outcomes with 1 L therapy in patients with advanced NSCLC stratified by KRAS mutation status and PD-L1 levels.</p><p><strong>Patients and methods: </strong>Deidentified, multimodal RWD from the Tempus database was utilized to retrospectively analyze 1980 patients with advanced NSCLC receiving 1 L ICI containing therapy. Patients were stratified by tumor KRAS mutational status. Subgroup analyses were performed using Cox model stratified by KRAS mutational status, PD-L1 levels, and the presence of pathogenic alterations in STK11, KEAP1 and TP53.</p><p><strong>Results: </strong>KRAS mutations were identified in 33.4% (662/1980) of patients. There was a higher proportion of PD-L1 high tumors in the KRASmt to KRAS wild-type cohort. Among KRASmt NSCLC, median overall survival (mOS) was longest in the PD-L1 high cohort. Patients with KRAS G12C and PD-L1 high tumors had the longest mOS at 30.28 months. Finally, pathogenic mutations in KEAP1 and STK11 correlated with worse outcomes in KRASmt tumors.</p><p><strong>Conclusions: </strong>Outcomes following 1 L therapy in KRASmt advanced NSCLC varied based on PD-L1 levels and the presence of STK11 and KEAP1 co-mutations, indicating that KRASm NSCLC represents a heterogeneous disease.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339888","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":"Phase II Trial of LP-300 in Combination With Carboplatin and Pemetrexed in Never Smoker Patients With Relapsed Advanced Primary Adenocarcinoma of the Lung After Treatment With Tyrosine Kinase Inhibitors.","authors":"J Nicholas Bodor, Jonathan Dowell, Joseph Treat, Janakiraman Subramanian, Nihal Abdulla, Eric Lee, Kamlesh Sankhala, Chun-Hui Lee, Go Makimoto, Eisaku Miyauchi, Kartik Konduri, Hajime Asahina, Shuji Murakami, Yueh-Feng Wen, Yung-Hung Luo, Shan Yueh Chang, Reginald Ewesuedo, Jianli Zhou, Yasushi Goto","doi":"10.1016/j.cllc.2025.05.013","DOIUrl":"10.1016/j.cllc.2025.05.013","url":null,"abstract":"<p><strong>Introduction: </strong>Most patients with non-small cell lung cancer (NSCLC) who have never smoked possess tumors bearing tyrosine kinase oncogenes. While such tumors may exhibit robust responses to front-line tyrosine inhibitors (TKIs), disease progression is inevitable. Subsequent available therapies confer limited benefit, thus developing effective treatments for these patients remains a critical need. LP-300 is a novel compound that enhances chemotherapy sensitivity and inhibits the activity of tyrosine kinase oncogenes. Retrospective subset analyses of prior phase III studies found females and never-smokers, groups likely to have oncogene-driven tumors, obtained a considerable survival advantage with LP-300 combined with platinum-based chemotherapy as compared to chemotherapy alone. Prospective validation of these findings in patients with oncogene-driven NSCLC is needed.</p><p><strong>Methods: </strong>The HARMONIC clinical trial, which is currently in progress, is a global, randomized, phase II study (NCT05456256) evaluating the 3-drug regimen of LP-300 with pemetrexed and carboplatin versus pemetrexed and carboplatin alone in 90 patients with advanced primary lung adenocarcinoma bearing tyrosine kinase oncogenes. Patient randomization is stratified by gender and favors the LP-300 containing arm (2-1). Patients must have tumors bearing tyrosine kinase actionable alterations (i.e. EGFR, ALK, ROS1, MET, RET, BRAF, or NTRK) and have prior TKI progression or intolerance. Primary endpoints are progression-free survival (PFS) and overall survival (OS). Secondary endpoints include objective response rate, duration of objective response, clinical benefit rate, and incidence of adverse events.</p><p><strong>Conclusion: </strong>This phase II trial is accruing patients at sites in the U.S, Japan, and Taiwan. Patient accrual is expected to be completed in the Fall of 2026.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368698","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 Patient-Centric, Open-Label, Multicenter, Phase II Study of Lorlatinib Monotherapy in the First-Line Treatment of Patients With locally Advanced or Metastatic ALK-Positive Non-Small Cell Lung Cancer (CTONG2203).","authors":"Jia-Xin Lin, Qing Zhou, Hong-Hong Yan, An-Wen Liu, Guo-Wu Wu, Qian Chu, Ying-Ying Du, Jiu-Wei Cui, Ying Cheng, Yi Yang, Hai-Peng Xu, Hai-Yan Tu, Yi-Long Wu, Si-Yang Maggie Liu","doi":"10.1016/j.cllc.2025.05.014","DOIUrl":"10.1016/j.cllc.2025.05.014","url":null,"abstract":"<p><strong>Background: </strong>Lorlatinib is a potent third-generation ALK tyrosine kinase inhibitor (TKI). CROWN study demonstrated remarkable efficacy and manageable toxicity of first-line lorlatinib treatment for advanced non-small cell lung cancer (NSCLC) with ALK rearrangements. However, only 10 ALK-positive NSCLC patients were randomized to the lorlatinib group in China mainland. There is a vast vacancy of efficacy and safety regarding first-line lorlatinib treatment in China advanced ALK-positive NSCLC. Additionally, understanding of the benefit-risk profile of lorlatinib in a broader population and real-world data of diversity of ALK-TKIs are limited.</p><p><strong>Patients and methods: </strong>We adopted a patient-centric trial (PCT) design to provide more generalizable data to better inform clinical decision-making. This is a 3 cohorts, open-label, multicenter, phase II study (CTONG2203), conducted to prospectively enroll 189 treatment-naïve patients with advanced ALK-positive NSCLC in China, which was divided into 2 treatment intervention cohorts and real-world observing (RO) cohort. The treatment intervention cohorts include restrictive eligibility criteria \"CROWN criteria (CC) cohort,\" and broadening eligibility criteria \"Expand Eligibility Criteria (EC) cohort,\" who will receive first-line lorlatinib treatment. And we concomitantly set up a prospective RO cohort to observe the clinical outcomes of these patients treated with different ALK-TKI who received physician's therapy of choice.</p><p><strong>Conclusion: </strong>This patient-centric study will contribute data on efficacy, safety and resistance mechanism of first-line lorlatinib, and offer better perspectives on the current status of real-world treatment of ALK-TKIs in advanced ALK-positive NSCLC in China.</p><p><strong>Clinical trial registration: </strong>NCT06092086 (CTONG 2203).</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336384","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":"Baseline Characteristics of Participants and Pulmonary Nodules in the Watch the Spot Trial: A Pragmatic Trial of Less versus More Intensive Strategies for Active Surveillance of Patients With Small Pulmonary Nodules.","authors":"Michael K Gould, Evan de Bie, Lihong Qi, Beth Creekmur, Peter J Mazzone, Richard A Mularski, Debra P Ritzwoller, Christopher G Slatore, Anil Vachani, Eric C Walter, Renda Soylemez Wiener, Debra S Dyer, Charlene E McEvoy, Karen Kelly, Rebecca Smith-Bindman, Diana L Miglioretti","doi":"10.1016/j.cllc.2025.05.011","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.05.011","url":null,"abstract":"<p><strong>Background: </strong>Optimal surveillance strategies for patients with small pulmonary nodules are uncertain. The Watch the Spot Trial, a large, cluster-randomized, pragmatic clinical trial, compared less- versus more-intensive strategies for surveillance of patients with incidental or screening-detected nodules ≤15 mm.</p><p><strong>Methods: </strong>We describe between-site variation in methods to identify and enroll patients with small nodules; we used standard measures to describe baseline characteristics of participants and nodules.</p><p><strong>Results: </strong>Participants included a diverse sample of 34,686 individuals who were passively enrolled at one of 14 participating healthcare systems using methods tailored to fit each site. Most patient characteristics were similar between the more- and less-intensive study arms, but participants in the more-intensive arm were more likely to identify as Hispanic/Latino (19.9% vs. 16.5%) or Black (17.8% vs. 10.5%). People who never smoked comprised 35.9% of the sample, and 22.7% of participants had ≥3 comorbidities. Screening-detected nodules were more common in the less-intensive arm (26.2% vs. 14.3%), but arms were balanced for nodule size, lobe, laterality and attenuation. Over 40% of identified nodules measured ≤4 mm in size, while only 14.1% of nodules measured >8 mm. Nodule attenuation and edge characteristics were not described in 36.7% and 74.5% of radiology reports, respectively. Few nodules were noted to be nonsolid (9.5%) or part-solid (3.2%).</p><p><strong>Conclusions: </strong>In a real-world sample of patients with pulmonary nodules measuring ≤15 mm, many nodules were of questionable importance (≤4 mm), and information about nodule attenuation and edge was often not specified by radiologists, representing important opportunities for quality improvement.</p><p><strong>Clinical trials registration: </strong>NCT02623712.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301259","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":"Chemotherapy Plus Anti-PD-1 or Anti-PD-L1 in Advanced PD-L1-Negative Squamous Cell Lung Carcinoma: A Systematic Review and Meta-Analysis.","authors":"Nicolas Peruzzo, Gabriel Lenz, Ted Akhiwu, Mariah Bilalaga, Greeshma Nihitha Gaddipati, Nathalia Luisy Farias Müller, Loren Zarpellon, Fernando Venero, Marcelo Corassa, Andrés F Cardona, Joshua E Reuss, Bruna Pellini","doi":"10.1016/j.cllc.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.04.006","url":null,"abstract":"<p><strong>Introduction: </strong>Squamous cell lung carcinoma (sqNSCLC) accounts for 25% to 30% of all non-small cell lung cancer (NSCLC) cases and is associated with a worse prognosis. Although immune checkpoint inhibitors improve outcomes in advanced sqNSCLC, the true benefit of chemotherapy plus anti-PD-(L)1 in patients with advanced PD-L1-negative sqNSCLC is unclear.</p><p><strong>Material and methods: </strong>We performed a systematic review and meta-analysis of randomized clinical trials comparing chemotherapy plus anti-PD-(L)1 to chemotherapy with or without placebo in locally advanced (ineligible for concurrent chemoradiation or surgery) or metastatic PD-L1-negative sqNSCLC.</p><p><strong>Results: </strong>A total of 1548 patients with advanced PD-L1-negative sqNSCLC from 11 studies were included. Of these, 810 patients (52%) received chemotherapy plus anti-PD-(L)1 (intervention group), while 738 patients (48%) received chemotherapy with or without placebo (control group). All included studies were phase 3 trials and used platinum-doublet chemotherapy regimens. Chemotherapy plus anti-PD-(L)1 was associated with increased probability of overall response rate (risk ratio, 1.36; 95% CI, 1.16-1.60; P = .0001), increased progression-free survival (HR = 0.58; 95% CI, 0.48-0.69; P < .00001), and increased overall survival (HR = 0.81; 95% CI, 0.69-0.96; P = .02) compared to chemotherapy, with or without placebo.</p><p><strong>Conclusions: </strong>Our findings support the use of combination anti-PD-(L)1 plus chemotherapy as first-line therapy for patients with advanced PD-L1-negative sqNSCLC. Prospective studies are warranted to determine whether dual checkpoint inhibition, with or without chemotherapy, is superior to anti-PD-(L)1 plus chemotherapy in this patient population.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265517","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}