Clinical lung cancer最新文献

{"title":"Lymphovascular Invasion is a Predictor of Postoperative Recurrence or Death in Stage I Non-small-cell Lung Cancer (NSCLC).","authors":"Margaret Locke, Wint Yan Aung, Michael Esposito, Nagashree Seetharamu","doi":"10.1016/j.cllc.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.07.001","url":null,"abstract":"<p><strong>Background: </strong>Histopathological features can be valuable prognostic tools in risk stratification of early-stage nonsmall cell lung cancers (NSCLC). This study evaluates the correlation between lymphovascular invasion (LVI), visceral pleural invasion (VPI), micropapillary pattern, and spread through airspaces (STAS) with outcomes in stage I NSCLC.</p><p><strong>Methods: </strong>Retrospective chart review was conducted on patients who underwent lung resection at a single academic center between 2015 and 2019 with pathology confirming NSCLC. Patients treated with neoadjuvant chemotherapy or with stage II or above cancers were excluded. Records were reviewed for demographics, histopathological features, Charlson comorbidity index (CCI), TNM staging (IASLC 8th edition), recurrence, and death. Recurrence free survival (RFS) was estimated via Kaplan-Meier Method. Correlation between STAS, VPI, LVI, micropapillary pattern, and patient outcomes was examined via multivariate Cox proportional hazards regression models.</p><p><strong>Results: </strong>A total of 596 patients were included in the analysis. Median follow-up was 35.3 months. Median RFS at 3 years was 88.4%. In multivariate analysis, LVI was an independent predictor for shorter RFS (HR = 4.19; 95% CI, 1.85-9.47; P < .001). Age > 75 and receipt of adjuvant chemotherapy were also found to be independent poor prognosticators. STAS, VPI, and micropapillary pattern had nonsignificant associations with RFS. A significant interaction was noted between LVI and adjuvant chemotherapy suggesting lower risk of recurrence (HR = 0.12; 95% CI, 0.02-0.74; P = .022).</p><p><strong>Conclusions: </strong>LVI was a strong independent predictor associated with postoperative recurrence. Adjuvant chemotherapy, while associated with poor prognosis overall, seemed to decrease the risk of recurrence in patients whose tumors had LVI.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717656","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 First-Line Anti-PD-1 Antibody Combined With Taxane-Platinum Versus Taxane-Platinum Alone in Metastatic Thymic Carcinoma: A Real-World Retrospective Study.","authors":"Maolin Liu, Jiaqi Zhao, Zuhui Liu, Dilimulati Abulizi, Yajing Wen, Xue Hou","doi":"10.1016/j.cllc.2025.06.010","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.06.010","url":null,"abstract":"<p><strong>Background: </strong>Thymic carcinoma (TC) is a rare, aggressive malignancy with limited treatment options. While paclitaxel combined with carboplatin is the standard first-line regimen, its efficacy remains suboptimal. This study assessed the efficacy and safety of adding anti-PD-1 antibodies to taxane-platinum (TP) in a homogeneous cohort.</p><p><strong>Methods: </strong>In this real-world retrospective study, 107 patients with metastatic TC were divided into the TP plus anti-PD-1 antibody (TP + PD-1) group (n = 47) and the TP group (n = 60). Survival outcomes were analyzed using the Kaplan-Meier method, and the factors affecting survival were evaluated by Cox regression analysis.</p><p><strong>Results: </strong>The TP + PD-1 group showed significantly prolonged median progression-free survival (PFS, 9.43 vs. 6.3 months; HR = 0.37, 95% CI, 0.25-0.65; P < .001), with comparable overall survival (52.3 vs. 32.8 months; HR = 0.44, 95% CI, 0.17-1.17; P = .080). Objective response rate (44.7% vs. 46.7%, P = .880) and disease control rate (97.9% vs. 90.0%, P = .085) were comparable between groups. Multivariate analysis identified anti-PD-1 antibody (HR = 0.34, P = .004) and ECOG PS (HR = 3.7, P = .009) as independent predictors of PFS. Grade 3-4 treatment-related adverse events (23.4% vs. 31.7%, P = .449) and immune-related adverse events (31.9% grade 1-2) were manageable.</p><p><strong>Conclusions: </strong>The addition of anti-PD-1 antibodies to TP significantly improved PFS in metastatic TC with manageable toxicity, suggesting that this combination may represent a promising first-line option. Further randomized trials are needed to confirm OS benefits.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717655","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":"Response to the Letter to the Editor on \"CNS Outcomes of Osimertinib Plus Chemotherapy in Patients with EGFR Mutation-Positive Lung Cancer Beyond Osimertinib Progression\".","authors":"Wesley Wong, Molly Li","doi":"10.1016/j.cllc.2025.06.007","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.06.007","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667344","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 Outcomes of Compound EGFR Mutations in Non-Small Cell Lung Cancer: A National, Retrospective, Multicenter Study.","authors":"Lina Atlagh, Anne-Claire Toublanc, Benoit Roch, Arianna Marinello, Julia Ruuth-Praz, Sophie Cousin, Christos Chouaid, Céline Basset, Solène Evrard, Michaël Duruisseaux, Nicolas Girard, Karine Durand, Julien Mazières, Aurélien Brindel","doi":"10.1016/j.cllc.2025.06.005","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.06.005","url":null,"abstract":"<p><strong>Background: </strong>Compound EGFR mutations are found in a rare proportion of non-small cell lung cancer (NSCLC). Currently there is no clear recommendation regarding the best therapeutic strategy in this setting. Chemotherapy, and tyrosine kinase inhibitors (TKI) are often used as first or second line of treatment. Recently, an in vitro structure-based classification of EGFR mutations showed a promising way of predicting response to treatment (Robichaux JC, Nature 2021).</p><p><strong>Methods: </strong>We conducted a multicenter, retrospective, nationwide study of patients with advanced non-small cell lung cancer (NSCLC) harboring compound EGFR mutations. The common T790M mutation and exon 20 insertions were excluded. Compound EGFR mutations were structure-based classified as classical mutations and P-loop and αC-helix compressing (PACC) mutations or unclassified mutations. Clinical data and outcome of selected patients were collected. Overall survival (OS) and progression free survival (PFS) according to structure-based classification and exon-based classification were reported, overall survival being the primary objective.</p><p><strong>Results: </strong>Eighty-one patients were enrolled in the analysis, including 24 patients in \"classical mutations\" group, 36 in the PACC group, and 21 as unclassified group. Median overall survival (OS) of the population was 42 months (95% CI, 25.5-64.4), significantly different according to structure-based classification (69.5 m in unclassified group, vs 47 m in classical mutations group and 24,3 in PACC mutations group, P = .01). There was no significant difference in OS according to the type of first-line treatment in the overall population or the presence or not of a frequent mutation (L858R or Del19). The median progression free survival in the first line setting (PFS1L) was shorter in the chemotherapy group (7.1 m.; 95% CI, 1.9-12.2) than in the TKI group (12.6 m.; 95% CI, 8.6-17), P = .005. In the PACC group, PFS1L was higher in the osimertinib group compared to other treatments, HR 0.34 (95% CI, 0.12-0.99), P=.027, whereas no difference was observed in other structure-based groups.</p><p><strong>Conclusions: </strong>This study demonstrates that treatment with TKIs is associated with favorable outcomes in patients with compound EGFR mutations. Structure-based configuration of EGFR might also be considered when selecting a first-line TKI.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717681","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":"Letter to the Editor: \"CNS Outcomes of Osimertinib Plus Chemotherapy in Patients With EGFR Mutation-Positive Lung Cancer Beyond Osimertinib Progression\".","authors":"Arif Hakan Önder","doi":"10.1016/j.cllc.2025.06.009","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.06.009","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625500","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 Case of Retroperitoneal Fibrosis During Antiprogrammed Cell Death 1 Antibody Treatment.","authors":"C Kouroussis, L Thanos, A Tsipoura, G Koulaxouzidis, V Chaniotis","doi":"10.1016/j.cllc.2025.06.008","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.06.008","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144697814","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":"Impact of Unsuccessful Steroid Tapering on Survival in Patients Treated for Radiation Pneumonitis Following Definitive Radiation for Non-Small Cell Lung Cancer.","authors":"Aya Ghaleb Hashim, Rasmus Froberg Brøndum, Martin Skovmos Nielsen, Kasper Lind Laursen, Sille Vestergaard, Wenja Heijkoop, Weronika Maria Szejniuk","doi":"10.1016/j.cllc.2025.06.002","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.06.002","url":null,"abstract":"<p><strong>Objectives: </strong>Radiation pneumonitis (RP) presents a significant concern in the management of patients with locally advanced non-small cell lung cancer (NSCLC) undergoing definitive radiation therapy (RT). This study aims to investigate the clinical implication of unsuccessful steroid tapering due to rebound of respiratory symptoms in patients diagnosed with RP.</p><p><strong>Materials and methods: </strong>This retrospective analysis included NSCLC patients treated with definitive RT between 2010 and 2020. Clinical data, steroid treatment outcome for RP, progression and survival data were collected. Patients were stratified based on RP diagnosis and successful or unsuccessful tapering of steroids due to rebound of respiratory symptoms. Survival was estimated using Kaplan-Meier and log-rank analyses. Univariate and multivariate Cox regression analyses were performed, P-values < .05 were considered significant.</p><p><strong>Results: </strong>The cohort consisted of 273 patients. About 30.4% of patients (n = 83) developed RP. In the RP-group, 22.9% (n = 19) experienced unsuccessful tapering of steroid due to rebound of respiratory symptoms. Median progression-free survival (PFS) and overall survival (OS) in those patients were 9.0 months (95% CI 6.4-13.8) and 22.2 months (95% CI 17.0-34.9) respectively, significantly shorter than median PFS of 14.8 months (95% CI 5.9-36.3) and OS of 43.4 months (95% CI 27.9-71.2) in patients with successful tapering. A multivariate Cox regression with time-varying covariates confirmed the significantly higher risk of progression and death in those patients.</p><p><strong>Conclusion: </strong>Patients with RP who experienced unsuccessful tapering of steroids due to rebound of respiratory symptoms had a significantly higher risk of progression and death compared to RP patients with successful tapering of steroids. More frequent surveillance may be considered in those patients.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616627","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":"Genomic Landscape of Resected Invasive Mucinous Adenocarcinoma of the Lung.","authors":"Katsuhiro Masago, Hiroaki Kuroda, Katsutoshi Seto, Eiichi Sasaki, Yasuko Fujita, Yoshitsugu Horio, Shiro Fujita, Hirokazu Matsushita","doi":"10.1016/j.cllc.2025.06.004","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.06.004","url":null,"abstract":"<p><strong>Background: </strong>Invasive mucinous adenocarcinoma (IMA) is a rare subtype of lung adenocarcinoma, accounting for 3%-10% of cases. It is often associated with KRAS mutations or, in nonsmokers, NRG1 fusions. Approximately 20% of IMAs have unclear genomic backgrounds. This study aimed to clarify the genomic etiology of these cases through a retrospective molecular analysis and RNA sequencing.</p><p><strong>Patients and methods: </strong>This study analyzed 107 cases of NSCLC that were treated by surgical resection at Aichi Cancer Center from 2009 to 2023, with a focus on IMAs. For cases with unclear genomic backgrounds, RNA sequencing was conducted to identify potential driver gene alterations, and the results were compared to those of known KRAS-positive cases. Statistical analyses, including Cox regression and Kaplan-Meier analyses, were used to evaluate risk factors, recurrence-free survival, and the prognosis.</p><p><strong>Results: </strong>In this study, 107 cases of resected IMA were analyzed. KRAS mutations were found in 70.1% of cases, followed by NRG1 fusions (9.2%), and other mutations. A novel fusion gene, ATP6V1H::LYN, was discovered in 1 case. RNA sequencing and a gene set enrichment analysis revealed distinct molecular pathways in KRAS-positive tumors, including the activation of oxidative phosphorylation and TNFα-NF-κB signaling. Tumors with no driver gene alterations exhibited a higher frequency of copy number variations and tumor mutational burden than KRAS and NRG fusion-positive cases.</p><p><strong>Conclusion: </strong>IMAs are characterized by relatively higher incidences of harboring KRAS mutations and NRG fusion genes, revealing potential therapeutic targets including druggable mutations and immune-related markers, while highlighting the heterogeneous genomic background and utility of RNA sequencing.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599591","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":"Assessing Factors Associated With Patient-Provider Discussions About Lung Cancer Screening Using Andersen's Behavioral Model of Health Services Utilization.","authors":"Owen Y Cai, Jessica R Fernandez, Melinda C Aldrich, Jennifer Richmond","doi":"10.1016/j.cllc.2025.06.006","DOIUrl":"10.1016/j.cllc.2025.06.006","url":null,"abstract":"<p><strong>Background: </strong>Patient-provider shared decision-making discussions are an important component of lung cancer screening guidelines, but little is known about factors associated with these discussions among screening-eligible patients. We used Andersen's Behavioral Model of Health Services Utilization to examine factors associated with discussing LCS with a provider.</p><p><strong>Patients: </strong>Data came from an online survey of N = 516 U.S. adults meeting United States Preventive Services Task Force LCS eligibility criteria (ie, were 50-80 years of age and had at least a 20-pack year history of tobacco use).</p><p><strong>Methods: </strong>We used logistic regression to investigate whether having a LCS discussion was associated with predisposing factors (eg, chronic obstructive pulmonary disease [COPD] diagnosis), enabling factors (eg, having a primary care provider [PCP]), and need factors (eg, smoking history).</p><p><strong>Results: </strong>About 36% participants had ever discussed LCS with a provider. Participants diagnosed with COPD (OR = 3.56, 95% CI, 1.90-6.67) and who had a first-degree relative with lung cancer (OR = 1.78, 95% CI, 1.02-3.09) had higher odds of LCS discussion than those without COPD and with no family history, respectively. Women had lower odds of LCS discussion than men (OR = 0.37, 95% CI, 0.24-0.58). Participants with an income of $30,000 to $59,999 had higher odds of LCS discussion compared to those earning < $30,000 (OR = 1.78, 95% CI, 1.06-2.98). Not having a PCP (OR = 0.39, 95% CI, 0.21-0.72) and currently smoking (OR = 0.38, 95% CI, 0.18-0.79) were associated with lower odds of LCS discussion.</p><p><strong>Conclusions: </strong>Future interventions are needed to ensure all LCS-eligible individuals have access to provider discussions about LCS.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574958","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":"Pulmonary Sclerosing Pneumocytoma Masquerading as a Carcinoid Tumor.","authors":"Rucha Alur, Omar Bushara, Anna Garcia Whitlock, Alessandro Brunetti, Roseann Wu, Sunil Singhal","doi":"10.1016/j.cllc.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.05.008","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574959","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}