Clinical lung cancer最新文献

{"title":"Clinicogenomic Predictors of First-line Immune Checkpoint Inhibitor Outcomes in Non–Small Cell Lung Cancer: A Nationwide CCAT Cohort From Japan","authors":"Mika Iwasaki ,&nbsp;Takahiro Ando ,&nbsp;Koki Fujii ,&nbsp;Kousuke Watanabe ,&nbsp;Katsutoshi Oda ,&nbsp;Hidenori Kage","doi":"10.1016/j.cllc.2026.03.003","DOIUrl":"10.1016/j.cllc.2026.03.003","url":null,"abstract":"<div><h3>Background</h3><div>The efficacy of immune checkpoint inhibitors (ICIs) in non-small cell lung cancer (NSCLC) varies, requiring predictive biomarkers.</div></div><div><h3>Methods</h3><div>We analyzed the nationwide Center for Cancer Genomics and Advanced Therapeutics (C<img>CAT) database and identified 1629 patients with stage IV NSCLC who received first-line ICI-based therapy between 2019 and 2025. The primary endpoint was time to treatment failure (TTF); the secondary endpoint was overall survival (OS). Age-stratified Cox models were adjusted for covariates. Genomic covariates included <em>KRAS, KEAP1</em>, and <em>STK11</em>, with genes from exploratory screening. We tested <em>KRAS</em>–<em>KEAP1</em> and <em>KRAS</em>–<em>STK11</em> interactions. Sensitivity analyses included an FFPE-only subset with tumor mutational burden (TMB) and models adjusting for the ECOG status.</div></div><div><h3>Results</h3><div><em>BRAF</em> mutation was independently associated with longer TTF (HR 0.77, 95% CI 0.59-1.00; <em>P</em> = .049), whereas <em>KRAS, KEAP1</em>, and <em>STK11</em> alone were not. A significant <em>KRAS</em>–<em>KEAP1</em> interaction was associated with shorter TTF (HR 1.89, 95% CI 1.06-3.36; <em>P</em> = .032). In a 4-level comparison versus wild-type, <em>KRAS</em>-only and <em>KEAP1</em>-only were not significant, whereas <em>KRAS</em>–<em>KEAP1</em> co-mutation was associated with higher risk of failure (HR 2.48, 95% CI 1.50-4.10; <em>P</em> &lt; .001). Results were consistent across sensitivity analyses. <em>KEAP1</em> and <em>STK11</em> were associated with worse OS, while <em>BRAF</em> showed no OS advantage.</div></div><div><h3>Conclusions</h3><div>In first-line ICI–treated stage IV NSCLC, <em>KRAS</em>–<em>KEAP1</em> co-mutation, not <em>KRAS</em> or <em>KEAP1</em> alone, identifies patients at high risk of early failure, whereas <em>BRAF</em> was associated with longer TTF. These findings highlight the importance of co-mutation profiling and warrant prospective validation with integrative models incorporating PD-L1 and TMB.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 4","pages":"Pages 81-90.e7"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147607824","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":"Stereotactic Versus Conventional Radiotherapy in Medically Inoperable Stage I Non–Small Cell Lung Cancer: A Bayesian Reanalysis of the LUSTRE Randomized Trial","authors":"Yanchen Wang ,&nbsp;Elysia K. Donovan ,&nbsp;Mark N. Levine ,&nbsp;Timothy J. Whelan ,&nbsp;Anand Swaminath ,&nbsp;Sameer Parpia","doi":"10.1016/j.cllc.2026.03.008","DOIUrl":"10.1016/j.cllc.2026.03.008","url":null,"abstract":"<div><h3>Introduction</h3><div>The results of the LUSTRE trial investigating stereotactic body radiotherapy in early-stage non–small cell lung cancer were inconclusive. A Bayesian analysis could potentially address this by integrating prior knowledge.</div></div><div><h3>Methods</h3><div>The LUSTRE trial was a randomized-controlled superiority trial conducted from 2014 to 2020. Patients with medically inoperable Stage I non–small cell lung cancer were randomized 2:1 to stereotactic radiotherapy (intervention) or conventional radiotherapy (control). The primary outcome was time-to-local control, defined as the period from randomization to absence of a primary tumor or marginal failure during follow-up. Primary analyses used Bayesian multivariable Cox regression, adjusting for strata (tumor size, tumor location, and clinical center). A neutral prior distribution was used for primary analysis, with optimistic (obtained from meta-analyses of 2 previous trials) and pessimistic prior distributions/knowledge for sensitivity analyses.</div></div><div><h3>Results</h3><div>Among 233 patients, 154 received stereotactic radiotherapy, and 79 received conventional radiotherapy. Using a noninformative neutral prior distribution, there was a 91% probability that the posterior adjusted hazard ratio (aHR) for local control with stereotactic radiotherapy was less than 1 (posterior aHR: 0.63, 95% credible interval, 0.32, 1.25). Incorporating the optimistic prior distribution, the posterior aHR was 0.62 (95% credible interval, 0.37, 1.02), indicating a 97% probability of benefit. Under the pessimistic prior distribution, the posterior aHR was 0.97 (95% credible interval, 0.71, 1.34), suggesting a 57% probability of benefit.</div></div><div><h3>Conclusions</h3><div>Post hoc Bayesian reanalyses provided additional insight into the posterior probability of local control benefit with stereotactic radiotherapy.</div></div><div><h3>LUSTRE trial registry ID</h3><div>NCT01968941 (date of registration: October 21, 2013)</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 4","pages":"Pages 117-122.e4"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715875","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":"Mapping Real-world Rebiopsy Events to Treatment Trajectories in EGFR/ALK/ROS1-Driven Non-small-cell Lung Cancer: Insights from the AURORA Cohort","authors":"C. Williams ,&nbsp;J. Rogers ,&nbsp;D. Arasaratnam ,&nbsp;T. Pham ,&nbsp;A. Nguyen ,&nbsp;L. Rashed ,&nbsp;F. Tadesse ,&nbsp;A. Truong ,&nbsp;H. Zhang ,&nbsp;L. Selbie ,&nbsp;J. Geng ,&nbsp;L. Tan ,&nbsp;S. Harden ,&nbsp;B.J Solomon ,&nbsp;M. Alexander","doi":"10.1016/j.cllc.2026.03.007","DOIUrl":"10.1016/j.cllc.2026.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Rebiopsy to identify resistance mechanisms and guide individualised treatment plans for systemic therapy is emerging as a fundamental practice in the management of oncogene-driven non-small cell lung cancer (NSCLC). The application of rebiopsy in real-world practice remains incompletely characterised.</div></div><div><h3>Patients and Methods</h3><div>This retrospective cohort study included patients with <em>EGFR</em>-, <em>ALK</em>-, and <em>ROS1</em>-positive NSCLC from the Australasian AURORA cohort treated at an Australian academic cancer centre (ACTRN12625000038493). Eligible adults were enrolled 2012–2025 with oncogenic driver status confirmed by fluorescence in situ hybridization (FISH) or next-generation sequencing (NGS). Data collected included biopsy timing, indication, and context, alongside systemic therapy, surgery, and radiotherapy. Progression re-biopsies were further characterised by molecular testing modalities, identification of acquired resistance mechanisms and evidence of histological transformation. Treatment trajectories were visualised using Swimmer plots to map biopsy and rebiopsy events across longitudinal lines of therapy, stratified by oncogenic driver.</div></div><div><h3>Results</h3><div>This analysis included 621 biopsies from 281 patients: 105 EGFR, 141 ALK, and 35 ROS1. All patients had a diagnostic biopsy (20% more than one); additional biopsies occurred at resection (20%), during treatment (11%), and during surveillance (2%). Among patients with disease progression, 56% underwent rebiopsy overall, with rates increasing over time from 51% before 2018 to 57% during 2018–2021 and 70% during 2022–2025 (<em>P</em> = 0.04).</div></div><div><h3>Conclusion</h3><div>This real-world analysis provides contemporary insight into rebiopsy practices and longitudinal treatment patterns in oncogene-driven NSCLC. By mapping biopsy events to treatment trajectories, this study highlights evolving real-world practice, with rebiopsy rates at progression increasing over time across <em>EGFR, ALK</em>, and <em>ROS1</em> cohorts.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 4","pages":"Pages 108-116.e2"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764559","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":"Neighborhood Socioeconomics and Lung Cancer Recurrence and Progression","authors":"Shelton Lo ,&nbsp;Yi Li ,&nbsp;Francine Laden ,&nbsp;William Kessler ,&nbsp;Michael Lanuti ,&nbsp;Justin F. Gainor ,&nbsp;Andrea Shafer ,&nbsp;David C. Christiani","doi":"10.1016/j.cllc.2026.03.011","DOIUrl":"10.1016/j.cllc.2026.03.011","url":null,"abstract":"<div><h3>Introduction/Background</h3><div>In the United States, about 50% of patients with lung cancer, across all stages, experience recurrence or progression even after undergoing successful treatment. Though research has been conducted on the risk of lung cancer recurrence and progression, the impact of neighborhood socioeconomic status has not been investigated.</div></div><div><h3>Materials and Methods</h3><div>We examined associations of neighborhood socioeconomic status (nSES) with lung cancer recurrence and progression among 3439 non–small cell lung cancer patients in the follow-up period from 1992 to 2012 in the Boston Lung Cancer Study. The nSES variables, including education level and annual household income, were estimated utilizing patient zip code and census tract data. Multivariable Cox regression was used to estimate associations.</div></div><div><h3>Results</h3><div>A total of 496 lung cancer recurrence and progression cases were observed in our study population. Patients living in zip codes where the majority of the population had fewer than four years of college education and an annual household income of less than $75,000 had a 2% and 10% increased hazard of lung cancer recurrence or progression, respectively; moreover, for every 10% increase in the neighborhood population that had less than 4 years of college education and had an annual household income of less than $75,000, patients had a 3% and 3% increased hazard of lung cancer recurrence or progression, respectively.</div></div><div><h3>Conclusions</h3><div>These findings suggest that nSES is associated with the risk of lung cancer recurrence and progression, with evidence of a potential exposure-response relationship. Disadvantaged neighborhoods may therefore represent a critical target for health policies and interventions aimed at reducing morbidity and mortality.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 4","pages":"Pages 132-140.e2"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764652","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 Analysis of Different Histological Types of 2-3 cm pN0M0 Carcinoma Based on Surgical Procedure: A SEER Database Study","authors":"Zhongjie Wang ,&nbsp;Yuanyuan Xu ,&nbsp;Chao Chen ,&nbsp;Mingqiang Ye ,&nbsp;Shaojun Xu ,&nbsp;Shuchen Chen","doi":"10.1016/j.cllc.2026.02.006","DOIUrl":"10.1016/j.cllc.2026.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Sublobar resection is increasingly used for 2-3 cm non-small cell lung cancer (NSCLC), but its survival benefit compared to lobectomy for intermediate- and high-risk histological types (acinar, papillary, micropapillary, and solid) remains unclear. This study compares oncological outcomes of 2 surgical procedures in node-negative, non-metastatic NSCLC patients with such histological types.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis using data from the Surveillance, Epidemiology, and End Results database of the United States National Cancer Institute from 2004 to 2022. Patients with 2-3 cm pN0M0 histologically recorded as acinar, papillary, micropapillary, or solid carcinoma, who were treated with either sublobar resection or lobectomy, were included. We compared overall survival ​by histological type.</div></div><div><h3>Results</h3><div>Among 1,458 patients, univariate and multivariate analyses identified age, sex, surgical procedure, and pleural invasion as independent prognostic factors. Stratified analysis by histological type suggested that sublobar resection was associated with worse survival in patients with solid (<em>p</em> &lt; .001) and acinar carcinomas (<em>p</em> &lt; .001), while pleural invasion significantly affected overall survival only in acinar carcinoma (<em>p</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>For patients with stage ​pN0M0​ non-small cell lung cancer measuring 2-3 cm, the specific histological type plays a critical role in guiding the choice of surgical extent and in evaluating the prognostic implications of pleural invasion. Individualized treatment based on histological type is essential to optimize outcomes.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 4","pages":"Pages 47-53.e1"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497858","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":"Exploring Thoracic Radiotherapy in Metastatic NSCLC: A Retrospective Review in the Era of Immunotherapy and Targeted Therapies","authors":"Sina Mansoorian ,&nbsp;Janina Lehmann ,&nbsp;Lukas Käsmann ,&nbsp;Richard Gaus ,&nbsp;Cedric Richlitzki ,&nbsp;Helene Kravutske ,&nbsp;Florian Putz ,&nbsp;Nina-Sophie Schmidt-Hegemann ,&nbsp;Niels Reinmuth ,&nbsp;Amanda Tufman ,&nbsp;Julien Dinkel ,&nbsp;Gabriel Sheikh ,&nbsp;Claus Belka ,&nbsp;Chukwuka Eze","doi":"10.1016/j.cllc.2026.02.009","DOIUrl":"10.1016/j.cllc.2026.02.009","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer remains the leading cause of cancer-related deaths worldwide. Advances in immunotherapy and targeted therapies have improved survival in stage IV non–small cell lung cancer (NSCLC), highlighting the importance of local control of the primary tumor. Hypofractionated radiotherapy (hypo-RT), delivering high biologically effective doses (BEDs) over shorter durations, shows potential in locally advanced NSCLC but is underexplored in metastatic settings.</div></div><div><h3>Purpose</h3><div>This retrospective study evaluated 104 patients with stage IV NSCLC who received hypo-RT to the primary tumor at LMU Munich between December 2013 and June 2022. The primary endpoints were overall survival (OS) and progression-free survival (PFS), while the secondary endpoints included local failure-free survival, regional failure-free survival, distant failure-free survival, and the identification of prognostic factors.</div></div><div><h3>Findings</h3><div>Median OS and PFS were 15.4 months (95% confidence interval [CI]: 10.5-24.4) and 3.9 months (95% CI, 3.2-6.2), respectively. Significant predictors of OS included Eastern Cooperative Oncology Group performance status &gt;1 (hazard ratio [HR]: 3.260, <em>P</em> = .0003), male sex (HR: 1.869, <em>P</em> = .038), metastases in &gt;2 organ systems (HR: 2.014, <em>P</em> = .022), and BED &lt; 58.5 Gy (HR: 2.117, <em>P</em> = .017). Predictors of PFS included smoking history &lt;30 pack-years (HR: 1.912, <em>P</em> = .003) and BED &lt; 58.5 Gy (HR: 1.816, <em>P</em> = .025).</div></div><div><h3>Conclusion</h3><div>Hypo-RT is effective and feasible in metastatic NSCLC, with higher BEDs improving survival. Findings highlight the importance of personalized treatment strategies integrating clinical, molecular, and therapeutic factors.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 4","pages":"Pages 54-64.e1"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147851403","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":"Adjuvant Therapy After Pathologic Complete Response to Neoadjuvant Immunochemotherapy in Non–Small Cell Lung Cancer: A Multicenter Retrospective Real-World Study","authors":"Haoran Liu ,&nbsp;Zhitao Gu ,&nbsp;Keke Yu ,&nbsp;Ze-Rui Zhao ,&nbsp;Wanpu Yan ,&nbsp;Yifan Fang ,&nbsp;Xiangyang Yu ,&nbsp;Long Jiang ,&nbsp;Yiyang Wang","doi":"10.1016/j.cllc.2026.03.015","DOIUrl":"10.1016/j.cllc.2026.03.015","url":null,"abstract":"<div><h3>Background</h3><div>Whether resectable stage II to IIIB non–small cell lung cancer (NSCLC) patients could benefit from adjuvant therapy when pathologic complete response (pCR) is achieved after neoadjuvant immunochemotherapy remains unclear.</div></div><div><h3>Methods</h3><div>We conducted a multicenter retrospective real-world study including patients with resectable stage II to IIIB NSCLC who achieved pCR after neoadjuvant immunochemotherapy and curative-intent resection between January 2020 and December 2023. Patients were categorized according to receipt of adjuvant systemic therapy or surveillance alone. Disease-free survival (DFS) was the primary outcome. Overall survival (OS), cancer-specific survival, recurrence patterns, and treatment-related adverse events (TRAE) were secondary outcomes. Propensity score matching and multivariable Cox regression were used for survival analyses.</div></div><div><h3>Results</h3><div>Among 214 eligible patients, 133 received adjuvant therapy and 81 underwent surveillance. During a median follow-up of 29.5 months, 25 patients experienced recurrence and 11 died. After propensity score matching, 148 patients (74 per group) were included. In the matched cohort, adjuvant therapy was not associated with improved DFS (pair-stratified hazard ratio [HR] 1.22, 95% confidence interval [CI] 0.51-2.95) or OS (pair-stratified HR 1.00, 95% CI 0.20-4.96) compared with surveillance alone. Recurrence after pCR was predominantly distant. Grade 3 or higher TRAEs were observed in 18% of patients who received adjuvant therapy.</div></div><div><h3>Conclusions</h3><div>In patients achieving pCR after neoadjuvant immunochemotherapy, adjuvant systemic therapy was not associated with improved survival outcomes compared with surveillance alone and was accompanied by treatment-related toxicity. These findings suggest postoperative surveillance may be an appropriate consideration in discussions of postoperative management after confirmed pCR.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 4","pages":"Pages 160-169.e5"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764620","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 Significance of Inflammatory, Cellular, and Tumor-Specific Biomarkers in Patients With Pleural and Peritoneal Mesothelioma.","authors":"Keval Yerigeri, Manjistha Sengupta, Jingli Zhang, Jeevan Puthiamadathil, Raffit Hassan","doi":"10.1016/j.cllc.2026.04.005","DOIUrl":"https://doi.org/10.1016/j.cllc.2026.04.005","url":null,"abstract":"<p><strong>Background: </strong>Mesothelioma is an aggressive malignancy with poor outcomes, particularly when diagnosed at advanced stages. This study evaluated the prognostic value of tumor-specific biomarkers: soluble mesothelin-related peptide (SMRP), megakaryocyte potentiating factor (MPF) and CA125; inflammatory markers: C-reactive protein (CRP) and fibrinogen; cellular markers: platelet count and neutrophil-to-lymphocyte ratio (NLR) in patients with pleural (MPM) and peritoneal mesothelioma (MPeM).</p><p><strong>Methods: </strong>A total of 414 patients including 241 MPM, 153 MPeM and 20 with mesothelioma at other body sites were enrolled in the Natural History Protocol (NCT01950572) at the National Cancer Institute. Blood samples collected at enrollment were assessed for biomarker levels and based on their expression levels patients were stratified into quartiles. Kaplan-Meier survival curves were plotted, and median overall survival (mOS) was compared between groups.</p><p><strong>Results: </strong>For all the biomarkers evaluated, there was a significant decrease in mOS in the high expression cohorts. The mOS in years in low versus high expression cohorts being: SMRP (3 vs. 0.7), MPF (3.7 vs. 0.7), CA125 (1.6 vs. 0.8), CRP (4.1 vs. 0.4), fibrinogen (4.1 vs. 0.6), platelet count (1.4 vs. 0.8) and NLR (2.1 vs. 0.7). When analyzed separately, the pleural and peritoneal cohorts showed similar trends. Strong correlations existed between SMRP and MPF (r = 0.84), as well as CRP and fibrinogen (r = 0.86).</p><p><strong>Conclusions: </strong>Biomarkers such as SMRP, MPF, CA125, CRP, fibrinogen, platelet count and NLR can independently predict overall survival in mesothelioma. These biomarkers can therefore provide prognostic information for these patients and help guide treatment strategies.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863648","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 Radiation After Chemoimmunotherapy for Stage III Lung Cancer.","authors":"Giorgio Caturegli, Maureen Canavan, Oluwaseun F Ayoade, Daniel J Boffa, Benjamin J Resio","doi":"10.1016/j.cllc.2026.03.016","DOIUrl":"https://doi.org/10.1016/j.cllc.2026.03.016","url":null,"abstract":"<p><strong>Background: </strong>Radiation following chemoimmunotherapy is not currently a standard treatment approach for Stage III non-small cell lung cancer (NSCLC). However, a need for this treatment scenario may arise in patients who underwent intended neoadjuvant chemoimmunotherapy but ultimately no resection. Here we evaluate the practice patterns and outcomes of radiation after chemoimmunotherapy as a nonsurgical option for stage III NSCLC patients.</p><p><strong>Methods: </strong>Clinical Stage III NSCLC patients diagnosed between 2018 and 2022 who received chemoimmunotherapy followed by thoracic radiation (or chemoradiation) were identified in the National Cancer Database. Characteristics were compared by Chi-squared test to patients receiving chemoimmunotherapy alone, chemoradiation followed by immunotherapy, or chemoimmunotherapy followed by surgery. Three-year overall survival was described with Kaplan-Meier curves.</p><p><strong>Results: </strong>In total, 1293 stage III patients received chemoimmunotherapy followed by radiation, while 5382 received chemoradiotherapy followed by immunotherapy, 1921 received chemoimmunotherapy, and 745 received chemoimmunotherapy followed by surgery. Most (1145, 88.6%) chemoimmunotherapy followed by radiation patients received a total radiation dose of ≥ 54 Gy, and 90-day mortality after radiation was 5.3%. Chemoimmunotherapy followed by radiation patients were more often staged T4 (41.5% vs. 34.8%, P < .001) or N3 (26.2% vs. 20.5%, P < .001) compared to chemoradiation/immunotherapy. Three-year overall survival was 51.7%. For reference, 3-year overall survival was 37.3% for chemoimmunotherapy alone, 56.0% for chemoradiation/immunotherapy, and 81.5% for chemoimmunotherapy/surgery.</p><p><strong>Conclusions: </strong>Radiation after chemoimmunotherapy appears to be a substantially utilized, safe, and potentially effective regimen for Stage III NSCLC. Further study is indicated to evaluate chemoimmunotherapy followed by radiation as an alternative nonsurgical option for clinical stage III patients.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811771","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 Efficacy of HER2-targeted Monotherapy in ERBB2-mutant Non-Small-Cell Lung Cancer: A Systematic Review and Single-arm Meta-Analysis.","authors":"Fumihiro Kashizaki, Ryusuke Orii, Shohei Watanabe, Kentaro Yumoto","doi":"10.1016/j.cllc.2026.03.018","DOIUrl":"https://doi.org/10.1016/j.cllc.2026.03.018","url":null,"abstract":"<p><strong>Background: </strong>ERBB2 (HER2)-mutant NSCLC, most commonly driven by exon 20 insertions, has historically shown limited benefit from early pan-ERBB inhibitors. Although multiple HER2-targeted agents have since emerged, the relationship between objective response, disease control, and durability remains incompletely defined across heterogeneous single-arm studies.</p><p><strong>Methods: </strong>We conducted a systematic review and single-arm meta-analysis of HER2-targeted monotherapies in advanced HER2-mutant NSCLC. Objective response rate (ORR) and disease control rate were pooled using random-effects meta-analysis of proportions with logit transformation. PFS was summarized descriptively because time-to-event outcomes were not consistently reported in a form suitable for pooling. Prespecified analyses evaluated outcomes by drug class and TKI generation, with additional analyses restricted to ERBB2 exon 20 insertion-mutant disease.</p><p><strong>Results: </strong>Twenty studies (n = 1489) met eligibility criteria; 7 prospective cohorts (n = 524) formed the main analysis. The pooled ORR was 0.51 (95% CI, 0.33-0.68; I² = 89.8%). The pooled disease control rate was 0.88 (95% CI, 0.69-0.96) with limited separation across TKI generations. Median PFS ranged from approximately 5.5-11.5 months. Twelve-month overall survival estimates were similar between pyrotinib and trastuzumab deruxtecan. In exon 20-restricted analyses (n = 392), the pooled ORR was 0.52 (95% CI, 0.28-0.74).</p><p><strong>Conclusions: </strong>Next-generation HER2-selective TKIs achieved higher ORRs than older inhibitors, particularly in ERBB2 exon 20 insertion-mutant disease; however, differences in durability-related outcomes were less distinct in currently available later-line studies. These findings are exploratory and support prospective studies to better define durability and optimize sequencing strategies for HER2-mutant NSCLC.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811746","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}