Clinical lung cancer最新文献

{"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":"KRAS ctDNA Detection in Patients With Resectable Lung Adenocarcinoma.","authors":"Meghan L De Meo, Joseph Seitlinger, Roni F Rayes, Lyndon C Walsh, Muhammad H Shahzad, Thupten Tsering, Ramy Saleh, Nicole Ezer, Benjamin Shieh, Annick Wong, Scott Owen, Logan Walsh, Pierre-Olivier Fiset, Julia V Burnier, Jonathan D Spicer","doi":"10.1016/j.cllc.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.05.006","url":null,"abstract":"<p><strong>Introduction/background: </strong>Clinical trials are assessing the suitability of KRAS^G12C inhibitors in the neoadjuvant setting. Appropriate patient selection is paramount to ensure therapeutic efficacy. Here we sought to investigate the clinical utility of ctDNA to identify resectable lung adenocarcinoma (LUAD) patients with KRAS-driven disease.</p><p><strong>Materials & patients: </strong>From our institution's clinical database and biobank, we identified 47 patients based on our inclusion criteria: research-consented, treatment-naïve, NGS-confirmed KRAS-mutated resectable stage IA-IIIB LUAD with available pre-operative blood. cfDNA was isolated from 700-2000µL plasma and was preamplified. In a tumour-informed approach, digital droplet polymerase chain reaction (ddPCR) was performed to identify hotspot KRAS^G12C & KRAS^G12V ctDNA and wild-type KRAS cfDNA in the same reaction based on prior tumor tissue profiling.</p><p><strong>Results: </strong>In overall clinical staging, KRAS^G12C ctDNA was detected in liquid biopsies of stage II (1/7, 14%) and III (2/5, 40%) patients. In overall pathological staging, KRAS^G12C ctDNA was detected exclusively in liquid biopsies of stage III patients (4/11, 36%). KRAS^G12V ctDNA was detected in liquid biopsies of overall clinical stage I (1/3, 33%) and III (1/1, 100%) patients and in pathological stage II (1/3, 33%) and III (1/2, 50%) patients. KRAS ctDNA positivity was associated with shorter overall survival (median OS 21 months vs. 41 months, P < .05). KRAS^G12C ctDNA positivity was associated with larger tumour size, presence of nodal involvement, and higher overall pathological stage.</p><p><strong>Conclusion: </strong>ctDNA positivity from liquid biopsy is a low-cost and accessible method for triaging patients with LUAD towards trials evaluating KRAS inhibitors in the neoadjuvant setting.</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":"144599592","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}

{"title":"Real-life Experience of Rare Hepatoid Adenocarcinomas of the Lung: A Large Retrospective French Cohort.","authors":"Thomas Fave, Jessica Nguyen, Renaud Descourt, Gilles Quéré, Estelle Dhamelincourt, Arnaud Simaki, Victor Basse, Arnaud Uguen, Chloé Ntshaykolo, Chantal Decroisette, François Lucia, Margaux Geier","doi":"10.1016/j.cllc.2025.05.003","DOIUrl":"10.1016/j.cllc.2025.05.003","url":null,"abstract":"<p><strong>Background: </strong>Hepatoid adenocarcinoma of the lung (HAL) is a rare subtype of lung cancer exhibiting common histological features with hepatocellular carcinomas (HCC). Therapeutic landscape is currently similar to lung adenocarcinoma standards. We report here the largest descriptive cohort of HAL with focus on (chemo)immunotherapy (chemo)IO) efficacy.</p><p><strong>Methods: </strong>In this single-center retrospective observational study, we selected all consecutive cases of HAL patients from January 2013 to December 2022. Eligible patients had primary lung tumor with positive immunohistochemical hepatocyte marker. HCC was eliminated with liver imaging. We provide a descriptive analysis of HAL population and describe our therapeutic experience.</p><p><strong>Results: </strong>A total of 23 patients were included. Main characteristics at diagnosis were: median age of 64.5 years [41-81], 78.3% of males, with 79% of PS 0-1. All patients had smoking history, with 8 active smokers. Majority of HAL (73.9%) originated from the upper lobes and 69.5% affected the right lung. Twenty-two patients (95.6%) had stage IV disease. Median number of metastatic sites was 2 with a maximum of 6 metastatic sites; most common metastatic sites were the bone (39.1%) and the brain (30.4%). PD-L1 status was < 1% (n = 11), 1-49% (n = 3), ≥ 50% (n = 5), unknown (n = 4). Ten (43.5%) patients harbored KRAS mutation: G12C (n = 6), G60D (n = 1), G12V (n = 1), G12F (n = 1), G13C (n = 1). Median overall survival (mOS) since diagnosis achieved 6.4 months (95% CI, 3.7-9.6). Early exclusive palliative care concerned 7 patients. Seven patients received first-line chemoIO. Best overall response was: partial response (n = 3), stable disease (n = 2), progressive disease (n = 1), not evaluable (n = 1). One patient treated with first-line pembrolizumab achieved stable disease. Median progression free survival of first line (chemo)IO was estimated at 4.5 months (95% CI, 2.3-5.4), objective response rate was 37.5%, and disease control rate was 75%. Five patients received second-line IO but experienced early progressive disease. Two patients received a KRAS inhibitor as third-line treatment, but no response was observed.</p><p><strong>Conclusion: </strong>Our results highlighted that HAL patients were more frequently male and heavy smokers. HALs most often originate from the right upper lobe, with an overrepresentation of KRAS mutations and an aggressive, metastatic profile, which accounted for the poor mOS of 6.4 months. Patients may benefit from upfront (chemo)IO, but further studies were warranted to confirm it.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332583","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":"Correlation of PET-CT, Endobronchial Ultrasound Cytology and Surgical Biopsy in Patients with Non-Small Cell Lung Cancer Undergoing Curative Surgery.","authors":"Stav Rakedzon, Elad Mor, Yaniv Yechiel, Yaron Saiet, Fuad Khoury, Ivan Gur, Tzah Feldman, Ludmila Guralnik, Amit Katz, Yaniv Zohar, Zohar Keidar, Sameh Daher, Olga Kagna, Anna Solomonov, Hanna Dawood, Talia Shentzer Kutiel, Alona Zer Kuch, Eyal Fuchs, Yaniv Dotan","doi":"10.1016/j.cllc.2025.05.005","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.05.005","url":null,"abstract":"<p><strong>Background: </strong>Non-small cell lung cancer (NSCLC) is the leading cause of cancer mortality worldwide. The recommended approach for mediastinal staging is a combination of both positron emission tomography- computed tomography (PET-CT) and endobronchial ultrasound (EBUS). Data on the correlation of PET-CT uptake to EBUS cytology and surgical lymph node biopsy is scarce.</p><p><strong>Patients and methods: </strong>Of 379 patients diagnosed with NSCLC, 65 underwent preoperative PET-CT, EBUS, and surgical lymph node biopsies. The correlations between EBUS cytology, fluoro-deoxy glucose (FDG) uptake (SUVmax) by PET-CT, and surgical biopsy were analyzed.</p><p><strong>Results: </strong>About 229 lymph nodes derived from 65 patients were sampled, of which 67 lymph nodes had data from EBUS, PET-CT, and surgical biopsy. 58 nodes were negative in all modalities; 6 were malignant on EBUS but negative on surgical biopsy; 2 were malignant for both modalities; and one was EBUS negative but malignant in surgical staging. EBUS sensitivity was 89% with a negative predictive value of 98%. Six patients were upstaged after surgery due to inaccessible lymph nodes (at stations 5 and intralobar) for EBUS. No malignant lymph nodes had maximum standardized uptake (SUVmax) lower than 2.9.</p><p><strong>Conclusion: </strong>EBUS has high sensitivity and specificity rates, however it misses intralobar and station 5 lymph nodes which might upstage the patient after surgery. In cases when there is a high suspicion for malignant lymph nodes inaccessible to EBUS, other invasive strategies or neoadjuvant treatment should be considered. PET-CT was shown to be accurate in ruling out but not ruling in lymph node involvement.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293418","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}