Clinical lung cancer最新文献

{"title":"Germline Mutation Analysis and Real-World Impact in a Selected Cohort of Patients with Non-Small Cell Lung Cancer: INHERITY LC Study","authors":"María Zurera ,&nbsp;Juan Carlos Laguna ,&nbsp;Laura Mezquita ,&nbsp;Oliver Higuera ,&nbsp;Sebastián Menao ,&nbsp;María Arruebo ,&nbsp;Javier Torres Jimenez ,&nbsp;Javier de Castro ,&nbsp;Dolores Isla ,&nbsp;Rodrigo Lastra","doi":"10.1016/j.cllc.2025.10.012","DOIUrl":"10.1016/j.cllc.2025.10.012","url":null,"abstract":"<div><h3>Purpose</h3><div>Hereditary predisposition has not traditionally been considered a significant risk factor for non-small-cell lung cancer (NSCLC), and germline testing is not routinely established. INHERITY LC is a prospective multicenter study designed to explore the prevalence of germline variants in a selected cohort of patients with NSCLC and to assess the clinical impact of germline testing in NSCLC.</div></div><div><h3>Methods</h3><div>Germline genetic testing was conducted using next-generation sequencing (NGS) using a 72-gene panel. 145 patients with NSCLC who met one of the following criteria were selected: 1) family history of NSCLC; 2) young age and negative/low tobacco exposure; or 3) presence of somatic actionable mutations.</div></div><div><h3>Results</h3><div>Pathogenic germline variants (PGVs) were identified in 15 patients (10.3%; 95% CI, 5.9-16.3), involving the following genes: BRCA2 (1), CHEK2 (2), ATM (2), PALB2 (1), BARD1 (1), XRCC2 (1), MRE11 (1), NBN (3), FAN1 (1), MLH1 (1), and TP53 (1). A notably higher prevalence of PGVs (22%) was observed among patients who met all three selection criteria. After 1 year of prospective follow-up, cascade testing was performed in PGV-positive families, leading to the identification of 12 healthy relatives carrying PGVs.</div></div><div><h3>Conclusion</h3><div>The INHERITY LC study identified a PGV prevalence of 10.3% in a selected NSCLC cohort, with most variants affecting genes involved in the DNA damage repair (DDR) pathway. The application of specific selection criteria may enhance the yield of germline testing in this setting. Larger confirmatory studies are warranted to demonstrate that germline testing and genetic counseling for NSCLC may have implications for prevention, early detection, and treatment.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 3","pages":"Pages 144-152.e4"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145602515","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 Comprehensive Analysis of HER2 status Heterogeneity Using Matched Samples among Potential Beneficiaries of Trastuzumab Deruxtecan Therapy in Non-Small Cell Lung Cancer","authors":"Haiyue Wang ,&nbsp;Wei Sun ,&nbsp;Chenglong Wang ,&nbsp;Xin Yang,&nbsp;Kaiwen Chi,&nbsp;Xinying Liu,&nbsp;Xiaozheng Huang,&nbsp;Lixin Zhou,&nbsp;Dongmei Lin","doi":"10.1016/j.cllc.2025.11.015","DOIUrl":"10.1016/j.cllc.2025.11.015","url":null,"abstract":"<div><h3>Background</h3><div>HER2 overexpression is defined as immunohistochemistry (IHC) 2+/3+, and trastuzumab deruxtecan (T-DXd) is approved for treating unresectable or metastatic solid tumors with HER2 3+. HER2 spatiotemporal heterogeneity is crucial for identifying patients responsive to T-DXd. While extensively studied in gastric and breast cancers, research in non-small cell lung cancer (NSCLC) is limited. We aim to examine HER2 expression and their implications for optimizing specimen selection in potential T-DXd beneficiaries.</div></div><div><h3>Materials and Methods</h3><div>We retrospectively collected NSCLC cases from Peking University Cancer Hospital (2015-2024) with HER2 testing, matched specimens (resection vs. biopsy; primary vs. metastasis), at least 1 lesion with HER2 2+ or 3+. Two pathologists independently re-evaluated enrolled cases using gastric cancer criteria.</div></div><div><h3>Results</h3><div>A total of 5211 cases underwent HER2 testing, with 2+ expression in 773 (14.8%) and 3+ in 35 (0.7%) cases. Ultimately, 129 patients met inclusion criteria, comprising 88 surgical/biopsy and 102 primary/metastatic samples. Concordance between biopsy and resection was 51.4% (38/74) for HER2 2+ and 21.4% (3/14) for HER2 3+, with significantly higher concordance for 2+ (<em>P</em> = .040). Concordance was 39.4% (28/85) for HER2 2+ and 35.4% (5/14) for HER2 3+ in primary vs metastatic tumors, with no significant difference between lymph node and distant metastases. Both biopsy and metastatic samples underestimated HER2 2+ and 3+ expression.</div></div><div><h3>Conclusions</h3><div>Our study demonstrates that in potential NSCLC beneficiaries of T-DXd therapy, HER2 expression is underestimated in biopsy samples and metastatic lesions compared to resected and primary sites. This heterogeneity holds great significance for guiding clinical sample selection.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 3","pages":"Pages 201-211.e1"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145755430","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":"Lost to Follow-up: Social Determinants and Patient Perceptions in Lung Cancer Screening Adherence","authors":"Masashi Azuma ,&nbsp;Alexander Nguyen ,&nbsp;Anastasiia K. Tompkins ,&nbsp;Kristine Chin ,&nbsp;Bradley Walker ,&nbsp;Rishabh Matta ,&nbsp;Daohai Yu ,&nbsp;Cherie P. Erkmen","doi":"10.1016/j.cllc.2025.10.004","DOIUrl":"10.1016/j.cllc.2025.10.004","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer screening (LCS) with Low-Dose Computed Tomography (LDCT) significantly reduces cancer mortality but remains substantially underutilized. This study examines how social determinants of health (SDOH), including financial concerns, transportation barriers, and patient-provider trust, influence adherence to annual LCS.</div></div><div><h3>Methods</h3><div>A prospective cohort study was conducted at an urban, safety-net academic health system. Participants who initially underwent LDCT but failed to adhere to annual follow-up were surveyed, assessing demographics, financial and transportation concerns, patient-provider relationships, and experiences of racial discrimination. Data was analyzed using descriptive statistics, chi-square tests, and Spearman correlations.</div></div><div><h3>Results</h3><div>Among surveyors (<em>n</em> = 236), cost concerns (54.4%) and access to transportation (13.3%) were significant barriers to LCS adherence. Access to transportation was more limited for non-White (22.2%) and female (18.4%) populations, compared to White (6.5%, <em>P</em> &lt; .01) and male (7.1%, <em>P</em> = .02) populations. However, there was no difference in cost concerns (<em>P</em> = .50, <em>P</em> = .89). Additionally, non-White (4.51/5 vs. 4.26/5, <em>P</em> &lt; .01) and female (4.44/5 vs. 4.31/5, <em>P</em> = .04) patients reported higher levels of trust and comfort with providers comparing to their counter cohorts. Perceived racial discrimination in healthcare remained higher in non-White participants (1.53/5 vs. 1.25/5, <em>P</em> &lt; .01) without effect in gender cohorts (<em>P</em> = .24).</div></div><div><h3>Conclusions</h3><div>LCS can decrease the chance of lung cancer death among eligible individuals but is drastically underutilized. Most people not adhering to LCS cited cost concerns, despite coverage by insurers. Patient-provider trust can be leveraged to assess and address individual barriers to LCS.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 3","pages":"Pages 65-75"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of CT Attenuation on Subsolid Pulmonary Nodule Detection With the Zero Echo Time MRI Technique","authors":"Wan-Ting Tao ,&nbsp;Tsai-Wang Huang ,&nbsp;Hsian-He Hsu ,&nbsp;Shih-Wei Chiang ,&nbsp;Hsu-Kai Huang ,&nbsp;Wen-Chiuan Tsai ,&nbsp;Kai-Hsiung Ko","doi":"10.1016/j.cllc.2025.10.006","DOIUrl":"10.1016/j.cllc.2025.10.006","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the association between CT attenuation and zero echo time (ZTE) MRI detectability of subsolid pulmonary nodules (SSNs), and to identify a potential attenuation threshold to inform radiation-free follow-up approaches.</div></div><div><h3>Materials and methods</h3><div>Patients with SSNs ≤ 2 cm scheduled for surgical resection were prospectively enrolled between July 2022 and June 2023. Two radiologists reviewed nodule type (part-solid nodule [PSN] and ground-glass nodule [GGN]), size, location, and attenuation on preoperative CT, and evaluated detectability on ZTE-MRI. Associations between CT features, pathology, and ZTE-MRI detectability were analyzed using univariable and multivariable methods, and predictive performance was assessed with ROC curve analysis.</div></div><div><h3>Results</h3><div>Thirty-nine patients with 64 SSNs (median diameter, 6.6 mm) participated in the study. Of these, 43 (67.2%) SSNs were identified on ZTE-MRI, including 11 PSNs (100%) and 32 GGNs (60.4%). CT attenuation was the most significant predictor for ZTE-MRI detectability (AUC, 0.993; <em>P</em> &lt; .001), with an optimal threshold of −637.6 HU (sensitivity, 95.2%; specificity, 100.0%). Interreader agreement for ZTE-MRI measurements was high (intraclass correlation coefficient [ICC], 0.986). The size measurements between CT and ZTE-MRI demonstrated minimal bias, up to 0.3 mm. Surgical resection and pathological confirmation were performed for 47 SSNs. Detectable nodules were more frequently invasive adenocarcinomas (IACs) than undetectable nodules (94.1%, 32/34 vs. 30.8%, 4/13; <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>ZTE-MRI detectability of SSNs was significantly associated with CT attenuation, with a potential threshold of −637.6 HU, and correlated with pathological invasiveness. These results may contribute to individualized follow-up protocols for SSNs initially identified by CT imaging.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 3","pages":"Pages 88-97"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457875","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":"Computer Assisted Nodule Analysis and Risk Yield Outcomes May be Associated with Recurrence after Stereotactic Body Radiation Therapy in Clinical Stage I Non–Small-Cell Lung Cancer","authors":"Duy Pham ,&nbsp;Nikita Thakur ,&nbsp;Ju Ae Park ,&nbsp;Wei Nie ,&nbsp;Michael Correa ,&nbsp;Hongkun Wang ,&nbsp;Melanie Subramanian ,&nbsp;Michael Weyant ,&nbsp;Christopher B. Johnson ,&nbsp;Kei Suzuki","doi":"10.1016/j.cllc.2025.10.008","DOIUrl":"10.1016/j.cllc.2025.10.008","url":null,"abstract":"<div><h3>Objective</h3><div>There is a paucity of pretreatment, noninvasive assessment of tumor characteristics in non–small-cell lung cancer (NSCLC) undergoing stereotactic body radiation therapy (SBRT). Our goal was to determine if Computer Assisted Nodule Analysis and Risk Yield (CANARY) could stratify risk for recurrence in patients undergoing SBRT for clinical stage I NSCLC.</div></div><div><h3>Methods</h3><div>We performed a retrospective review of NSCLC patients who underwent SBRT from 2016 to 2022. Recurrence dates were collected from the date of therapy to May 2023. Pretreatment imaging was entered into the CANARY software, the correct lesion verified and demarcated, and each lesion was categorized into good, intermediate, and poor Score Indicative of Lung Cancer Aggression (SILA). Kaplan–Meier methodology was used to analyze the recurrence free survival (RFS), and Log-rank test was used for group comparison.</div></div><div><h3>Results</h3><div>The SBRT cohort included 85 patients. By clinical stage, there were 4 (4.7%) IA1, 41 (48.2%) IA2, 30 (35.3%) IA3, and 10 (11.8%) IB. By histology, 48 (56.5%) patients were adenocarcinoma, 23 (27.1%) were squamous cell carcinoma, and 14 (16.5%) were NSCLC. The 2-year RFS was 68.5%. By CANARY, 11 (12.9%) patients were considered to have good risk, 14 (17.6%) intermediate risk, and 60 (70.6%) poor risk by their SILA scores. Their 2-year RFS was 100.0% (100.0%-100.0%), 80.2% (58.7%-100.0%), and 68.1% (54.4%-85.3%), respectively. Intermediate and poor SILA scores had worse RFS than good SILA score patients (<em>P</em> = .09).</div></div><div><h3>Conclusions</h3><div>CANARY can potentially risk stratify recurrence in clinical stage I NSCLC patients undergoing SBRT.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 3","pages":"Pages 107-114"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444169","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 Pulmonary Resection Extent on Nodal Upstaging in Clinical Stage IA1-2 NSCLC: Real-World Evidence of Low Detection Rates with Sublobar Resections","authors":"Yahya Alwatari ,&nbsp;Robert A. Vierkant ,&nbsp;Matthew J. Aizpuru ,&nbsp;Sahar A. Saddoughi ,&nbsp;Carlos A. Puig ,&nbsp;Janani S. Reisenauer ,&nbsp;K. Robert Shen ,&nbsp;Stephen D. Cassivi ,&nbsp;Dennis A. Wigle ,&nbsp;Luis F. Tapias","doi":"10.1016/j.cllc.2025.11.014","DOIUrl":"10.1016/j.cllc.2025.11.014","url":null,"abstract":"<div><h3>Objective</h3><div>Identification of regional lymph node involvement has an impact on prognosis and treatment after surgery for clinical stage IA1-2 non-small cell lung cancer (NSCLC). This study investigates nodal upstaging rates and associated factors, with a focus on sublobar resections.</div></div><div><h3>Methods</h3><div>The National Cancer Database (NCDB) was used to identify NSCLC patients with clinical T1a-b (≤ 2 cm), N0, M0 disease (stage IA1-2) who had sublobar resection or lobectomy from 2004 to 2021. Rates of nodal upstaging (cN0→pN+) were calculated over the study period according to the type of pulmonary resection. Factors associated with nodal upstaging were evaluated with multivariable logistic regression.</div></div><div><h3>Results</h3><div>The study included 58,626 patients. Nodal upstaging occurred in 6.4% of patients: 3.8% to pN1, 2.7% to pN2. Factors associated with nodal upstaging included male gender, larger tumor size, histology, higher tumor grade, positive resection margins, more regional lymph nodes examined, and type of pulmonary resection. Nodal upstaging rates were 2.9% for wedge resections, 3.7% for segmentectomies, and 8.3% for lobectomies (<em>P</em> &lt; .001). Compared to lobectomy, sublobar resections had lower odds of nodal upstaging: wedge resection (adjusted OR 0.58, 95% CI, 0.51-0.65) and segmentectomy (adjusted OR 0.59, 95% CI, 0.49-0.70; <em>P</em> &lt; .001). This gap in nodal upstaging between sublobar resections and lobectomy persisted over the study period.</div></div><div><h3>Conclusions</h3><div>The extent of surgical resection and lymph node evaluation were independent factors in detecting patients with regional lymph node involvement, signaling more advanced disease. As sublobar resections establish themselves as a widespread, valid treatment, strategies to close the gap in the detection of nodal disease are needed.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 3","pages":"Pages 190-200.e1"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145721464","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":"Multicenter Real-World Data on First-Line Chemoimmunotherapy in Patients With Advanced Non-Small Cell Lung Cancer and Performance Status 2: WJOG18424L","authors":"Shunichi Kataoka ,&nbsp;Takehito Shukuya ,&nbsp;Hiroshi Ohtsu ,&nbsp;Taichi Miyawaki ,&nbsp;Daichi Fujimoto ,&nbsp;Hidetoshi Hayashi ,&nbsp;Yukihiro Toi ,&nbsp;Toshihide Yokoyama ,&nbsp;Teruhumi Kato ,&nbsp;Teppei Yamaguchi ,&nbsp;Kaoru Tanaka ,&nbsp;Satoru Miura ,&nbsp;Motohiro Tamiya ,&nbsp;Motoko Tachihara ,&nbsp;Kohei Otsubo ,&nbsp;Yuki Sato ,&nbsp;Satoshi Ikeda ,&nbsp;Shinya Sakata ,&nbsp;Takeshi Masuda ,&nbsp;Shinnosuke Takemoto ,&nbsp;Kazuhisa Takahashi","doi":"10.1016/j.cllc.2025.12.002","DOIUrl":"10.1016/j.cllc.2025.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitors (ICIs) with platinum-doublet chemotherapy (Chemo-ICIs) are used as the standard treatment for advanced non-small cell lung cancer (NSCLC) with performance status (PS) 0 to 1. However, patients with PS2 are often excluded from clinical trials, leading to an evidence gap that makes it difficult to select the optimal treatment strategy. The efficacy and safety of first-line Chemo-ICIs in PS2 remain unclear.</div></div><div><h3>Patients and Methods</h3><div>This multicenter retrospective cohort study analyzed real-world data of 2425 patients with stage IV NSCLC and PS0 to 2 without driver oncogenes. Propensity score matching was used to compare outcomes between patients receiving Chemo and those receiving Chemo-ICIs. Primary endpoints included progression-free survival (PFS), overall survival (OS), the objective response rate (ORR), and the incidence of grade ≥ 3 adverse events.</div></div><div><h3>Results</h3><div>Among 424 patients with PS2 (median age 71 years; 73% men), 56 received Chemo-ICIs and 117 received Chemo. After matching, median PFS was significantly longer in the Chemo-ICIs group (5.7 vs. 2.3 months; hazard ratio [HR] 0.58 [0.36-0.93]; <em>P</em> = .025), and ORR was higher (43% vs. 21%; <em>P</em> = .02). OS showed a non-significant trend toward improvement (8.0 vs. 6.0 months; HR 0.75 [0.47-1.19]; <em>P</em> = .219). Rates of grade ≥ 3 adverse events were comparable (50.0% vs. 43.6%; <em>P</em> = .514).</div></div><div><h3>Conclusions</h3><div>Chemo-ICIs significantly improved PFS and ORR compared to Chemo in patients with NSCLC with PS2 without higher toxicity. These findings highlight the clinical relevance of chemoimmunotherapy in patients with PS2 and may help bridge the evidence gap in existing treatment guidelines.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 3","pages":"Pages 212-223.e10"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896420","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 Firmonertinib Plus Anlotinib as First-Line Treatment for Advanced NSCLC With EGFR Mutations: A Single-Arm, Phase I/II Trial","authors":"Huiyang Shi ,&nbsp;Haohua Zhu ,&nbsp;Le Tang,&nbsp;Jingyu Lu,&nbsp;Kai Zhu,&nbsp;Miaohan Wang,&nbsp;Xingsheng Hu,&nbsp;Yuankai Shi","doi":"10.1016/j.cllc.2025.11.010","DOIUrl":"10.1016/j.cllc.2025.11.010","url":null,"abstract":"<div><h3>Background</h3><div>This single-arm, phase I/II trial aimed to evaluate the efficacy and safety of firmonertinib plus anlotinib as first-line treatment for patients with non small-cell lung cancer (NSCLC) harboring epidermal growth factor receptor (<em>EGFR</em>) mutations.</div></div><div><h3>Methods</h3><div>We enrolled patients aged 18 years or older and had locally advanced or metastatic NSCLC harboring <em>EGFR</em> sensitive mutation. Patients were treated with oral firmonertinib 80 mg once daily combined with oral anlotinib (days 1-14 in 21-day cycle). The primary endpoint was objective response rate (ORR).</div></div><div><h3>Results</h3><div>Between March, 19th, 2022 and July, 27th, 2023, 36 patients were enrolled. In dose-exploration phase, 2 patients were treated with anlotinib 8 mg, 3 were treated with anlotinib 10 mg and 3 were treated with anlotinib 12 mg combined with firmonertinib 80 mg. In dose-expansion phase, 5 were treated with 10 mg anlotinib and 23 were treated with anlotinib 12 mg combined with firmonertinib 80 mg. The median follow-up time was 19.4 months. ORR was 63.9% and disease control rate (DCR) was 100.0%. Median progression free survival (PFS) was 19.6 months (95% CI 16.9-22.3). Median duration of response (DoR) was 23.0 months (95% CI 12.1-34.0). Concurrent pathogenic <em>TP53</em> mutation was an independent prognostic factor (HR 2.38, 95% CI 0.90-6.30, <em>P</em> = .07). Diarrhea and hypertension were the most common TRAEs. ≥Grade 3 TRAEs occured in 36.1% patients. 47.2% patients experienced dose reduction and 33.3% patients experienced treatment discontinuation.</div></div><div><h3>Conclusion</h3><div>Firmonertinib plus anlotinib demonstrated preliminary efficacy and manageable safety as first-line treatment among patients with NSCLC harboring <em>EGFR</em> mutations.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 3","pages":"Pages 170-179.e5"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917201","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":"Association Between Lung Volume Reduction and Symptomatic Radiation Pneumonitis in Lung Cancer Patients Undergoing Definitive Concurrent Chemoradiotherapy","authors":"Jeong Won Lee ,&nbsp;Sea-Won Lee ,&nbsp;Hyeseon Kang ,&nbsp;Yun Hee Lee","doi":"10.1016/j.cllc.2025.10.007","DOIUrl":"10.1016/j.cllc.2025.10.007","url":null,"abstract":"<div><h3>Purpose</h3><div>This study assessed lung volume alterations during radiotherapy (RT) and their predictive value for symptomatic radiation pneumonitis (RP) in lung cancer patients undergoing definitive concurrent chemoradiotherapy (CCRT)</div></div><div><h3>Materials and Methods</h3><div>This retrospective study included 49 patients who underwent re-simulation four-dimensional (4D) computed tomography (CT) during RT. Lung volume was measured on the 30% phase of 4D CT at initial and re-simulation scans. Associations between volume changes and symptomatic RP were analyzed using the Mann–Whitney U test. To determine the optimal cut-off value, ROC analysis and the Youden index were utilized. RP was graded based on CTCAE v5.0.</div></div><div><h3>Results</h3><div>Among the 49 patients, seven (14.3%) developed symptomatic RP. Dosimetric parameters did not differ significantly between patients with and without RP. However, changes in ipsilateral lung volume were significantly associated with symptomatic RP. A volume decrease &gt;130 cm³ or a relative reduction &lt;–7% was predictive of RP (<em>P</em> = .001). The area under the ROC curve for absolute change and relative change of ipsilateral lung volume were 0.905 and 0.883, respectively.</div></div><div><h3>Conclusion</h3><div>Ipsilateral lung volume reduction during RT may serve as an early predictor of symptomatic RP, independent of traditional dosimetric factors. Monitoring volume changes with re-simulation CT could enhance RP risk assessment and guide adaptive RT planning.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 3","pages":"Pages 98-106"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457905","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":"Squamous Non-Small Cell Lung Cancer: Current and Emerging Treatment Options","authors":"Paul K. Paik ,&nbsp;Jianjun Zhang ,&nbsp;Howard (Jack) West ,&nbsp;Jonathan W. Riess","doi":"10.1016/j.cllc.2025.10.001","DOIUrl":"10.1016/j.cllc.2025.10.001","url":null,"abstract":"<div><div>Although the pharmacologic management of non-small cell lung cancer (NSCLC) has advanced substantially in the past 2 decades, disparities in the applicability to different histologic subtypes remain. Several treatment options are not suitable for squamous NSCLC, with use restricted to nonsquamous NSCLC (eg, bevacizumab and pemetrexed) because of safety concerns or comparative activity. Differences in mutational landscapes and a lack of matched targeted therapies specific to squamous NSCLC oncogenic aberrations present additional limitations. In the absence of suitable targeted therapies, immunotherapy with or without chemotherapy is the mainstay of squamous NSCLC treatment; however, survival-related outcomes remain poorer for patients with squamous than with nonsquamous NSCLC. Several studies are investigating promising drug therapies for patients with squamous NSCLC. This review seeks to summarize the current and emerging treatment options for patients with</div><div>squamous NSCLC.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 3","pages":"Pages 28-45"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145548568","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}