Clinical lung cancer最新文献

{"title":"Socioecological Factors Associated With Lung Cancer Clinical Trial Participation: Real-world California Cancer Registry Data","authors":"Angel Arizpe ,&nbsp;Jorge Nieva ,&nbsp;Lihua Liu ,&nbsp;Trevor A. Pickering ,&nbsp;Albert J. Farias","doi":"10.1016/j.cllc.2025.10.015","DOIUrl":"10.1016/j.cllc.2025.10.015","url":null,"abstract":"<div><h3>Introduction</h3><div>Racial/ethnic minority enrollment in oncological clinical trials (CT) remains a persistent priority. Using a population-based cancer registry, we identify whether modifiable policy-, health system-, and patient-domains are associated with CT enrollment.</div></div><div><h3>Patient and Methods</h3><div>We analyzed retrospective data from the Los Angeles Cancer Surveillance Program between 2002 and 2021 to identify lung cancer cases and receipt of treatment in a cancer protocol (CT enrollment vs. not enrolled). We assessed patient- (eg, Charlson comorbidity score, socioeconomic status, and insurance type), health system- (facility designated cancer center status), and policy- (2014 FDA guideline to report demographic CT enrollment data) domain levels of influence. We used a multivariable logistic regression model to identify these associations.</div></div><div><h3>Results</h3><div>Only 0.88% (<em>n</em> = 599/68,245) of our cohort enrolled in a CT protocol. Individuals who were seen at cancer-designated facilities (CoC, NCI, NCCN) were significantly more likely to be enrolled in CT (OR = 5.57[3.69, 8.33]) compared to those not seen at a cancer-designated facility. We also found an inverse association between comorbidity categories and CT enrollment (OR: 1 vs. 0 = 0.72 [0.59, 0.88], 2 vs. 0 = 0.51 [0.37, 0.69], 3 + vs. 0 = 0.25 [0.16, 0.37]). Among Black individuals, those on Medicaid had lower odds of being enrolled in CT compared to those on Medicare (OR: 0.05 [95% CI, 0.01, 0.68]). This pattern was similar across all race/ethnicity groups (interaction <em>P</em> &lt; .03).</div></div><div><h3>Conclusion</h3><div>Using population-based data, our findings underscore that racial/ethnic disparities in CT enrollment could be mitigated by addressing where individuals get cancer care, broadening comorbidity restrictions, and expanding cancer care research facilities in underserved areas.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 3","pages":"Pages 153-161.e1"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145502556","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 Profiles as Predictors of Occult Lymph Node Metastasis and Clinical Outcomes in Early-Stage Clinical N0 Non-Small Cell Lung Cancer","authors":"Chihiro Takemura ,&nbsp;Tatsuya Yoshida ,&nbsp;Yukihiro Yoshida ,&nbsp;Ryoko Inaba Higashiyama ,&nbsp;Hidehito Horinouchi ,&nbsp;Hiroshi Igaki ,&nbsp;Noboru Yamamoto ,&nbsp;Yuichiro Ohe ,&nbsp;Yasushi Yatabe ,&nbsp;Shun-ichi Watanabe","doi":"10.1016/j.cllc.2025.10.002","DOIUrl":"10.1016/j.cllc.2025.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>Occult lymph node (LN) metastasis, indicating pathological LN involvement, is often observed in clinical N0 (cN0) early-stage non-small cell lung cancer (NSCLC). Identifying preoperative predictors of occult LN metastasis (pathologically N1 and N2) is crucial for determining the surgical procedure for cN0 NSCLC. This study aimed to investigate the role of genetic mutations in predicting occult LN metastasis and their influence on surgical strategies.</div></div><div><h3>Materials and Methods</h3><div>We retrospectively reviewed patients who underwent lobectomy or segmentectomy for cN0 NSCLC with pathological stages higher than IB, between May 2017 and April 2024. Clinicopathological characteristics and genetic mutations were analyzed. Occult LN metastasis was not detected by imaging but identified through histopathology.</div></div><div><h3>Results</h3><div>We evaluated 644 patients, median age 71 years. Occult LN metastases were observed in 179 (27.8%) patients. EGFR mutations and ALK rearrangements were significantly associated with occult LN metastasis (EGFR, <em>P</em> = .04; ALK, <em>P</em> = .007), particularly EGFR exon 19 deletions (<em>P</em> = .006). Multivariate analysis confirmed these as significant predictors (<em>P</em> = .006). Notably, patients with these mutations had longer recurrence-free survival (RFS) than those without (HR 1.27, 95% CI, 0.90-1.80, <em>P</em> = .02). For patients with EGFR mutations and ALK rearrangements, RFS was significantly shorter after segmentectomy (HR 3.18, 95% CI, 1.02-9.99, <em>P</em> = .04) and longer after lobectomy (HR 1.28, 95% CI, 0.87-1.90, <em>P</em> = .01).</div></div><div><h3>Conclusion</h3><div>Genomic profiles, such as EGFR mutations and ALK rearrangements, are associated with occult LN metastasis and outcomes in cN0 NSCLC. Integrating genetic assessments into preoperative planning may optimize surgical strategies and improve prognosis.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 3","pages":"Pages 46-57.e1"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145430551","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 of Concurrent Radiotherapy With Tarlatamab in Extensive-Stage Small Cell Lung Cancer From the DLL3 PanTUMOR Database","authors":"Diana Kim ,&nbsp;Sarah Blocker ,&nbsp;Courtney C. Cavalieri ,&nbsp;Sabrina Cannon ,&nbsp;Amanda S. Cass ,&nbsp;Alexander Olinger ,&nbsp;Bryce Bortka ,&nbsp;Beth Gustafson ,&nbsp;Allison Schepers ,&nbsp;Jacob Hobbs ,&nbsp;Lauren Blackwell ,&nbsp;Kori Holman ,&nbsp;Wilder Widman ,&nbsp;Austin Quick ,&nbsp;Dennis Grauer ,&nbsp;Manidhar Reddy Lekkala ,&nbsp;Chao Huang ,&nbsp;Prakash Neupane ,&nbsp;Jun Zhang ,&nbsp;Sanjana Mullangi ,&nbsp;Timothy Schieber","doi":"10.1016/j.cllc.2026.01.007","DOIUrl":"10.1016/j.cllc.2026.01.007","url":null,"abstract":"<div><h3>Background</h3><div>Small cell lung cancer (SCLC) is an aggressive malignancy in which radiotherapy remains integral across both limited and extensive stages (ES-SCLC). Tarlatamab has shown improved survival versus chemotherapy and is the preferred second-line therapy. Early tarlatamab studies restricted radiotherapy use limiting knowledge of concurrent use. We evaluated the safety and efficacy of real-world concurrent radiotherapy with tarlatamab in ES-SCLC using the DLL3 PanTUMOR database.</div></div><div><h3>Methods</h3><div>We performed a multicenter retrospective analysis of adults treated with tarlatamab for ES-SCLC between May 2024 and July 2025. Patients receiving radiotherapy after tarlatamab initiation were assigned to the concurrent radiation arm; others formed the nonradiotherapy (non-RT) arm. The primary endpoint was the rate of grade ≥ 3 adverse events attributed to radiotherapy. Secondary endpoints included overall survival (OS), progression-free survival (PFS), tumor regression at irradiated sites, discontinuation due to adverse events, and maximum CRS or ICANS grade.</div></div><div><h3>Results</h3><div>Among 109 patients (23 concurrent RT, 86 non-RT), baseline characteristics were balanced. Stereotactic radiotherapy was most common (56.5%), predominantly to the brain. Only 1 patient (4.3%) experienced grade ≥ 3 radiotherapy-related toxicity after whole-brain radiotherapy. Median OS was not reached in the concurrent RT arm versus 7.5 months in non-RT (<em>P</em> = .155); median PFS was 4.6 versus 3.1 months (<em>P</em> = .606). Tumor regression occurred in 5 of 6 evaluable patients (83.3%). No delayed CRS or ICANS were observed after the tarlatamab step-up phase.</div></div><div><h3>Conclusions</h3><div>Concurrent radiotherapy with tarlatamab is safe, with low severe toxicity, frequent local tumor response, and a trend toward improved OS, supporting further study in ES-SCLC.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 3","pages":"Pages 252-258.e3"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147303035","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":"Characterizing Risk Factors and Outcomes in Patients With Unresectable, Stage III Non-Small-Cell Lung Cancer Who Do Not Complete, or Who Experience Progression During/Within 42 Days of, Concurrent Chemoradiotherapy: The POSITION Study","authors":"Giannis Mountzios ,&nbsp;Julius K. Weng ,&nbsp;Eleni Zairi ,&nbsp;Kristin Hsieh ,&nbsp;Pratibha Chander ,&nbsp;William Dunlop ,&nbsp;Yao Qiao ,&nbsp;Alice Wang ,&nbsp;Adam Januszewski","doi":"10.1016/j.cllc.2026.01.005","DOIUrl":"10.1016/j.cllc.2026.01.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Many patients with unresectable stage III non-small-lung cancer (NSCLC) may face challenges in receiving consolidation durvalumab following concurrent chemoradiotherapy (cCRT) due to incomplete cCRT or disease progression. The retrospective POSITION study characterized this population.</div></div><div><h3>Methods</h3><div>Adults with unresectable stage III NSCLC diagnosed between 2010 and 2021 who received cCRT were identified from TEMPUS Oncology (database). Among these patients, we estimated proportions with incomplete cCRT or progression during/within 42 days of cCRT and assessed overall survival (OS). Factors associated with incomplete cCRT or progression during/within 42 days of cCRT were identified via multivariable logistic regression.</div></div><div><h3>Results</h3><div>Of 2076 eligible patients, 23.0% had incomplete cCRT (Group A), 12.7% experienced progression during/within 42 days of cCRT (Group B), and 64.3% completed cCRT without progression (Group C). Median OS (95% CI) was 21.6 (17.2-28.0), 10.1 (7.2-12.5), and 32.4 (29.8-34.6) months for Groups A, B, and C, respectively. Landmark 60-month OS rates were 26.3%, 11.6% and 33.2% for Groups A, B and C, respectively. Higher comorbidity burden (Charlson Comorbidity Index) and Black (vs. White) race were associated with higher likelihood of incomplete cCRT. Stage IIIB/C (vs. IIIA), cerebrovascular, and renal disease were associated with higher likelihood of progression during/within 42 days of cCRT.</div></div><div><h3>Conclusion</h3><div>In POSITION, 35.7% of patients had incomplete cCRT or progressed during/within 42 days of cCRT and may have faced challenges receiving consolidation durvalumab; race, disease stage, and comorbidities were associated with incomplete cCRT or progression.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 3","pages":"Pages 244-251.e2"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147316572","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":"Cardiac Substructure Dose Response after Lung Cancer Radiotherapy","authors":"Vanessa L. Wildman ,&nbsp;Richard L.J. Qiu ,&nbsp;Anant Mandawat ,&nbsp;Kirk Luca ,&nbsp;Xiaofeng Yang ,&nbsp;Aparna H. Kesarwala","doi":"10.1016/j.cllc.2026.02.002","DOIUrl":"10.1016/j.cllc.2026.02.002","url":null,"abstract":"<div><div>While curative radiation therapy provides excellent disease control for lung tumors, adverse cardiac events can occur from treatment. Due to the central proximity of the heart to the lungs, patients treated for lung cancer with radiation therapy are at heightened risk of increased cardiac radiation exposure. Conventionally, the whole heart is considered an organ-at-risk in which radiation dose should be minimized during treatment planning, employing strategic constraints such as maximum and mean dose. Emerging research highlights specific cardiac substructure doses, which are rarely utilized in clinical organ-at-risk planning, as more accurate predictors of postradiotherapy cardiac risk than whole heart dose alone. This review consolidates findings on substructure radiation doses associated with various cardiac outcomes to optimize lung treatment planning and guide development of thresholds, particularly for high-risk patients. Two PubMed searches identified 32 key studies published between 2017 and 2024. Radiation doses to heart chambers, conduction nodes, great vessels, coronary arteries, pericardium, and valves correlate with various adverse outcomes postradiotherapy. Minimizing radiation exposure to the left ventricle, left atrium, heart base, and left coronary arteries, including the left anterior descending and left circumflex arteries, is recommended. This systematic review supports the utilization of individual substructure doses rather than solely whole heart dose during lung radiotherapy planning to improve long term patient outcomes and wellbeing.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 3","pages":"Pages 273-296.e1"},"PeriodicalIF":3.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442658","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":"Optimizing Tarlatamab Delivery in Small Cell and Neuroendocrine Lung Cancer: Real-World Insights into Step-Up Dosing and Prophylactic Tocilizumab Use","authors":"Utsav Joshi ,&nbsp;Faustine Ong ,&nbsp;Daniel Melzer ,&nbsp;Joanna C. Ma ,&nbsp;Andreas Saltos ,&nbsp;Alberto Chiappori ,&nbsp;Benjamin Creelan ,&nbsp;Bruna Pellini ,&nbsp;Charles Lu ,&nbsp;Eric Haura ,&nbsp;Michael Shafique ,&nbsp;Tawee Tanvetyanon ,&nbsp;Syeda Saba Kareem ,&nbsp;Pravash Budhathoki ,&nbsp;Daniela C. Bravo Solarte ,&nbsp;Syeda Mahrukh Hussnain Naqvi ,&nbsp;Omar Castaneda Puglianini ,&nbsp;Sameh Gaballa ,&nbsp;Jhanelle E. Gray ,&nbsp;Sonam Puri","doi":"10.1016/j.cllc.2025.11.018","DOIUrl":"10.1016/j.cllc.2025.11.018","url":null,"abstract":"<div><h3>Purpose</h3><div>Tarlatamab, a DLL3-targeted bispecific T-cell engager, has emerged as a second-line therapy for extensive-stage small cell lung cancer (ES-SCLC) following progression on platinum-based chemoimmunotherapy. While clinical trials have demonstrated promising efficacy, real-world data on safety remain limited.</div></div><div><h3>Methods</h3><div>This retrospective study included 40 patients with SCLC or high-grade neuroendocrine carcinoma treated with tarlatamab at Moffitt Cancer Center between May 2024 and February 2025. Clinical, laboratory, and treatment-related variables including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) were reviewed. Predictive models for these toxicities were developed using Firth logistic regression based on data from 30 patients who did not receive prophylactic tocilizumab.</div></div><div><h3>Results</h3><div>The median age was 66.5 years; 55% were male, and 87.5% had an ECOG performance status of 0 to 1. Among patients who did not receive prophylactic tocilizumab (N = 30), 53.3% developed CRS and 23.3% developed ICANS after Cycle 1 Day 1, with 10% experiencing grade ≥ 3 severity for each. Three patients discontinued treatment due to severe CRS/ICANS, with 2 deaths and 1 transition to hospice. Among those who received prophylactic tocilizumab (N = 10), 1 patient developed grade 2 CRS and none developed ICANS. Elevated LDH and liver metastasis were independent predictors of CRS; LDH was also predictive of grade ≥ 2 CRS. Diabetes and cardiovascular disease were independently associated with ICANS.</div></div><div><h3>Conclusion</h3><div>Tarlatamab is associated with higher CRS and ICANS rates in real-world settings than observed in trials. Prophylactic tocilizumab may mitigate these toxicities in high-risk patients and should be considered for incorporation into treatment protocols.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 2","pages":"Pages 48-58"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osimertinib-Induced Lung Injury and Treatment Rechallenge: Clinical Insights From a Case Report With a Comprehensive Literature Review","authors":"Fabrizio Citarella ,&nbsp;Emanuele C. Mingo ,&nbsp;Matteo Fiorenti ,&nbsp;Marco Russano ,&nbsp;Giuseppe Perrone ,&nbsp;Giulia La Cava ,&nbsp;Valentina Santo ,&nbsp;Alessia Vendittelli ,&nbsp;Leonardo Brunetti ,&nbsp;Cecilia Saracino ,&nbsp;Ludovica Esposito ,&nbsp;Andrea Malgeri ,&nbsp;Sara Ramella ,&nbsp;Bruno Vincenzi ,&nbsp;Giuseppe Tonini ,&nbsp;Alessio Cortellini","doi":"10.1016/j.cllc.2025.12.006","DOIUrl":"10.1016/j.cllc.2025.12.006","url":null,"abstract":"<div><div>Osimertinib is a third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) widely used in EGFR mutant non-small cell lung cancer (NSCLC). Despite a favorable safety profile, osimertinib-induced lung injury (OILI) remains a rare but clinically significant adverse event. Guidelines recommend permanent discontinuation after severe cases; the rechallenge feasibility in selected patients remains an area of ongoing debate.</div><div>We report a case of a 70-year-old patient with EGFR mutant NSCLC who developed grade 4 OILI requiring hospitalization. After resolution with corticosteroids, treatment was switched to afatinib. The patient later progressed showing a de novo EGFR T790M mutation and MET amplification. Considering the limited treatment options, a carefully monitored osimertinib rechallenge at a reduced dose (40 mg/d) was attempted. The patient tolerated treatment without pneumonitis recurrence and achieved disease control for several months before ultimately progressing.</div><div>To contextualize this case, we conducted a scoping review of the available literature on osimertinib administration after lung toxicity. Among 27 studies comprising 1645 patients, 449 (27.3%) developed OILI. One hundred eighty nine (42%) were re-treated, either with (114) or without (75) a temporary interruption. The reported risk of recurrence after rechallenge was low, particularly in cases of mild-to-moderate lung injury. In more severe cases the risk was difficult to determine based on the clinical details available.</div><div>This study highlights the heterogeneous approaches to OILI and the potential feasibility of rechallenge in selected patients. Given the expanding osimertinib use for early and advanced stage NSCLC, further research is warranted to refine treatment decisions and optimize patient safety.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 2","pages":"Pages 59-68"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975195","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":"Is Lobectomy Associated With Improved Outcomes Compared to Segmentectomy in Small Cell Lung Cancer Discovered at the Time of Resection?","authors":"Sneha S. Alaparthi ,&nbsp;Anurag Ishwar ,&nbsp;Gregory Whitehorn ,&nbsp;Isheeta Madeka ,&nbsp;Tyler Grenda ,&nbsp;John D. Jacob ,&nbsp;Nathaniel  R. Evans  III ,&nbsp;Olugbenga  T. Okusanya","doi":"10.1016/j.cllc.2025.08.017","DOIUrl":"10.1016/j.cllc.2025.08.017","url":null,"abstract":"<div><h3>Background</h3><div>Small cell lung cancer (SCLC) represents approximately 10%-15% of all lung cancer cases in the United States. The extent of surgery for early-stage SCLC remains controversial,with the treatment standard being chemotherapy or chemoradiotherapy. We aim to evaluate outcomes among the patients who underwent a lobectomy or segmentectomy in SCLC diagnosed on the day of resection.</div></div><div><h3>Methods</h3><div>This retrospective cohort study utilized the NCDB. We examined patients &gt;18 who underwent a lobectomy or segmentectomy between 2010 and 2019 who had clinically node negative SCLC diagnosed at the time of resection. Outcome variables include 5- year, 30-day, 90-day mortality and readmission rates. Propensity score matching was utilized to compare outcomes between groups.</div></div><div><h3>Results</h3><div>564 patients were examined, with a mean age of 68. Males comprised of 42.9% of the cohort. 65 (12%) patients underwent segmentectomy and 499 (88%) patients underwent lobectomy. There were no differences in nodal upstaging (<em>P</em> = .31) and T stage upstaging (<em>P</em> = .37) between the 2 cohorts. 90.2% of the population was clinical stage I (<em>P</em> = .003). There were no significant differences in 5- year, 30-day, 90-day mortality (<em>P</em> = .22, <em>P</em> = .40, <em>P</em> = .77), and readmission (<em>P</em> = .57) in this cohort. After PSM (<em>n</em> = 118) there continued to be no significant difference in all outcomes between cohorts.</div></div><div><h3>Conclusions</h3><div>In this study, we found that rates of T and N upstaging, 5-year mortality, and short-term outcomes did not differ amongst cohorts, showing that patients who undergo segmentectomy may not benefit from undergoing a more extensive resection.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 2","pages":"Pages 161-168"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205839","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":"Effects of Sex on Mortality in Patients With Lung Cancer: A Multiple Mediation Analysis of The Boston Lung Cancer Study","authors":"Adriana Araceli Rodriguez Alvarez ,&nbsp;Yuming Sun ,&nbsp;Yi Li ,&nbsp;David C. Christiani","doi":"10.1016/j.cllc.2025.09.007","DOIUrl":"10.1016/j.cllc.2025.09.007","url":null,"abstract":"<div><h3>Objective</h3><div>Identify the specific variables that can explain the sex difference in lung cancer mortality.</div></div><div><h3>Material and Methods</h3><div>This retrospective cohort study analyzed data from the Boston Lung Cancer Study (1992-2022). We employed descriptive statistics, Wilcoxon rank-sum test, and Pearson’s Chi-square test to compare demographic and clinical variables by sex. Kaplan–Meier survival curves and Cox proportional hazards models were used to evaluate survival differences. Mediation analysis was conducted to investigate causal pathways through which sex influences mortality, incorporating cancer stage, smoking status, and treatment modalities.</div></div><div><h3>Results</h3><div>Among 7642 patients, 53.7% were women. Men were older, had heavier smoking histories, and more frequently received chemotherapy and radiotherapy, whereas women underwent more surgeries. Median survival was significantly longer for women (4.54 vs. 2.59 years), with a 29% reduced hazard of lung cancer–related death (HR: 0.71; 95% CI, 0.66-0.75; <em>P</em> &lt; .0001). Approximately 32% of this survival difference was mediated by early-stage diagnosis, surgical intervention, and smoking history.</div></div><div><h3>Conclusion</h3><div>Women exhibited a survival advantage, of which only about one-third was explained by earlier diagnosis and higher surgical intervention rates. The remaining two-thirds of the mortality difference remains unexplained. Addressing these modifiable factors may reduce sex inequalities in lung cancer outcomes.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 2","pages":"Pages 201-209.e3"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354015","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":"Revisiting AI Model Interpretability in Lung Cancer Screening: Challenges in Balancing Predictive Performance and Reliability","authors":"Souichi Oka ,&nbsp;Yoshiyasu Takefuji","doi":"10.1016/j.cllc.2025.09.005","DOIUrl":"10.1016/j.cllc.2025.09.005","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 2","pages":"Pages 197-198"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279101","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}