Clinical lung cancer最新文献

{"title":"Late Survival and Hospital Trajectory After Pneumonectomy for Non-small Cell Lung Cancer","authors":"Elisa Daffré ,&nbsp;Samir Bouam ,&nbsp;Salvatore Strano ,&nbsp;Kim Blanc ,&nbsp;Audrey Lupo-Mansuet ,&nbsp;Emelyne Canny ,&nbsp;Ludovic Fournel ,&nbsp;Antonio Bobbio ,&nbsp;Mathilde Prieto ,&nbsp;Marco Alifano","doi":"10.1016/j.cllc.2025.09.014","DOIUrl":"10.1016/j.cllc.2025.09.014","url":null,"abstract":"<div><h3>Objectives</h3><div>Lung cancer may require complex interventions such as pneumonectomy. This study investigates late survival after pneumonectomy and assesses the need for late rehospitalizations.</div></div><div><h3>Methods</h3><div>We performed a retrospective analysis of 479 consecutive patients with lung cancer undergoing pneumonectomy at our institution between 2005 and 2015. Survival was assessed at 3, 5, and 8 years and Cox multivariate analysis was used to identify independent predictors. The National anonymized medico-economic database (PMSI) was used to study early and late (up to 10 years after surgery) postpneumonectomy hospital trajectories (excluding routine follow-up visits) of patients in the last 2 years of the study period (<em>n</em> = 179).</div></div><div><h3>Results</h3><div>The mean age of patients was 62.7 ± 9.9 years and 74.9% were men; 56.18% had FEV1 below 80% of predicted. Stage III accounted for 62.84% of patients. Overall survival at 3, 5 and 8 years was 58.9%, 47.6% and 39.6%, respectively. Male sex, active tobacco smoking, Charlson Comorbidity Index &gt;5, stage III-IV, and occurrence of Clavien Dindo≥3 postoperative complications were independent predictors of worse survival.</div><div>After pneumonectomy, a total of 4845 hospitalisations were recorded in 179 patients, 886 for postoperative adjuvant treatments. Forty-five out of the 179 patients had a late hospitalisation for lung cancer recurrence, with an average delay of 23.3 months. There were 25 readmissions, involving 20/179 patients, for respiratory failure, whereas 15/179 patients were readmitted for cardiac failure. In addition, 9/179 patients were readmitted for a new nonpulmonary cancer.</div></div><div><h3>Conclusions</h3><div>Despite the strong physiological impact, pneumonectomy has satisfactory short and long-term results.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 2","pages":"Pages 249-258.e1"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421488","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":"Advanced Thymic Carcinoma Responds to Venetoclax and Azacitidine","authors":"James Ryan ,&nbsp;Zane Yang ,&nbsp;Christina Brown ,&nbsp;Michael J. Fulham ,&nbsp;Wendy A. Cooper ,&nbsp;Steven Kao","doi":"10.1016/j.cllc.2026.01.006","DOIUrl":"10.1016/j.cllc.2026.01.006","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>Thymic carcinoma is a rare, aggressive malignancy with limited systemic treatment options beyond platinum-based chemotherapy. Responses to chemotherapy, immunotherapy, and subsequent lines of therapy are often short-lived, and there are no well-established targeted therapies. The anti-apoptotic protein BCL-2 is frequently expressed in thymic carcinomas, but BCL-2 directed therapy is not part of current standard management. Venetoclax in combination with azacitidine is an established, well-tolerated regimen for older or unfit patients with acute myeloid leukemia (AML), where it enhances apoptosis through BCL-2 inhibition and epigenetic modulation.</div></span></li><li><span>•</span><span><div>In this heavily pretreated patient with advanced thymic carcinoma who developed therapy-related AML, venetoclax plus azacitidine induced not only to hematologic remission of AML but also marked metabolic and radiologic regression of metastatic thymic carcinoma, accompanied by symptomatic improvement. The tumor demonstrated diffuse BCL-2 expression on immunohistochemistry, supporting a biologically plausible mechanism of response.</div></span></li><li><span>•</span><span><div>This case adds to the limited emerging evidence that BCL-2 blockade, particularly in combination with hypomethylating agents, may have clinically meaningful activity in thymic epithelial malignancies. These findings identify BCL-2 as a potential therapeutic target in thymic carcinoma and suggests that venetoclax-based regimens could be explored as a therapeutic strategy in selected patients, particularly those with BCL-2 expressing tumors or limited standard options. This case also supports prospective investigation of BCL-2 directed strategies in thymic epithelial tumors and highlights the value of biomarker driven treatment even in rare thoracic cancers.</div></span></li></ul></div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 2","pages":"Pages 135-139"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147316602","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":"Effect of adjuvant EGFR-TKI therapy on the prognosis of pathological stage I invasive lung adenocarcinoma with sensitive EGFR mutations","authors":"Zetao Liu ,&nbsp;Zhiyu Peng ,&nbsp;Jie Cao ,&nbsp;Zhaokang Huang ,&nbsp;Xizhou Liao ,&nbsp;Xiaorong Zong ,&nbsp;Chenglin Guo ,&nbsp;Jiandong Mei","doi":"10.1016/j.cllc.2025.09.001","DOIUrl":"10.1016/j.cllc.2025.09.001","url":null,"abstract":"<div><h3>Background</h3><div>The prognosis of stage I non-small cell lung cancer (NSCLC) remains significant heterogeneity. It is not clear whether adjuvant epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy can reduce recurrence and improve survival in patients with stage I disease, especially stage IA.</div></div><div><h3>Methods</h3><div>This retrospective, single-center, observational, propensity score-matched study enrolled patients with completely resected pathological stage I invasive lung adenocarcinoma (LUAD) with sensitive <em>EGFR</em> mutations. Inverse probability of treatment weighting (IPTW) was applied to address the imbalance in baseline characteristics. The primary endpoint was relapse-free survival (RFS), and the secondary endpoint was overall survival (OS). RFS and OS were calculated using the Kaplan-Meier method, and the log-rank test was used to compare differences between the two groups. The hazard ratio (HR) and 95% confidence interval (CI) were calculated using Cox regression. Stratified analysis was performed according to the risk of recurrence determined by tumor characteristics and surgical procedure.</div></div><div><h3>Results</h3><div>A total of 819 eligible patients were included in the study. After IPTW, 823 patients were included in the analysis, of which 183 (22.2%) patients were in the EGKF-TKI group and 640 (77.8%) patients were in the observation group. In patients with stage I disease, the 5-year RFS was 92.6% in the EGFR-TKI group, compared with 77.0% in the observation group (HR = 0.26; 95% CI, 0.15–0.46; <em>P</em> &lt; .001). Superior RFS was observed with adjuvant EGFR-TKI therapy in most predefined subgroups. There was no significant difference in OS between the two groups for patients with stage I, stage IA, or stage IB disease.</div></div><div><h3>Conclusions</h3><div>Our study demonstrates that adjuvant EGFR-TKI therapy improves RFS in patients with stage IA and IB invasive LUAD, but the difference in OS is not statistically significant.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 2","pages":"Pages 177-188.e5"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145581665","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":"Striving for an Enhanced Tumor Classification System: Reflections on Cancer, Prognosis, Human Nature and Reality","authors":"Frank Detterbeck ,&nbsp;Ramon Rami-Porta","doi":"10.1016/j.cllc.2025.09.011","DOIUrl":"10.1016/j.cllc.2025.09.011","url":null,"abstract":"<div><div>The TNM classification of anatomic tumor extent is a prominent part of the clinical care of patients with lung cancer. As treatment increasingly involves a blend of local and systemic therapies there is an increasing desire for an “enhanced TNM” that includes other factors that impact clinical decision-making. Typically, this is expressed as a need to include prognostic factors in the TNM classification to better predict patient outcomes. A clear understanding of the issues involved is needed in order to satisfy this desire in a way that is useful in clinical practice. We aim to add to the discussion of the topic in the lung cancer medical community by offering a perspective on what the TNM classification is, what the prognosis of patients as defined by tumor stage represents, and an exploration of what is meant when people talk about needing better prognostic prediction.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 2","pages":"Pages 237-241"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147449102","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":"Cumulative Incidence and Type-Specific Risk Factors of Pneumonitis After Definitive Chemoradiotherapy With or Without Immunotherapy in Locally Advanced Non-Small Cell Lung Cancer","authors":"Jiawen Sun ,&nbsp;Xin Dong ,&nbsp;Zhixue Fu ,&nbsp;Sen Han ,&nbsp;Yuliang Liu ,&nbsp;Anhui Shi ,&nbsp;Huiming Yu ,&nbsp;Yuting Zhao ,&nbsp;Wei Deng ,&nbsp;Leilei Jiang ,&nbsp;Dan Yang ,&nbsp;Xiao Chang ,&nbsp;Liuhua Long ,&nbsp;Jiayi Yu ,&nbsp;Yue Teng ,&nbsp;Rong Yu ,&nbsp;Weihu Wang","doi":"10.1016/j.cllc.2025.11.020","DOIUrl":"10.1016/j.cllc.2025.11.020","url":null,"abstract":"<div><h3>Objectives</h3><div>This study assessed the impact of immune checkpoint inhibitors (ICIs) addition and timing on the incidence of treatment-related pneumonitis (TRP) and explored type-specific risk factors in unresectable locally advanced non-small cell lung cancer (LA-NSCLC) patients receiving definitive chemoradiotherapy (CRT).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 449 LA-NSCLC patients receiving definitive CRT±ICIs from January 2019 to December 2021. Patients were grouped by CRT alone (<em>n</em> = 236) or CRT+ICIs (<em>n</em> = 213), with the latter stratified by ICIs timing (induction/concurrent/consolidation) relative to radiotherapy. TRP (including radiation pneumonitis [RP] and checkpoint inhibitor pneumonitis [CIP]) was graded per CTCAE v5.0 through multidisciplinary review. We applied inverse probability of treatment weighting (IPTW) to adjust baseline covariates, Fine-Gray competing-risk model to estimate cumulative incidence and risk factors.</div></div><div><h3>Results</h3><div>Grade ≥ 2 TRP incidence was significantly increased with CRT+ICIs than CRT (30.6% vs. 9.8%; IPTW-adjusted <em>P</em> &lt; .001), highest with concurrent ICIs (51.5%), followed by induction (32.0%) and consolidation (24.2%). Grade ≥ 2 RP increased to 16.7% with ICIs (IPTW-adjusted <em>P</em> = .004), peaking in the concurrent subgroup (39.1%), while comparable between induction and consolidation (16.1% vs. 12.2%). Independent predictors of grade ≥ 2 RP included ICIs treatment, gemcitabine-based induction chemotherapy, and higher lung dosimetry, with cut-offs of lung V20 (volume receiving ≥ 20 Gy) = 26.8% and mean lung dose (MLD) = 14.05 Gy. Grade ≥ 2 CIP incidence (14.2%) was associated with pre-existing interstitial lung disease or emphysema, PD-1 inhibitors and elevated MLD.</div></div><div><h3>Conclusions</h3><div>ICIs addition and timing significantly affected TRP risk. Mitigating lung toxicity requires careful selection of ICIs strategy, chemotherapy agents, and optimizing lung radiation dosimetry.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 2","pages":"Pages 14-24"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924420","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":"Incidence of Pneumonitis in Asian Patients With Lung Cancer: A Systematic Literature Review and Meta-analysis","authors":"Yuting Kuang ,&nbsp;Ke Zu ,&nbsp;Dezhi Xing ,&nbsp;Aixue Liu ,&nbsp;Jennifer Uyei ,&nbsp;Arianna Nevo ,&nbsp;Hsiu-Ching Chang ,&nbsp;Christine M. Pierce","doi":"10.1016/j.cllc.2025.11.019","DOIUrl":"10.1016/j.cllc.2025.11.019","url":null,"abstract":"<div><div>Pneumonitis is a notable toxicity of lung cancer therapies, particularly radiation and immune checkpoint inhibitors. Racial and ethnic disparities in pneumonitis risk exist, yet heterogeneity remains understudied. This study aimed to quantify pneumonitis incidence among East and Southeast Asian patients treated for non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). A systematic literature review (SLR) and single-arm meta-analysis were conducted following Cochrane and PRISMA guidelines. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and 5 local language databases were searched for studies published from January 1, 2014 to August 2, 2023. Included were clinical trials in Asian patients undergoing pharmacological or radiation therapy for NSCLC or SCLC. The SLR included 218 trials (NSCLC: 202, SCLC: 16). Pooled incidence of all-grade, grade 1 to 2, and grade 3 to 5 pneumonitis in NSCLC was 5.42% (95% CI, 4.25-6.89), 3.58% (95% CI, 2.54-5.03) and 1.34% (95% CI, 1.06-1.70), respectively. For SCLC, pooled incidence was 12.21% (95% CI, 4.77-27.85), 7.64% (95% CI, 2.48-21.23), and 2.43% (95% CI, 1.47-3.97), respectively. Significantly higher rates of pneumonitis were observed in patients receiving chemoradiation or radiation-containing treatments, in general, compared to those not treated with radiation; grade 3 to 5 events in SCLC were not significantly different. This study establishes baseline pneumonitis risk in East and Southeast Asian patients treated for NSCLC and SCLC, highlighting higher incidence in those receiving radiation-containing treatments, particularly for lower-grade events. The results help contextualize safety data from clinical trials enrolling Asian patients.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 2","pages":"Pages 25-37"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145975196","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":"Pembrolizumab Plus Platinum Doublet Chemotherapy With Lenvatinib in Unresectable Pleural Mesothelioma as First-Line Treatment (PENINSULA): A Study Protocol for a Single-Arm, Multi-Institutional, Phase II Clinical Trial","authors":"Tetsuya Takagawa ,&nbsp;Kanae Takahashi ,&nbsp;Yuji Orimoto ,&nbsp;Yukie Morisaki ,&nbsp;Shinichiro Suna ,&nbsp;Takashi Daimon ,&nbsp;Takashi Kijima ,&nbsp;Kozo Kuribayashi","doi":"10.1016/j.cllc.2025.12.010","DOIUrl":"10.1016/j.cllc.2025.12.010","url":null,"abstract":"<div><h3>Background</h3><div>In pleural mesothelioma (PM), platinum-based chemotherapy and immune checkpoint inhibitors including nivolumab and ipilimumab have been approved but have not shown sufficient therapeutic efficacy, and the development of new therapies is desired. Pembrolizumab, anti-PD-1 antibody and lenvatinib which has inhibitory effect of angiogenesis are also expected to have a therapeutic effect on PM.</div></div><div><h3>Patients and Methods</h3><div>Twenty-five patients will be enrolled in PENINSULA trial. In induction treatment, study interventions include oral lenvatinib, 8 mg QD, and pembrolizumab, 200 mg, carboplatin (AUC 5 mg/mL/min) or cisplatin (75 mg/m²), and pemetrexed, 500 mg/m² all given by intravenous (IV) infusion. In maintenance treatment, participants may receive lenvatinib, 20 mg QD, and pembrolizumab, 200 mg. Lenvatinib and pembrolizumab may be given for up to a total of 35 courses. The primary endpoint is overall response rate. The secondary endpoints are progression-free survival, overall survival time, tumor shrinkage (disease control rate), duration of response, best overall response and safety evaluation.</div></div><div><h3>Conclusion</h3><div>The purpose of this clinical trial is to evaluate the efficacy and safety of lenvatinib in combination with pembrolizumab and standard chemotherapy as first-line therapy in adult patients with PM.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 2","pages":"Pages 75-79"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146074256","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":"Pembrolizumab in Combination With Platinum-Based Chemotherapy in Patients With Recurrent EGFR and ALK Gene Altered Non-Small-Cell Lung Cancer (NSCLC)","authors":"Shirish M. Gadgeel ,&nbsp;Misako Nagasaka ,&nbsp;Karen Dziubek ,&nbsp;Thomas Braun ,&nbsp;Khaled Hassan ,&nbsp;Haiying Cheng ,&nbsp;Balazs Halmos ,&nbsp;Antoinette Wozniak ,&nbsp;James Stevenson ,&nbsp;Pradnya Patil ,&nbsp;Nathan Pennell ,&nbsp;Mary Jo Fidler ,&nbsp;Angel Qin ,&nbsp;Zeqi Niu ,&nbsp;Sunitha Nagrath ,&nbsp;Gregory P. Kalemkerian","doi":"10.1016/j.cllc.2025.09.002","DOIUrl":"10.1016/j.cllc.2025.09.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Immune checkpoint inhibitors have limited efficacy in patients with EGFR-mutant (EGFR+) and ALK-rearranged (ALK+) non-small cell lung cancer (NSCLC). We conducted a phase II study to evaluate the efficacy of pembrolizumab with carboplatin and pemetrexed in these patients.</div></div><div><h3>Patients and Methods</h3><div>EGFR+ or ALK+ NSCLC patients, previously treated with targeted therapy, were eligible. Carboplatin, pemetrexed and pembrolizumab were administered every 3 weeks for 4 cycles followed by maintenance pemetrexed and pembrolizumab. The primary endpoint was response rate (RR). Blood for circulating tumor cells (CTCs) was collected prior to the 1st and 3rd cycles. The plan was to enroll 28 evaluable patients in both EGFR+ and ALK+ cohorts.</div></div><div><h3>Results</h3><div>Of the 33 patients enrolled, 26 had EGFR+ and 7 had ALK+ NSCLC. RR (95% CI,) was 46% (27%, 67%) in EGFR+ and 29% (4%, 71%), in ALK+ patients, respectively. Median progression free survival (PFS) and overall survival (OS) in the EGFR+ cohort were 8.3 months (7.2-16.5) and 22.2 months (20.6-NE), respectively. In the ALK+ cohort, median PFS and OS were both 2.9 months. The median CTC count at baseline in 15 evaluable EGFR+ patients was 4 cells/mL (0-23). OS among EGFR+ patients with decreasing vs. increasing CTC count during treatment was not reached vs. 18.5 months, respectively (<em>P</em> = .52). The most common adverse events were fatigue, nausea, anemia and AST/ALT elevation.</div></div><div><h3>Conclusion</h3><div>Pembrolizumab in combination with chemotherapy demonstrated encouraging RR of 42% and OS of 22 months among patients with recurrent EGFR+ NSCLC. The efficacy in ALK+ patients was not encouraging.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 2","pages":"Pages 189-196.e1"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes and Predictive Factors in NSCLC after Surgery: Findings from the RAC-TAC Study","authors":"Alessio Bruni ,&nbsp;Davide Franceschini ,&nbsp;Beatrice Marini ,&nbsp;Stefano Vagge ,&nbsp;Patrizia Ciammella ,&nbsp;Matteo Sepulcri ,&nbsp;Roberta Grassi ,&nbsp;Federico Gagliardi ,&nbsp;Anna Cappelli ,&nbsp;Elisa D'Angelo ,&nbsp;Mattia Manetta ,&nbsp;Melissa Scricciolo ,&nbsp;Cesare Guida ,&nbsp;Ivan Fazio ,&nbsp;Paolo Borghetti ,&nbsp;Salvatore Cappabianca ,&nbsp;Valerio Nardone","doi":"10.1016/j.cllc.2025.09.012","DOIUrl":"10.1016/j.cllc.2025.09.012","url":null,"abstract":"<div><h3>Purpose</h3><div>Recent trials like LUNG-ART and PORT-C have redefined postoperative radiation therapy (PORT) for pN2 non-small cell lung cancer (NSCLC). To assess the acute and long-term toxicities of contemporary PORT techniques, the Italian Association of Radiotherapy and Oncology Lung Cancer Study Group initiated a multicenter observational study, analyzing clinical factors influencing local control, distant control, and overall survival.</div></div><div><h3>Methods</h3><div>Data from 6 Italian centers were reviewed for NSCLC patients undergoing PORT between 2015 and 2020. Acute and late toxicity outcomes were previously reported. This study correlates clinical variables with local recurrence, distant recurrence, and survival outcomes.</div></div><div><h3>Results</h3><div>Local recurrence correlated with the number of lymph nodes removed (<em>P</em> = .003) and patient age (<em>P</em> = .006). Distant recurrence was linked to the number of positive lymph nodes (<em>P</em> = .001) and T stage (<em>P</em> = .009). Overall survival was significantly associated with the number of positive nodes (<em>P</em> = .006) and ECOG performance status (<em>P</em> &lt; .001). A risk stratification system categorized patients into low, intermediate, and high-risk groups, with the low-risk group showing significantly better progression-free survival (<em>P</em> &lt; .001), distant control (<em>P</em> = .004), and overall survival (<em>P</em> = .008).</div></div><div><h3>Conclusions</h3><div>Distant metastases remain the main recurrence type. The extent of lymph node dissection and the count of positive nodes significantly influence recurrence patterns. These findings support integrating systemic and local therapies to improve outcomes in pN2 NSCLC.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 2","pages":"Pages 242-248"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the Editor","authors":"Margrethe Bang Henriksen ,&nbsp;Ole Hilberg ,&nbsp;Christian Juul ,&nbsp;Rasmus Thomsen ,&nbsp;Sara Witting Christensen Wen ,&nbsp;Morten Borg ,&nbsp;Andreas Fanø ,&nbsp;Alon Lanyado ,&nbsp;Itamar Menuhin-Gruman","doi":"10.1016/j.cllc.2025.09.006","DOIUrl":"10.1016/j.cllc.2025.09.006","url":null,"abstract":"","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"27 2","pages":"Pages 199-200"},"PeriodicalIF":3.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147449210","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}