Journal of Thoracic Oncology最新文献

{"title":"Overdiagnosis of Lung Cancer due to Introduction of Low-Dose Computed Tomography in Average-Risk Populations in China.","authors":"Dongchen Xie, Li Zhang, Na He, Chen Yang, Ruoxin Zhang, Haiquan Chen, Xing Liu, Chen Suo, Mengyan Wang, Yan Wei, Lipeng Hao, Wanghong Xu","doi":"10.1016/j.jtho.2025.02.013","DOIUrl":"https://doi.org/10.1016/j.jtho.2025.02.013","url":null,"abstract":"<p><strong>Background: </strong>Low-dose computed tomography (LDCT) has been widely used in health check-ups in China since 2011. The introduction of LDCT in average-risk populations may have led to substantial overdiagnosis of lung cancer.</p><p><strong>Methods: </strong>This registry-based study included 46,978 incident cases and 34,475 deaths of lung cancer derived from a population of approximately 3.21 million in the Pudong New Area of Shanghai, China, from 2002 to 2020. We calculated the age-standardized rates of overall, stage- and histology-specific incidence and overall mortality by sex. The numbers and proportions of cases attributable to overdiagnosis were estimated based on the comparison between the shape of the age-specific curve with that prior to the introduction of LDCT in average-risk populations since 2011.</p><p><strong>Results: </strong>The age-standardized incidence of lung cancer increased rapidly since 2011 in both males and females, while the age-standardized mortality declined over the period. The upward trends in incidence were mainly observed in women for early-stage cancer and for lung adenocarcinoma. Overall, no significant overdiagnosis was observed in men, whereas the overdiagnosis rate grew from 22% in 2011-2015 to 50% in 2016-2020 in women. Further analysis showed elevated numbers (proportions) of lung adenocarcinoma cases attributable to overdiagnosis, which rose from 182 (8%) in 2011-2015 to 827 (22%) in 2016-2020 in men, and from 1,842 (85%) to 4,171 (89%) in women. ConclusionThis study demonstrates considerable and increasing overdiagnosis of lung adenocarcinoma in Chinese men and women. The guideline is urgently needed to maximize the benefits of LDCT screening and reduce the potential overdiagnosis of lung cancer.</p>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lurbinectedin plus pembrolizumab in relapsed small cell lung cancer (SCLC): the phase I/II LUPER study.","authors":"Antonio Calles, Alejandro Navarro, Bernard Gaston Doger Speville Uribe, Enric Álvarez Colomé, María de Miguel, Rosa Álvarez, Marta Arregui, Víctor Moreno, Pedro Rocha, Emiliano Calvo, Jorge Ramon-Patino, Elena Corral de la Fuente, Daniel Alcalá-López, Olga Boix, Melissa Fernández-Pinto, Jose Rodríguez-Morató, Ramón Palmero, Ernest Nadal, Maria Jove, Enriqueta Felip","doi":"10.1016/j.jtho.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.jtho.2025.02.005","url":null,"abstract":"<p><strong>Introduction: </strong>Small-cell lung cancer (SCLC) has limited second-line treatment options after chemotherapy. We assessed the efficacy and safety of lurbinectedin combined with pembrolizumab in relapsed SCLC patients who had not received prior immunotherapy, aiming to prevent early progression and achieve sustained responses.</p><p><strong>Methods: </strong>The LUPER trial (NCT04358237) is a phase I/II, single-arm, open-label, multicenter study. Phase I established the recommended phase II dose (RP2D). The primary endpoint of phase II was investigator-confirmed objective response rate (ORR). Secondary endpoints included duration of response (DoR), progression-free survival (PFS), overall survival (OS), and safety. Patients were categorized as platinum-sensitive (chemotherapy-free interval ≥90 days) or platinum-resistant (<90 days).</p><p><strong>Results: </strong>The RP2D was 3.2 mg/m² lurbinectedin and 200 mg pembrolizumab IV every 3 weeks. Phase II included 28 patients, 50% were platinum-resistant. ORR was 46.4% (95% CI, 27.5-66.1; p<0.001), including three complete responses, with 2 complete metabolic responses post-treatment completion at 35 cycles. Median DoR was 7.8 months, with 40% maintaining responses for ≥12 months. Median PFS was 4.6 months, and median OS was 10.5 months. Platinum-sensitive patients had significantly better PFS (8.0 vs. 2.8 months, p=0.012) and numerically superior OS (15.7 vs. 7.1 months, p=0.058). Grade ≥3 treatment-related adverse events occurred in 71.4% of patients, with transient neutropenia being the most common. Immune-related adverse events were consistent with prior pembrolizumab studies.</p><p><strong>Conclusions: </strong>Lurbinectedin plus pembrolizumab showed promising efficacy in relapsed SCLC, particularly for platinum-sensitive patients, with a known and manageable safety profile. These results support further exploration of this combination in SCLC treatment.</p>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to 'The International Association for the Study of Lung Cancer Staging Project for Lung Cancer: Proposals for the Revision of the M Descriptors in the Forthcoming Ninth Edition of the TNM Classification for Lung Cancer' [Journal of Thoracic Oncology, Volume 19 Issue 5 (2024) 786-802].","authors":"Kwun M Fong, Adam Rosenthal, Dorothy J Giroux, Katherine K Nishimura, Jeremy Erasmus, Yolande Lievens, Mirella Marino, Edith M Marom, Paul Martin Putora, Navneet Singh, Francisco Suárez, Ramon Rami-Porta, Frank Detterbeck, Wilfried E E Eberhardt, Hisao Asamura","doi":"10.1016/j.jtho.2025.01.017","DOIUrl":"https://doi.org/10.1016/j.jtho.2025.01.017","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety, Pharmacokinetics, and Efficacy of TY-9591 (Deuterated Osimertinib Derivative) in Advanced EGFR-mutated Non-Small Cell Lung Cancer: A Phase 1 Dose-Escalation and Dose-Expansion Study.","authors":"Baohui Han, Jie Liu, Lin Wu, Yanqiu Zhao, Wei Zhang, Bolin Chen, Jianbo He, Jianhua Shi, Yanqing Liu, Zhe Zhang, Xiugui Chen, Yusheng Wu","doi":"10.1016/j.jtho.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.jtho.2025.02.003","url":null,"abstract":"<p><strong>Background: </strong>This phase 1 study evaluated the safety, pharmacokinetics, and preliminary efficacy of TY-9591 (asandeutertinib), a deuterated osimertinib derivative.</p><p><strong>Methods: </strong>Patients with advanced EGFR-mutated (most commonly exon 19 deletions or L858R) non-small cell lung cancer (NSCLC) were enrolled. In the dose-escalation phase, TY-9591 was administered from 20 mg to 200 mg once daily to assess dose-limiting toxicities (DLTs) and the maximum tolerated dose (MTD). In the dose-expansion phase, patients were treated with 80 mg, 120 mg, or 160 mg doses to further evaluate safety, pharmacokinetics, and preliminary efficacy.</p><p><strong>Results: </strong>A total of 105 patients were enrolled (dose-escalation: n=19; dose-expansion: n=86). During the dose-escalation phase, no DLTs were observed, and MTD was not reached. Treatment-related adverse events (TRAEs) were reported in 100 patients (95.2%), with 32 (30.5%) experiencing grade ≥3 TRAEs. The most common TRAEs were white blood cell count decreased (54.3%), neutrophil count decreased (46.7%), blood creatine phosphokinase increased (39.0%), and anaemia (39.0%). Pharmacokinetic analysis showed that TY-9591 had a favorable profile with reduced levels of active metabolites. During the dose-expansion phase (n=79), the median progression-free survival (mPFS) for first-line EGFR-mutated (exon 19 deletions or L858R) NSCLC was 21.5 months (95% CI: 17.3, 27.3), while confirmed objective response rate (ORR) was 85.9% (95% CI: 76.2, 92.7). In patients with L858R mutations (n=36), mPFS was 19.3 months (95% CI: 13.1, 23.5), and confirmed ORR was 86.1% (95% CI: 70.5, 95.3).</p><p><strong>Conclusion: </strong>TY-9591 demonstrated a favorable safety profile and substantial efficacy in treating EGFR-mutated NSCLC, especially in patients with L858R mutations.</p>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-Line Camrelizumab versus Placebo Plus Chemotherapy with or without Radiotherapy for Brain Metastases in Non-Small-Cell Lung Cancer: The CTONG 2003 Randomized Placebo-Controlled Trial.","authors":"Yang-Si Li, Qitao Yu, Qing Bu, Lizhu Lin, Fangling Ning, Yun Zhao, Gang Wu, Gen Lin, Aimin Zang, Hao Sun, Jie Huang, Hai-Yan Tu, Shenglin Ma, Chengzhi Zhou, Anwen Liu, Cailian Wang, Yu Yao, Guang Han, Jun Zhao, Qing Zhou, Hong-Hong Yan, Si-Yang Maggie Liu, Mei-Mei Zheng, Jingye Lv, Fengzhuo Cheng, Zhongjiang Chen, Wen-Zhao Zhong, Yi Pan, Jin-Ji Yang, Yi-Long Wu","doi":"10.1016/j.jtho.2025.02.004","DOIUrl":"https://doi.org/10.1016/j.jtho.2025.02.004","url":null,"abstract":"<p><strong>Introduction: </strong>Retrospective studies have indicated potential benefits of immunotherapy for brain metastases (BM) in non-small-cell lung cancer (NSCLC). CTONG 2003 is the first randomized controlled trial to evaluate camrelizumab for untreated BM of NSCLC.</p><p><strong>Methods: </strong>CTONG 2003 is a multicenter, randomized, double-blind, placebo-controlled trial. Treatment-naïve NSCLC with BM, negative for EGFR mutations and ALK fusions, were randomized 1:1 to receive either camrelizumab or placebo, plus platinum-doublet chemotherapy for 4-6 cycles, followed by maintenance therapy with camrelizumab or placebo ± pemetrexed for up to 31 cycles. Radiotherapy was administered for BM, if necessary, within 42 days of the first treatment dose. The co-primary endpoints were intracranial progression-free survival (iPFS) and PFS. Planned enrollment was 200 patients, but recruitment was terminated early due to therapeutic paradigm shifts globally.</p><p><strong>Results: </strong>Between May 28, 2021, and July 21, 2023, 60 patients were randomized, with 32 assigned to the camrelizumab group and 28 to the placebo group. The median iPFS was 12.7 months (95% CI: 7.1-25.3) for camrelizumab versus 9.9 months (95% CI: 6.3-14.6) for placebo (HR: 0.45, 95% CI: 0.21-0.96). The median PFS was 9.7 months (95% CI: 6.6-14.0) for camrelizumab versus 6.7 months (95% CI: 4.1-8.6) for placebo (HR: 0.57, 95% CI: 0.29-1.11). Grade 3 or higher treatment-related adverse events occurred in 65.6% and 46.4% of the respective groups, mainly neutrophil count decreased and anemia.</p><p><strong>Conclusions: </strong>Despite early termination, camrelizumab demonstrated a trend toward improved iPFS and PFS in BM of NSCLC, with an acceptable safety profile.</p>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIV Impairs Immune Responses to Tumor Neoepitopes Without Altering Mutational Profiles in Non-Small Cell Lung Cancer.","authors":"Baptiste Abbar, Karim Labreche, Jacques Cadranel, Marianne Veyri, Véronique Morin, Fatou Seck Thiam, Nathalie Desire, Marine Baron, Erell Guillerm, Alexandre Perrier, Vincent Fallet, Thomas Maitre, Anthony Canellas, Nadine Tarantino, Oulfata Mze, Assia Samri, Lisa Dejancourt, Cecilia Nakid-Cordero, Aurore Vozy, Alberto Picca, Mehdi Touat, Amélie Guihot, Christos Chouaid, Karima Mokhtari, Franck Bielle, Isabelle Brocheriou, Philippe Rouvier, Anita Rodenas Osorio, David Buob, Amira Bouzidi, Yannick Marie, Jalal Assouad, Pierre-Yves Boelle, Florence Coulet, Vincent Vieillard, Jean-Philippe Spano, Brigitte Autran","doi":"10.1016/j.jtho.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.jtho.2025.02.001","url":null,"abstract":"<p><strong>Introduction: </strong>Non-small cell lung cancer (NSCLC) remains frequent and associated with poor prognosis among people living with HIV (PLWHIV) but the contributing factors remain unknown.</p><p><strong>Methods: </strong>We prospectively compared the immunogenomics characteristics of 27 NSCLC from 15 PLWHIV and 12 immunocompetent patients (IC). Tumor whole-exome and RNA-sequencing along with a bioinformatics pipeline allowed analysis of tumor mutational burden (TMB), molecular signatures, tumor microenvironment (TME) and prediction of tumor neoepitopes. We conducted ex vivo Interferon-gamma Enzyme-Linked ImmunoSpot assays and intracellular cytokine staining (ICS) flow cytometry assays to functionally validate our bioinformatic pipeline for neoepitope prediction and to investigate the antitumor immune response.</p><p><strong>Results: </strong>TMB, molecular profiles, number of predicted neoepitopes, and their MHC-class I/II predicted restriction were similar in both groups. However, T cell responses to neoepitopes, detectable in 4/11 PLWHIV and 5/11 IC, were exclusively directed against MHC-class-II-restricted neoepitopes in PLWHIV, while it was balanced between MHC-class I and class-II neoepitopes in IC. ICS revealed primarily monofunctional responses, mainly mediated by TNFα-producing CD4 T cells against MHC-class-II-restricted neoepitopes, and by CD8 T cells producing CD107, TNFα or IFNγ against MHC-class-I-restricted neoepitopes. A low CD4 nadir was associated with the lack of neoepitope-specific responses in PLWHIV. Furthermore, PLWHIV tumor microenvironments displayed lower neutrophils proportions and decreased T cell function markers.</p><p><strong>Conclusions: </strong>Our results indicate that despite similar mutational profiles, HIV-infection severely impairs both local and systemic antitumor immune responses in patients with NSCLC, particularly to MHC-class-I-restricted neoepitopes. These findings support the use of MHC-class I-restricted neoepitope-based immunotherapy in this population.</p>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Based on the CROWN Findings, Lorlatinib Should Be the Preferred First-Line Treatment for Patients With Advanced ALK-Positive NSCLC","authors":"Hui Jing Hoe M.B.B.S. ,&nbsp;Benjamin J. Solomon M.B.B.S., PhD, FRACP","doi":"10.1016/j.jtho.2024.10.018","DOIUrl":"10.1016/j.jtho.2024.10.018","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 2","pages":"Pages 154-156"},"PeriodicalIF":21.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Even With the CROWN Findings, There Remain Multiple First-Line Treatment Options for Patients With Advanced ALK–Positive NSCLC","authors":"Vincent K. Lam MD ,&nbsp;Shirish M. Gadgeel MD","doi":"10.1016/j.jtho.2024.10.014","DOIUrl":"10.1016/j.jtho.2024.10.014","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 2","pages":"Pages 150-153"},"PeriodicalIF":21.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations on Genetic and Treatment Factors in NSCLC Segmentectomy Outcomes","authors":"Qiang Hu PhD, MD,&nbsp;Jing Sun MD","doi":"10.1016/j.jtho.2024.11.006","DOIUrl":"10.1016/j.jtho.2024.11.006","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 2","pages":"Pages e26-e27"},"PeriodicalIF":21.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Response to the Letter to the Editor: “Sites of Primary Tumors as Crucial Points When Conducting Segmentectomy for NSCLC”","authors":"Kazuo Nakagawa MD,&nbsp;Shun-ichi Watanabe MD,&nbsp;Masashi Wakabayashi MSC,&nbsp;Yuta Sekino MD","doi":"10.1016/j.jtho.2024.11.031","DOIUrl":"10.1016/j.jtho.2024.11.031","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 2","pages":"Pages e24-e25"},"PeriodicalIF":21.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}