Journal of Thoracic Oncology最新文献

{"title":"Predicted Effect of Incidental Pulmonary Nodule Findings on NSCLC Mortality","authors":"S. Tuminello PhD ,&nbsp;R. Flores MD ,&nbsp;M. Untalan MPH ,&nbsp;T. Ivic-Pavlicic MPH ,&nbsp;C.I. Henschke MD ,&nbsp;R. Yip PhD ,&nbsp;D.F. Yankelevitz MD ,&nbsp;Emanuela Taioli MD, PhD","doi":"10.1016/j.jtho.2024.11.009","DOIUrl":"10.1016/j.jtho.2024.11.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the reduction in mortality by low-dose computed tomography lung cancer screening, the uptake is still low. Patients undergo chest imaging for several other medical reasons, and this is a unique opportunity to detect lung nodules.</div></div><div><h3>Methods</h3><div>In a cohort of patients with NSCLC from the Surveillance, Epidemiology, and End Results-Medicare–linked data, tumor size at previous imaging was calculated as follows: volume doubling time = [(T₂-T₁)·ln2]/ln(V₂/V₁), solving for the diameter of V₁. V₁ and V₂ are tumor volume at times T₁ (previous imaging) and T₂ (diagnostic procedure) according to three different growth models. The 10-year lung cancer-specific mortality was calculated as follows: lung cancer survival rate = (−0.0098 × maximum tumor diameter) + 1.</div></div><div><h3>Results</h3><div>A total of 1007 patients who had a chest imaging performed up to 1 year before lung cancer diagnosis were included in this study. The median size of the tumor at diagnosis was 25 mm, and the predicted median tumor size at previous imaging was 12.16 mm, 17.3 mm, and 20.42 mm under the fast, medium, and slow growth model, respectively. Under the fast growth model, a detection of the nodule at previous imaging would have yield a decrease in mortality of 7.79%; the corresponding value for the medium growth model is 4.5% and for the slow growth model 2.45%.</div></div><div><h3>Conclusions</h3><div>Identifying malignant lung nodules in imaging performed for other clinical reasons can help decrease the burden of NSCLC, especially for patients not eligible for low-dose computed tomography and the medically vulnerable. We reveal here that clinical benefits, especially among patients with aggressive disease, can be considerable.</div></div>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 3","pages":"Pages 273-284"},"PeriodicalIF":21.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621845","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":"Artificial Intelligence Technologies for Managing High-Risk Patients With Immune-Related Adverse Events and Optimizing Timing","authors":"Fangjie Liu MD,&nbsp;Hui Li MD","doi":"10.1016/j.jtho.2024.08.004","DOIUrl":"10.1016/j.jtho.2024.08.004","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 3","pages":"Pages e47-e48"},"PeriodicalIF":21.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535101","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 “Patients With Resectable NSCLC Undergoing Neoadjuvant Chemoimmunotherapy: To Adjuvant or Not to Adjuvant?”","authors":"Daniele Marinelli MD,&nbsp;Filippo Tommaso Gallina MD","doi":"10.1016/j.jtho.2024.12.015","DOIUrl":"10.1016/j.jtho.2024.12.015","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 3","pages":"Pages e43-e44"},"PeriodicalIF":21.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535076","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":"Improved Event-Free Survival After Complete or Major Pathologic Response in Patients With Resectable NSCLC Treated With Neoadjuvant Chemoimmunotherapy Regardless of Adjuvant Treatment: A Systematic Review and Individual Patient Data Meta-Analysis","authors":"Daniele Marinelli MD ,&nbsp;Antonio Nuccio MD ,&nbsp;Alessandro Di Federico MD ,&nbsp;Francesca Ambrosi MD ,&nbsp;Pietro Bertoglio MD ,&nbsp;Eleonora Faccioli MD ,&nbsp;Roberto Ferrara MD ,&nbsp;Alessandra Ferro MD ,&nbsp;Raffaele Giusti MD ,&nbsp;Francesco Guerrera MD ,&nbsp;Marco Mammana MD ,&nbsp;Alessandra Pittaro MD ,&nbsp;Matteo Sepulcri MD ,&nbsp;Giuseppe Viscardi MD ,&nbsp;Filippo Tommaso Gallina MD","doi":"10.1016/j.jtho.2024.09.1443","DOIUrl":"10.1016/j.jtho.2024.09.1443","url":null,"abstract":"<div><h3>Introduction</h3><div>Neoadjuvant chemoimmunotherapy has reshaped the treatment landscape for resectable NSCLC, yet the prognostic significance of pathologic response remains unclear. We conducted a systematic review and individual patient data (IPD) meta-analysis to evaluate the impact of achieving pathologic complete response (pCR) or major pathologic response (MPR) on event-free survival (EFS) and assessed the influence of adjuvant immunotherapy.</div></div><div><h3>Methods</h3><div>We performed an IPD meta-analysis of prospective clinical trials on neoadjuvant or perioperative anti–programmed death-ligand 1 in combination with platinum-based chemotherapy in patients with resectable NSCLC. The IPD was extracted from Kaplan-Meier curves for pCR and MPR from the included studies. Survival outcomes were compared between patients achieving pCR or MPR and those who did not, considering both intention-to-treat and resected populations.</div></div><div><h3>Results</h3><div>Achieving pCR or MPR was associated with improved EFS in the intention-to-treat population (pCR, hazard ratio = 0.13; MPR, hazard ratio = 0.18, respectively) with a 24 months EFS rate of 94% and 88% for patients who achieved pCR and MPR, respectively. Independently from pCR status, patients who were treated in an experimental arm that included adjuvant immunotherapy had similar EFS.</div></div><div><h3>Conclusions</h3><div>Our study reported a strong EFS improvement in patients who achieved either pCR or MPR after neoadjuvant chemoimmunotherapy. The use of adjuvant immunotherapy after tumor resection was not associated with improved EFS.</div></div>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 3","pages":"Pages 285-295"},"PeriodicalIF":21.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400631","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":"Erratum to ‘Critical Evaluation of Methodologic Approaches in ALK Tyrosine Kinase Inhibitor Research: Addressing Confounding Factors and Statistical Robustness’ [Journal of Thoracic Oncology Vol 19 Issue 11 (2024) e64-e65]","authors":"Wenqin Wang PhD,&nbsp;Xiangzhi Li PhD,&nbsp;Dan Shan MD","doi":"10.1016/j.jtho.2024.11.002","DOIUrl":"10.1016/j.jtho.2024.11.002","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 3","pages":"Page 400"},"PeriodicalIF":21.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Biomarker for SCLC Therapeutics: A Broken Promise or a Complex Disease With Missing Links","authors":"Quincy Siu-Chung Chu MD, FRCPC","doi":"10.1016/j.jtho.2024.12.021","DOIUrl":"10.1016/j.jtho.2024.12.021","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 3","pages":"Pages 252-255"},"PeriodicalIF":21.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535270","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":"Navigating the Complexity of Cerebral Prophylaxis: A Path Worth Taking?","authors":"Sara Ramella MD ,&nbsp;Michele Fiore MD ,&nbsp;Rolando M. D’Angelillo MD","doi":"10.1016/j.jtho.2025.01.001","DOIUrl":"10.1016/j.jtho.2025.01.001","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 3","pages":"Pages 256-258"},"PeriodicalIF":21.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535271","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":"Prophylactic Cranial Irradiation for Patients With SCLC—A New Perspective in the Immunotherapy Era","authors":"Antonin Levy MD, PhD ,&nbsp;Chad G. Rusthoven MD ,&nbsp;Paul D. Brown MD ,&nbsp;Cécile Le Péchoux MD ,&nbsp;Corinne Faivre-Finn MD, PhD","doi":"10.1016/j.jtho.2024.11.011","DOIUrl":"10.1016/j.jtho.2024.11.011","url":null,"abstract":"<div><div>Prophylactic cranial irradiation (PCI) has long been used for SCLC to reduce the risk of brain metastases and potentially improve overall survival. Nevertheless, recent immunotherapy trials have provided limited data on its impact, as few patients were treated with PCI. The ADRIATIC trial reported improved outcomes with consolidation immunotherapy in limited-stage SCLC, and PCI was a stratification factor. Notably, patients receiving PCI in both arms had better outcomes than those who did not. Ongoing studies, such as EORTC-1901 PRIMALung (NCT04790253) and SWOG 1827-MAVERICK (NCT04155034), are further investigating PCI’s role in the era of immunotherapy, highlighting its potential importance in evolving treatment strategies.</div></div>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 3","pages":"Pages 395-398"},"PeriodicalIF":21.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648400","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":"Low Dose Computed Tomography for Lung Cancer Screening in Tuberculosis Endemic Countries: A Systematic Review and Meta-Analysis","authors":"Vikram Damaraju DM ,&nbsp;Juhu Kiran Krushna Karri MBBS student ,&nbsp;Gayathri Gandrakota MBBS ,&nbsp;Yamini Marimuthu MD ,&nbsp;Adimulam Ganga Ravindra MD ,&nbsp;Rajeev Aravindakshan MD ,&nbsp;Navneet Singh DM","doi":"10.1016/j.jtho.2024.11.020","DOIUrl":"10.1016/j.jtho.2024.11.020","url":null,"abstract":"<div><h3>Introduction</h3><div>Lung cancer screening (LCS) using low-dose computed tomography (LDCT) reduces mortality. Nevertheless, in high tuberculosis-burden countries (HTBC), there are concerns about high false-positive rates due to persistent lung lesions from prior tuberculosis (TB) infections. This study aims to evaluate the screen-positive rate (SPR) of LDCT screening in HTBC.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis to identify studies utilizing LDCT for LCS in HTBC and reported SPR from inception to December 6, 2023. The primary outcome was the SPR, and the secondary outcome was the lung cancer detection rate (LCDR). The summary data was pooled using a random-effects model, and factors influencing the SPR were analyzed using multivariable meta-regression analysis.</div></div><div><h3>Results</h3><div>A total of 44 studies with 477,424 individuals (59.3% men) were included in the systematic review. Lung Imaging Reporting and Data System (Lung-RADS) (31%, 14 studies) and National Lung Screening Trial (NLST) criteria (non-calcified nodule ≥ 4 mm; 10 studies) were the most common criteria used for assessing SPR. The pooled SPR and LCDR were 18.36% (95% confidence interval [CI]: 14.6–22.1) and 0.94% (95% confidence interval: 0.75–1.15), respectively. Although SPR was significantly higher with NLST criteria than Lung-RADS criteria (25.6% versus 10.4%, <em>p</em> &lt; 0.0001), the LCDR remained similar (0.91% versus 0.95%, <em>p</em> = 0.92). Studies using NLST criteria had a higher SPR in multivariable meta-regression analysis. Nevertheless, the analysis is limited by significant statistical heterogeneity and publication bias.</div></div><div><h3>Conclusion</h3><div>Lung cancer screening by LDCT in HTBC demonstrates comparable SPR and LCDR to regions with lower TB incidence rates. Lung-RADS criteria are preferable to NLST criteria for LCS in HTBC to mitigate false-positive rates.</div></div>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 3","pages":"Pages 296-310"},"PeriodicalIF":21.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710558","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":"Differentiating Separate Primary Lung Adenocarcinomas From Intrapulmonary Metastases With Emphasis on Pathological and Molecular Considerations: Recommendations From the International Association for the Study of Lung Cancer Pathology Committee","authors":"Teh-Ying Chou MD, PhD ,&nbsp;Sanja Dacic MD, PhD ,&nbsp;Ignacio Wistuba MD, PhD ,&nbsp;Mary Beth Beasley MD ,&nbsp;Sabina Berezowska MD ,&nbsp;Yeun-Chung Chang MD, PhD ,&nbsp;Jin-Haeng Chung MD, PhD ,&nbsp;Casey Connolly MPH ,&nbsp;Yuchen Han MD, PhD ,&nbsp;Fred R. Hirsch MD, PhD ,&nbsp;David M. Hwang MD, PhD ,&nbsp;Andrew Janowczyk PhD ,&nbsp;Philippe Joubert MD, PhD ,&nbsp;Keith M. Kerr MBChB, FRCPath ,&nbsp;Dongmei Lin MD ,&nbsp;Yuko Minami MD, PhD ,&nbsp;Mari Mino-Kenudson MD ,&nbsp;Andrew G. Nicholson DM, FRCPath ,&nbsp;Mauro Papotti MD ,&nbsp;Natasha Rekhtman MD, PhD ,&nbsp;Wendy A. Cooper MBBS, PhD, FRCPA","doi":"10.1016/j.jtho.2024.11.016","DOIUrl":"10.1016/j.jtho.2024.11.016","url":null,"abstract":"<div><h3>Introduction</h3><div>With the implementation of low-dose computed tomography screening, multiple pulmonary tumor nodules are diagnosed with increasing frequency and the selection of surgical treatments versus systemic therapies has become challenging on a daily basis in clinical practice. In the presence of multiple carcinomas, especially adenocarcinomas, pathologically determined to be of pulmonary origin, the distinction between separate primary lung carcinomas (SPLCs) and intrapulmonary metastases (IPMs) is important for staging, management, and prognostication.</div></div><div><h3>Methods</h3><div>We systemically reviewed various means that aid in the differentiation between SPLCs and IPMs explored by histopathologic evaluation and molecular profiling, the latter includes DNA microsatellite analysis, array comparative genomic hybridization, <em>TP53</em> and oncogenic driver mutation testing and, more recently, with promising effectiveness, next-generation sequencing comprising small- or large-scale multi-gene panels.</div></div><div><h3>Results</h3><div>Comprehensive histologic evaluation may suffice to differentiate between SPLCs and IPMs. Nevertheless, molecular profiling using larger-scale next-generation sequencing typically provides superior discriminatory power, allowing for more accurate classification. On the basis of the literature review and expert opinions, we proposed a combined four-step histologic and molecular classification algorithm for addressing multiple pulmonary tumor nodules of adenocarcinoma histology that encourages a multidisciplinary approach. It is also noteworthy that new technologies combining machine learning and digital pathology may develop into valuable diagnostic tools for distinguishing SPLCs from IPMs in the future.</div></div><div><h3>Conclusions</h3><div>Although histopathologic evaluation is often adequate to differentiate SPLCs from IPMs, molecular profiling should be performed when possible, especially in cases with tumors exhibiting similar morphology. This manuscript summarized the previous efforts in resolving the current challenges and highlighted the recent progress in the differentiation methods and algorithms used in categorizing multiple lung adenocarcinomas into SPLCs or IPMs, which are becoming more and more critical in precision lung cancer management.</div></div>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 3","pages":"Pages 311-330"},"PeriodicalIF":21.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}