Journal of Thoracic Oncology最新文献

{"title":"The Potential Prognostic Value of the Tumor-Harboring Lung Segment","authors":"Raul Caso MD, Gaetano Rocco MD","doi":"10.1016/j.jtho.2024.11.007","DOIUrl":"10.1016/j.jtho.2024.11.007","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 2","pages":"Pages e23-e24"},"PeriodicalIF":21.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155660","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":"In Situ Veritas: In Lepidic, There Is Truth","authors":"Hironori Uruga MD, PhD , Mari Mino-Kenudson MD","doi":"10.1016/j.jtho.2024.12.005","DOIUrl":"10.1016/j.jtho.2024.12.005","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 2","pages":"Pages 141-143"},"PeriodicalIF":21.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143155654","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":"Letter in Response","authors":"Oscar Arrieta MD, MSc, Luis Lara-Mejía MD, MSc","doi":"10.1016/j.jtho.2024.11.012","DOIUrl":"10.1016/j.jtho.2024.11.012","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 2","pages":"Page e20"},"PeriodicalIF":21.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156224","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":"Denial of Access to CT Screening for Nonsmokers Is Unjust","authors":"Frederic W. Grannis Jr. MD","doi":"10.1016/j.jtho.2024.10.005","DOIUrl":"10.1016/j.jtho.2024.10.005","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 2","pages":"Pages e37-e39"},"PeriodicalIF":21.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156747","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":"Secondhand Smoke in Low-Risk Groups: A Hidden Danger in Lung Cancer Screening","authors":"Ying Cui MPH","doi":"10.1016/j.jtho.2024.08.039","DOIUrl":"10.1016/j.jtho.2024.08.039","url":null,"abstract":"","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":"20 2","pages":"Pages e33-e34"},"PeriodicalIF":21.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143156812","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":"Diabetic Ketoacidosis During Lorlatinib Treatment: Case Report.","authors":"Atsushi Yanagisawa, Takayuki Shiroyama, Kotaro Miyake, Yoshito Takeda, Atsushi Kumanogoh","doi":"10.1016/j.jtho.2025.01.010","DOIUrl":"https://doi.org/10.1016/j.jtho.2025.01.010","url":null,"abstract":"<p><p>Although hyperlipidemia is a well-known adverse event associated with lorlatinib treatment, lorlatinib-associated hyperglycemia is less common but can be potentially life-threatening. We present the case of a 65-year-old male patient with anaplastic lymphoma kinase-positive lung cancer and preexisting type 2 diabetes mellitus who developed diabetic ketoacidosis (DKA) after switching from alectinib to lorlatinib. After initiating lorlatinib treatment, the patient's glycemic control deteriorated rapidly, with the glycated hemoglobin levels increasing from 6% to 11.5% within three months. The patient was admitted and received intensive insulin therapy along with temporary discontinuation of lorlatinib, which successfully resolved DKA. After a 2-week interruption, lorlatinib was resumed at a reduced dose with satisfactory glycemic control. This case highlights the importance of vigilant glucose monitoring for patients receiving lorlatinib, especially those with preexisting diabetes, to prevent life-threatening complications such as DKA.</p>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074940","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":"Barriers to Lung Cancer Screening in a Multi-Disciplinary Thoracic Oncology Program Cohort: Effects of an Incidental Pulmonary Nodule Program.","authors":"Wei Liao, Meredith A Ray, Anita Patel, Jessica Roma, Hope Marshall, Carrie Fehnel, Jordan Goss, Osarenren Ogbeide, Anurag Mehrotra, Philip Lammers, Keith Tonkin, Ann Bishop, Matthew P Smeltzer, Raymond U Osarogiagbon","doi":"10.1016/j.jtho.2025.01.024","DOIUrl":"https://doi.org/10.1016/j.jtho.2025.01.024","url":null,"abstract":"<p><strong>Introduction: </strong>Lung cancer screening (LCS) reduces mortality, but adoption has been slow; some people who develop lung cancer are ineligible. Incidental pulmonary nodule (IPN) programs also detect lung cancer early. We quantified barriers to LCS and the impact of an IPN program.</p><p><strong>Methods: </strong>We categorized patients with lung cancer in a Multidisciplinary Thoracic Oncology Program from 2015-2023 as: screened; unscreened eligible; ineligible for LCS. We further categorized the unscreened cohorts according to exposure to an IPN program. We compared lung cancer outcomes between the groups.</p><p><strong>Results: </strong>Of 1,904 patients, 6.4%, 41.4% and 52.2% were screened, eligible unscreened, and ineligible; 42% of the eligible unscreened (17% of whole cohort) and 46% of the ineligible cohort (24% of the whole cohort) were diagnosed through the IPN program. Thirty-three percent of the eligible unscreened non-IPN cohort had clinical encounters 12 to 36 months before diagnosis. Among the ineligible, 28% were age-ineligible, 20% had never smoked, 20.5% had <20 pack-year history and 32.5% had excessive quit duration. 5-year overall survival (OS) was 77% (95% CI 73-89), 45% (41-49) and 50% (46-54), respectively (p<0.0001). With the eligible unscreened as reference, the aHR were: 0.36(0.23-0.54) and 0.87(0.75-1.01) for the screened and ineligible cohorts. 5-year OS was 61% (55-68) versus 35% (30-39) and 60% (55-67) versus 42% (37-47) among IPN versus non-IPN cohorts of eligible unscreened and ineligible cohorts, respectively.</p><p><strong>Conclusion: </strong>Screening improved survival in this community-based cohort. Eligibility criteria excluded more patients than non-screening of eligible patients. An IPN program alleviated both barriers.</p>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074938","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":"Outcomes After Surgical Management of Early-Stage Lung Cancer in Octogenarians: An in-depth Analysis of a Nationally Representative Cohort.","authors":"Ian C Bostock, Adam H Fox, Ralph C Ward, Kathryn E Engelhardt, Farhood Farjah, Chi-Fu Jeffrey Yang, Robert A Smith, Barry C Gibney, Gerard A Silvestri","doi":"10.1016/j.jtho.2025.01.020","DOIUrl":"https://doi.org/10.1016/j.jtho.2025.01.020","url":null,"abstract":"<p><p>IntroductionAs the U.S. population ages more octogenarians are undergoing surgical resection for lung cancer (LC). We aimed to provide an updated and expanded assessment of age-related risks associated with surgical resections for early-stage NSCLC.</p><p><strong>Methods: </strong>Surveillance, Epidemiology and End Results (SEER) and Medicare databases were queried for stage IA NSCLC cases treated by surgery between 2006-2018. Analyses included generalized linear models for 1-year mortality and Cox proportional hazards models for 5-year survival.</p><p><strong>Results: </strong>One-year all-cause mortality among 4,061 octogenarians was more than double that of the youngest group (age 65-69): 15.2% vs 7.3%, p<0.001. Octogenarians were discharged to extended skilled nursing facility (SNF) stays more than three times as often as the youngest group (19.9% vs 6.3%, p<0.001). For those with SNF duration > 30 days there was a 36% greater 1- year mortality risk compared to those discharged home or to home-health. In adjusted analyses, octogenarians had 62% greater 1- year mortality risk compared with those <80 (RR: 1.62, 95% CI: 1.48, 1.78). Risk of death within 5 years was 52% higher: (HR: 1.52, 95% CI: 1.42, 1.62). Additional factors associated with 1-year mortality included male sex, higher comorbidity burden, lower county median income, open approach and sub-lobar resection.</p><p><strong>Conclusions: </strong>This analysis provides an updated and expanded characterization of age-related outcomes based on a large national cohort representative of elderly patients treated outside of clinical trials. Substantial gaps in survival and discharge disposition motivate further research and the development of interventions to help improve outcomes in older patients.</p>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066709","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":"Gene copy deletion of STK11, KEAP1, and SMARCA4: clinicopathologic features and association with outcomes to immunotherapy +/- chemotherapy in nonsquamous non-small cell lung cancer.","authors":"Malini M Gandhi, Arielle Elkrief, Catherine Gutierrez Moore, Biagio Ricciuti, Joao V Alessi, Allison L Richards, Sam Tischfield, Jessica Williams, Giuseppe Lamberti, Federica Pecci, Alessandro Di Federico, Maisam Makarem, Bruce E Johnson, Mizuki Nishino, Lynette M Sholl, Adam J Schoenfeld, Mark M Awad","doi":"10.1016/j.jtho.2025.01.016","DOIUrl":"https://doi.org/10.1016/j.jtho.2025.01.016","url":null,"abstract":"<p><strong>Background: </strong>Mutations in STK11, KEAP1, and SMARCA4 predispose to inferior immune checkpoint inhibitor (ICI) efficacy in non-small cell lung cancer (NSCLC), particularly among KRAS-mutant cases. However, the frequency, clinicopathologic features, and clinical impact of deletions in these genes are poorly characterized.</p><p><strong>Methods: </strong>Clinicopathologic correlates of STK11, KEAP1, and SMARCA4 deletion were analyzed in nonsquamous NSCLCs at Dana-Farber Cancer Institute (DFCI). mRNA and LKB1 protein levels were assessed via The Cancer Genome Atlas. Clinical outcomes were analyzed in patients who received ICI+/-chemotherapy at DFCI and Memorial Sloan Kettering Cancer Center (MSKCC). Analyses of each deletion excluded cases with mutations in that gene.</p><p><strong>Results: </strong>Among 3,194 nonsquamous NSCLCs, 14.7% had STK11 deletion (STK11^DEL), 13.5% KEAP1 deletion (KEAP1^DEL), and 13.7% SMARCA4 deletion (SMARCA4^DEL). These deletions correlated with lower PD-L1 expression and higher disease stage, tumor mutational burden, and aneuploidy. STK11^DEL, KEAP1^DEL, and SMARCA4^DEL each correlated with lower corresponding mRNA expression, and STK11^DEL with lower LKB1 protein expression. Among 767 patients treated with chemoimmunotherapy, these deletions associated with worse objective response rates (STK11 31% vs. 45%, P=0.005; KEAP1 33% vs. 45%, P=0.03; SMARCA4 29% vs. 45%, P=0.0007), progression free survival (STK11 HR 1.5, P=0.0001; KEAP1 HR 1.4, P=0.002; SMARCA4 HR 1.6, P<0.0001), and overall survival (STK11 HR 1.7, P<0.0001; KEAP1 HR 1.5, P=0.003; SMARCA4 HR 1.7, P<0.0001). The effect of these deletions on chemoimmunotherapy outcomes was comparable to the effect of mutations in these genes. Among 1,267 patients treated with ICI alone, these deletions did not impact outcomes in the MSKCC cohort, but generally associated with worse outcomes in the DFCI cohort among KRAS-mutant cases.</p><p><strong>Conclusions: </strong>STK11, KEAP1, and SMARCA4 deletions correlate with distinct clinicopathologic features, reduced PD-L1, and poor chemoimmunotherapy efficacy in NSCLC.</p>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047203","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":"The International Association for the Study of Lung Cancer Staging Project: The Database and Proposal for the Revision of the Staging of Pulmonary Neuroendocrine Carcinoma in the Forthcoming Ninth Edition of the TNM Classification for Lung Cancer.","authors":"Ming Sound Tsao, Adam Rosenthal, Andrew G Nicholson, Frank Detterbeck, Wilfried E E Eberhardt, Yolande Lievens, Eric Lim, Jose-Maria Matilla, Yasushi Yatabe, Pier Luigi Filosso, Ricardo Beyruti, Katherine K Nishimura, William D Travis, Raymond Uyiosa Osarogiagbon, Ramon Rami-Porta, Valerie Rusch, Hisao Asamura","doi":"10.1016/j.jtho.2025.01.013","DOIUrl":"https://doi.org/10.1016/j.jtho.2025.01.013","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary high-grade neuroendocrine carcinoma (NEC) includes small cell lung carcinoma (SCLC) and large cell neuroendocrine carcinoma (LCNEC). The seventh and eighth editions of the TNM classification for lung cancer confirmed the applicability of this staging system for SCLC. With the proposal of N2 and M1c subcategories for the ninth edition classification, we assessed the applicability to NECs.</p><p><strong>Methods: </strong>The database included NEC cases diagnosed between January 2011 and December 2019. Eligible cases, with valid survival time and eighth edition TNM stage, were classified as pure SCLC, combined SCLC/non-small cell carcinoma and LCNEC. Survival was calculated by the Kaplan-Meier method, pairwise differences using log-rank test, and prognostic groups by a Cox regression analysis.</p><p><strong>Results: </strong>There were 6181 pure/combined SCLC and 697 LCNEC cases available. For SCLC, survival outcome analyses included 4453 with clinical stage, and 583 with pathologic stage data. The corresponding numbers for LCNEC were 585 and 508. The SCLC data validated the ninth edition classification for lung cancer, including the proposed new subcategories, N2a, single-station ipsilateral mediastinal/subcarinal lymph node involvement, and N2b, involvement of multiple ipsilateral/subcarinal stations. The data also validated the subcategorization of M1c into M1c1 (multiple lesions in a single extrathoracic organ system) and M1c2 (involvement of multiple extrathoracic organ systems). The LCNEC data were insufficient for complete survival analysis, but the available data showed decreasing survival with increasing clinical and pathological stages.</p><p><strong>Conclusions: </strong>The ninth edition TNM classification applies to patients with NEC and is the appropriate standard for use in clinical practice.</p>","PeriodicalId":17515,"journal":{"name":"Journal of Thoracic Oncology","volume":" ","pages":""},"PeriodicalIF":21.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047207","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}