JTO Clinical and Research Reports最新文献

{"title":"Evaluating Circulating Tumor DNA Clearance as an Early Intermediate End Point Predicting Clinical Benefit in Metastatic Nonsquamous NSCLC After First-Line Chemoimmunotherapy","authors":"Min Yuan PhD † , Haolun Ding MS † , Weiwei Zhuang PhD , Yaning Yang PhD , Xu Steven Xu PhD","doi":"10.1016/j.jtocrr.2025.100907","DOIUrl":"10.1016/j.jtocrr.2025.100907","url":null,"abstract":"<div><h3>Introduction</h3><div>In the first-line (1L) NSCLC setting, overall survival (OS) as a trial end point is increasingly challenging due to longer survival and confounding from novel later-line therapies. This study aims to evaluate whether circulating tumor DNA (ctDNA) clearance (alone or with radiographic response) is a reliable early surrogate end point for progression-free survival (PFS) and OS in 1L NSCLC studies.</div></div><div><h3>Methods</h3><div>Data from a phase III trial (IMpower150) of patients with untreated metastatic nonsquamous NSCLC were used. ctDNA clearance, unconfirmed radiographic response, and confirmed radiographic response at approximately 6 months after treatment were evaluated as surrogates for PFS and OS. The meta-analytic approaches were used. The data were randomly split into four cohorts, treating each as an independent “trial” to simulate a multi-trial meta-analysis. This process was repeated 50 times for statistical robustness.</div></div><div><h3>Results</h3><div>ctDNA decline correlated with longer PFS and OS, with greater declines associated with better outcomes. Patients achieving ctDNA clearance (CL) by week 21 had the most significant PFS and OS improvements (<em>p</em> < 0.001). Radiographic response (Resp) within 6 months posttreatment was also associated with improved survival. Combined ctDNA_CL and Resp further enhanced prognostic discrimination. When comparing atezolizumab plus bevacizumab plus carboplatin plus paclitaxel versus bevacizumab plus carboplatin plus paclitaxel (BCP), the individual-level association between 6-month ctDNA CL plus Resp and survival yielded a global odds ratio of 2.06 (95% CI: 2.02–2.11) for PFS and 6.08 (95% CI: 5.92–6.23) for OS. Similar global odds ratios were observed for atezolizumab plus carboplatin plus paclitaxel versus BCP. For the atezolizumab plus bevacizumab plus carboplatin plus paclitaxel versus BCP comparison, cohort-level associations between 6-month ctDNA CL plus Resp and PFS were R<sup>2</sup><sub>WLS</sub> = 0.41 (95% CI: 0.33–0.50) and R<sup>2</sup><sub>copula</sub> = 0.38 (95% CI: 0.30–0.45), whereas associations with OS were R<sup>2</sup><sub>WLS</sub> = 0.48 (95% CI: 0.40–0.56) and R<sup>2</sup><sub>copula</sub> = 0.51 (95% CI: 0.43–0.60) at 6 months. Slightly lower cohort-level associations were observed for atezolizumab plus carboplatin plus paclitaxel versus BCP (R<sup>2</sup> = 0.34–0.41).</div></div><div><h3>Conclusion</h3><div>ctDNA decline is associated with improved survival outcomes in a clear dose–response manner. ctDNA clearance and radiologic response provide complementary prognostic information, and combining these end points (ctDNA_CL + Resp) can further improve prediction of PFS and OS. This combination also enhanced the correlation between treatment effects on the early end points and PFS/OS at the trial level. However, their overall ability to predict treatment effects at the trial level remained modest for both PFS and OS, lik","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 12","pages":"Article 100907"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145469063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Metastatic Fibrous Tumor: Review of Literature With a Case Report","authors":"Gowri Swaminathan MD ,&nbsp;Jonathan Muratori DO ,&nbsp;Faateh Rauf MD ,&nbsp;Santino Patrizi DO ,&nbsp;Theo Trandafirescu MD ,&nbsp;Larry A. Sonna MD, PhD","doi":"10.1016/j.jtocrr.2025.100901","DOIUrl":"10.1016/j.jtocrr.2025.100901","url":null,"abstract":"<div><div>Solitary fibrous tumors (SFTs) can be either localized or metastatic. We present a rare case of a 69-year-old patient with a metastatic solitary fibrous tumor in uncommon anatomical locations, treated with a short course of pazopanib. While surgical resection remains the primary treatment for localized SFT, chemotherapy has been used for advanced cases. Our unique case highlights the need for more research into treatment options to improve patient outcomes. Since both benign and malignant SFTs can metastasize, mortality is mainly due to thoracic metastases; further studies are needed to understand the prognostic factors that influence disease spread versus local growth.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 12","pages":"Article 100901"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145620908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid-onset Severe Cytokine Release Syndrome With Marked Interleukin-6 Increase and Acute Liver Injury After the First Tarlatamab Dose in SCLC: Case Report","authors":"Kento Takagi MD ,&nbsp;Go Saito MD, PhD ,&nbsp;Toshiaki Inazaki MD ,&nbsp;Hikaru Shojima MD ,&nbsp;Jun Miyakoshi MD ,&nbsp;Akira Naito MD, PhD ,&nbsp;Shun Sato MD, PhD ,&nbsp;Takashi Shimazui MD, PhD ,&nbsp;Haruka Anzai MD ,&nbsp;Chiaki Imai PhD ,&nbsp;Takuji Suzuki MD, PhD","doi":"10.1016/j.jtocrr.2025.100917","DOIUrl":"10.1016/j.jtocrr.2025.100917","url":null,"abstract":"<div><div>Tarlatamab is a novel bispecific T-cell engager therapy with promising efficacy in patients with previously treated extensive-stage SCLC. Cytokine release syndrome (CRS) is the most common adverse event related to tarlatamab, although severe CRS remains rare, and grade 3 or higher adverse events have been reported to be less common with tarlatamab than with chemotherapy. Available clinical data on severe adverse events associated with tarlatamab remain limited. Herein, we report a case of a 55-year-old woman with extensive-stage-SCLC who was treated with tarlatamab. Severe CRS and liver injury rapidly developed in the patient after the first tarlatamab dose, which led to treatment discontinuation. This report also presents the temporal changes in serum interleukin-6 levels, highlighting its potential utility as a biomarker for the onset and severity of CRS.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 12","pages":"Article 100917"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of Short-Term Survivors With ALK or ROS1-Altered Metastatic NSCLC","authors":"Kai-Lin Liu BA, BS ,&nbsp;Alex Watts MS ,&nbsp;Connor B. Grady MPH ,&nbsp;Geoffrey Liu MD, MSc ,&nbsp;Devalben Patel BSc, MLT ,&nbsp;Karmugi Balaratnam MD ,&nbsp;Stephen V. Liu MD ,&nbsp;Gabriela Bravo Montenegro MD ,&nbsp;Yunan Nie MD ,&nbsp;Jorge Nieva MD ,&nbsp;Amanda Herrmann MD ,&nbsp;Kristen Marrone MD ,&nbsp;Vincent Lam MD ,&nbsp;Fangdi Sun MD ,&nbsp;Jonathan Dowell MD ,&nbsp;William Schwartzman MD ,&nbsp;Vamsidhar Velcheti MD ,&nbsp;Olivia Fankuchen MD, MS ,&nbsp;Tasfiq Ullah MD ,&nbsp;Liza Villaruz MD ,&nbsp;Melina E. Marmarelis MD, MSCE","doi":"10.1016/j.jtocrr.2025.100876","DOIUrl":"10.1016/j.jtocrr.2025.100876","url":null,"abstract":"<div><h3>Introduction</h3><div>The prognostic significance of baseline and on-treatment brain and liver metastasis in <em>ALK</em>+ or <em>ROS1</em>+ metastatic NSCLC (mNSCLC) remains unclear. As we consider intensification strategies, it is critical to identify factors that predict high-risk disease.</div></div><div><h3>Methods</h3><div>Clinical characteristics and outcomes were abstracted from the electronic medical records of patients with <em>ALK</em>+ or <em>ROS1</em>+ mNSCLC. Baseline characteristics and the cumulative incidence (CI) of brain and liver metastases were compared (≥2-year survivors versus &lt;2-year; pre-2017 versus post-2017). Multivariable Cox proportional hazard models were used to evaluate the association between factors and overall survival, and multivariable logistic regression models were used for the odds of death within 2 years.</div></div><div><h3>Results</h3><div>A total of 310 patients with <em>ALK</em>+ mNSCLC were identified (≥2-y: 229, &lt;2-y: 81). There was no difference in cumulative incidence of brain metastases between survival groups (29% at 21 mo). However, the cumulative incidence of liver metastasis was higher in those who survived less than 2 years (20.9% versus 5.4% at 21 mo). The cumulative incidence of brain but not liver metastases has improved post-2017 with the newer generation of ALK tyrosine kinase inhibitors. There were 69 patients with <em>ROS1</em>+ mNSCLC who were identified (≥2-y: 46, &lt; 2-y: 23). There was no significant difference in the cumulative incidence of brain or liver metastases between less-than-2-year and greater-than-or-equal-to-2-year survivor cohorts (<em>p</em> = 0.664, <em>p</em> = 0.201).</div></div><div><h3>Conclusions</h3><div>Among patients with <em>ALK</em>+ but not <em>ROS1</em>+ mNSCLC, the presence of liver metastases at baseline and on-treatment was associated with worse survival. In the ALK+ population, the cumulative incidence of brain but not liver metastases is improving, highlighting a need for therapies effective at the treatment and prevention of liver metastases.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 11","pages":"Article 100876"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tobacco Control and Smoking Cessation–Related Content in Oncology Meetings: A Systematic Scoping Review","authors":"Sun Choi BHSc ,&nbsp;Monisha Chawla HBSc, MPH ,&nbsp;Payton Catherwood MPH ,&nbsp;David Chen BMSc ,&nbsp;Ryan S. Huang MSc ,&nbsp;William Boateng BSc ,&nbsp;Jennifer Do BSc ,&nbsp;Maha Khan BHSc ,&nbsp;Abdulrahman Alghabban MD ,&nbsp;Naa Kwarley Quartey MSc ,&nbsp;Srinivas Raman MD, MASc ,&nbsp;Meredith E. Giuliani M.B.B.S., MEd, PhD, FRCPC ,&nbsp;William K. Evans MD, FRCPC ,&nbsp;Lawson Eng MD, SM, FRCPC","doi":"10.1016/j.jtocrr.2025.100874","DOIUrl":"10.1016/j.jtocrr.2025.100874","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite the importance of smoking cessation in cancer care, it remains unclear how much tobacco control and smoking-related content (TCSCR) is included in major oncology meetings. Developing an understanding of the amount of content can help to improve education and dissemination of the benefits of smoking cessation in cancer care.</div></div><div><h3>Methods</h3><div>We performed a scoping review of TCSCR abstracts and educational sessions using online programs and abstract books from 2018 to 2023 for 12 major oncology meetings across different disciplines and disease sites.</div></div><div><h3>Results</h3><div>A total of 5178 TCSCR content was identified using our search criteria; 421 abstracts and 119 educational sessions met the inclusion criteria. Between 2018 and 2023, the World Cancer Congress (WCC) and the World Conference on Lung Cancer (WCLC) had the highest mean percentage of smoking-related abstracts (WCC: 4.96 ± 3.77%; WCLC: 1.81 ± 0.77%) and educational sessions (WCC: 3.48 ± 1.30%; WCLC: 3.15 ± 1.06%). Among the included abstracts, most (79%) first authors were from high-income countries. Around 39% percent of abstracts focused on tobacco as a cancer risk factor, 34% smoking cessation, and 26% cancer outcomes. Most abstracts were presented as posters (65%), as oral abstracts (27%), or as published abstracts (8%). The distribution of topic focus (<em>p</em> = 0.004) and session type (<em>p</em> &lt; 0.001) differed between abstracts from high-income and low-middle-income countries.</div></div><div><h3>Conclusions</h3><div>Despite the importance of smoking cessation in oncology, TCSCR abstracts and educational content are limited at major oncology meetings. Organizers of oncology conferences should be encouraged to explore strategies to include sessions and attract submissions on these topics, particularly from underrepresented regions.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 11","pages":"Article 100874"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145334364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AdvanTIG-204: A Phase 2, Randomized, Open-Label Study of Ociperlimab Plus Tislelizumab and Concurrent Chemoradiotherapy Versus Tislelizumab and Concurrent Chemotherapy Versus Concurrent Chemoradiotherapy in First-Line Limited-Stage SCLC","authors":"Youling Gong MD ,&nbsp;Qingsong Pang MD ,&nbsp;Rong Yu MD ,&nbsp;Zhengfei Zhu MD ,&nbsp;Jiangqiong Huang MD ,&nbsp;Yufeng Cheng MD ,&nbsp;Diansheng Zhong MD ,&nbsp;Hongbo Wu MD ,&nbsp;Seung Soo Yoo PhD ,&nbsp;Tracy Dobbs MD ,&nbsp;Zinan Bao MD ,&nbsp;Yunxia Zuo MD ,&nbsp;Yujuan Gao PhD ,&nbsp;Pu Sun PhD ,&nbsp;You Lu MD","doi":"10.1016/j.jtocrr.2025.100911","DOIUrl":"10.1016/j.jtocrr.2025.100911","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with limited-stage SCLC (LS-SCLC) have a substantial unmet clinical need for new treatments that delay disease progression and prolong survival.</div></div><div><h3>Methods</h3><div>In this phase 2, multicenter, randomized, multiarm, open-label trial, patients with untreated LS-SCLC received ociperlimab and tislelizumab plus concurrent chemoradiotherapy (cCRT) (arm A), tislelizumab plus cCRT (arm B), or cCRT (arm C). The primary objective was to compare progression-free survival (PFS) per investigator for arms A and B versus C (NCT04952597). The contribution of ociperlimab was explored by comparison of arms A versus B. Statistical analyses were descriptive, with no formal hypothesis testing.</div></div><div><h3>Results</h3><div>A total of 126 patients were randomized to arms A (N = 41), B (N = 42), and C (N = 43). The median PFS [95% confidence interval] exhibited a trend for improvement in arms A (12.6 [8.7–not estimable] months) and B (13.2 [8.5–not estimable]) compared with C (9.5 [8.3–14.4]); the PFS benefit was comparable between Arms A and B.</div><div>The objective response rate, complete response rate, and median duration of response were numerically higher in arms A and B than in C. The median overall survival was not reached in all three arms, and the median distant metastasis–free survival revealed no trend for improvement for arms A and B compared with C. All patients experienced at least one treatment-related treatment-emergent adverse event.</div></div><div><h3>Conclusions</h3><div>Ociperlimab and tislelizumab plus cCRT and tislelizumab plus cCRT exhibited a trend for improvement in PFS and numerically higher objective response rate compared with cCRT, with no new safety signals beyond the known profiles of immune checkpoint inhibitors and cCRT. Adding ociperlimab to tislelizumab plus cCRT was not associated with additional improvement in efficacy.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 11","pages":"Article 100911"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety, Efficacy, and Central Nervous System Control in Patients with High Baseline Risk Factors Treated with Tarlatamab for SCLC or Extrapulmonary Small Cell Carcinoma","authors":"Sanjana Mullangi MD ,&nbsp;Manidhar Reddy Lekkala MD ,&nbsp;Sarah Blocker PharmD ,&nbsp;Diana Kim PharmD ,&nbsp;Jun Zhang MD ,&nbsp;Chao Huang MD ,&nbsp;Prakash Neupane MD ,&nbsp;Haoran Li MD ,&nbsp;Timothy Schieber PharmD","doi":"10.1016/j.jtocrr.2025.100875","DOIUrl":"10.1016/j.jtocrr.2025.100875","url":null,"abstract":"<div><h3>Introduction</h3><div>SCLC remains the most aggressive lung cancer with a poor prognosis. Tarlatamab, a bispecific T-cell engager, is approved for use in extensive-stage SCLC after progression on a platinum-based chemotherapy on the basis of the DeLLphi-301 trial. Because of the restrictive inclusion criteria of this trial, substantial gaps remain in our understanding of treatment for many patients.</div></div><div><h3>Methods</h3><div>We performed a retrospective chart review of patients who were treated with tarlatamab at the University of Kansas Cancer Center from May 2024 through December 2024 for SCLC (cohort 1) or extrapulmonary small cell carcinoma (EPSCC) (cohort 2). Patients were included if they received at least one dose of tarlatamab regardless of baseline characteristics.</div></div><div><h3>Results</h3><div>A total of 21 patients were included in cohort 1, and three patients were included in cohort 2. In the SCLC cohort, 14 patients (66.6%) had central nervous system (CNS) involvement, five patients (23.8%) required baseline oxygen, and five patients (23.8%) had an Eastern Cooperative Oncology Group (ECOG) Performance Status of 2 or greater. There were 13 patients (61.9%) who developed cytokine release syndrome (CRS), with grade 3 or higher CRS noted in two patients (15.3%). There were 10 patients (47.6%) who developed immune effector cell–associated neurotoxicity syndrome (ICANS), with three patients (14.2%) developing grade 3 or higher ICANS. In the three patients with extrapulmonary small cell carcinoma, any-grade CRS occurred in two patients (66.7%), and grade 1 ICANS occurred in one patient (33.3%). Characteristics such as ECOG of 2 or higher, baseline oxygen use, and untreated CNS metastases are associated with high rates of CRS and ICANS. In 17 patients evaluable for best response in cohort 1, partial response was seen in six (35.2%) patients. No patients in cohort 2 had disease assessment performed at the time of data cutoff. Alternative CNS disease control using tarlatamab alone or with concurrent radiation provided clinical benefit to three patients.</div></div><div><h3>Conclusions</h3><div>Baseline risk factors such as oxygen dependence, poor ECOG performance status, bulky disease, and untreated CNS involvement may increase CRS and ICANS rates after tarlatamab. However, subsequent doses exhibited a more favorable safety profile, supporting outpatient administration and reduced observation time. CNS management strategies, including concurrent radiation or monotherapy with tarlatamab, exhibited promising efficacy. These findings highlight the need for further research into CRS and ICANS risk stratification, optimal CNS management, and efficacy in extrapulmonary small cell carcinoma through larger studies.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 11","pages":"Article 100875"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145425162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lobectomy Induces Exercise-Induced Pulmonary Hypertension and Effort Intolerance Compared With Sublobar Resection","authors":"Atsushi Kamigaichi MD ,&nbsp;Yasuhiro Tsutani MD, PhD ,&nbsp;Akane Tsuchiya MD ,&nbsp;Hiroto Utsunomiya MD, PhD ,&nbsp;Yoshihiro Miyata MD, PhD ,&nbsp;Takahiro Mimae MD, PhD ,&nbsp;Norifumi Tsubokawa MD, PhD ,&nbsp;Yukiko Nakano MD, PhD ,&nbsp;Morihito Okada MD, PhD","doi":"10.1016/j.jtocrr.2025.100903","DOIUrl":"10.1016/j.jtocrr.2025.100903","url":null,"abstract":"<div><h3>Introduction</h3><div>The rationale underlying the benefits of the parenchyma-preserving nature of sublobar resection (SR) compared with lobectomy remains unclear. This study aimed to assess postoperative changes in cardiopulmonary function after lobectomy and SR using exercise stress testing.</div></div><div><h3>Methods</h3><div>This prospective, observational study enrolled patients scheduled for lobectomy or SR. Changes in cardiopulmonary function at 6 months postoperatively were evaluated using exercise stress echocardiography and cardiopulmonary exercise tests.</div></div><div><h3>Results</h3><div>Initially, 41 patients were enrolled, with 20 patients in the lobectomy group and 18 patients in the SR group (16 segmentectomies, two wedge resections) after excluding three ineligible patients. Preoperatively, all patients demonstrated well-preserved cardiopulmonary function. The systolic pulmonary artery pressure (SPAP) change at peak exercise was significantly higher for lobectomy (median 26.5%; interquartile range [IQR] 0.6–60.1) than for SR (median −8.2%; IQR −38.7–11.7; <em>p</em> = 0.001), despite nonsignificant differences at rest (<em>p</em> = 0.599). Postoperative exercise-induced pulmonary hypertension (exPH) occurred in nine patients (45%) in the lobectomy group but none in the SR group (0%, <em>p</em> = 0.010). Postoperative peak oxygen consumption during exercise decreased significantly in the lobectomy group (median −14.3%; IQR −24.0 to −4.2) compared with that in the SR group (median −7.8%; IQR −13.5–8.7; <em>p</em> = 0.024). The postoperative increase in SPAP at peak exercise (r = 0.402, <em>p</em> = 0.012), prevalence of postoperative exPH (r = 0.978, <em>p</em> = 0.004), and postoperative decrease in peak oxygen consumption (r = −0.330; <em>p</em> = 0.041) were correlated with the number of resected segments.</div></div><div><h3>Conclusions</h3><div>Lobectomy induces increased SPAP during exercise, exPH, and effort intolerance, compared with SR. This highlights the importance of preserving lung parenchyma in lung surgery.</div></div><div><h3>Clinical Trial Registration</h3><div>This trial is registered in the UMIN Clinical Trials Registry under the code UMIN000053694.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 11","pages":"Article 100903"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provider Behavioral Determinants and Preferences for Lung Cancer Screening Implementation: A Brief Report","authors":"Jennifer A. Lewis MD, MS, MPH ,&nbsp;Lauren R. Samuels PhD ,&nbsp;Lucy B. Spalluto MD, MPH ,&nbsp;Christopher Lindsell PhD ,&nbsp;Claudia I. Henschke PhD, MD ,&nbsp;David F. Yankelevitz MD ,&nbsp;Carol Callaway-Lane DNP, ACNP-BC ,&nbsp;Robert S. Dittus MD, MPH ,&nbsp;Hilary A. Tindle MD, MPH ,&nbsp;Renda Soylemez Wiener MD, MPH ,&nbsp;Christopher G. Slatore MD, MS ,&nbsp;Drew Moghanaki MD, MPH ,&nbsp;Carolyn M. Audet PhD ,&nbsp;Christianne L. Roumie MD, MPH","doi":"10.1016/j.jtocrr.2025.100905","DOIUrl":"10.1016/j.jtocrr.2025.100905","url":null,"abstract":"<div><h3>Introduction</h3><div>Implementation of lung cancer screening is suboptimal. Understanding health care provider preferences and behavior is important for implementation. In this work, provider preferences for lung cancer screening implementation and self-reported determinants of lung cancer screening behavior were reported using the theoretical domains framework.</div></div><div><h3>Methods</h3><div>In this mixed-methods evaluation, health care providers at nine Veterans Affairs were surveyed to list factors influencing their decision to screen patients for lung cancer in free-text responses and rank implementation strategies by usefulness in clinical practice. Free-text data were coded and mapped to the theoretical domains framework. Quantitative ranking data were descriptively analyzed overall and by specialty (primary care versus radiology), clinic setting (hospital versus community), and provider type (physician versus advanced practice provider).</div></div><div><h3>Results</h3><div>Of 234/254 eligible providers analyzed, most were primary care (83.8%), community-based (52.1%), and physicians (66.2%). Respondents identified social influences (69.2%), knowledge (55.6%), and environmental context and resources (15.4%) as influential behavioral determinants. Overall, patient reminders (29.9%), provider reminders (26.1%), and learning collaboratives (24.4%) were reported most frequently as useful implementation strategies. Strategy preferences differed by specialty, practice setting, and provider type: primary care (30.1%), physician (34.2%), and hospital-based (33.0%) providers most frequently ranked patient reminders; radiology providers most frequently ranked learning collaborative (42.1%); advanced practice providers (24.1%) and community-based providers (27.0%) most frequently ranked provider reminders as most useful.</div></div><div><h3>Conclusions</h3><div>Designing implementation strategies that target three behavioral determinants (social influences, knowledge, and environmental context and resources) and are tailored to providers’ preferences may effectively change providers’ lung cancer screening behavior.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 11","pages":"Article 100905"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multicenter, Retrospective, Real-World Study of Atezolizumab Plus Chemotherapy and Pembrolizumab Plus Chemotherapy for Older Patients With NSCLC","authors":"Kensuke Kanaoka MD ,&nbsp;Kinnosuke Matsumoto MD ,&nbsp;Takayuki Shiroyama MD, PhD ,&nbsp;Akihiro Tsukaguchi MD ,&nbsp;Nao Shoshihara MD ,&nbsp;Koki Moritomo MD ,&nbsp;Yuhei Kinehara MD, PhD ,&nbsp;Yasuhiro Mihashi MD ,&nbsp;Tomoki Kuge MD ,&nbsp;Midori Yoneda MD ,&nbsp;Soichiro Kato MD ,&nbsp;Keijiro Yamauchi MD ,&nbsp;Hirotomo Machiyama MD ,&nbsp;Yuki Nishikawa MD ,&nbsp;Osamu Morimura MD, PhD ,&nbsp;Akito Miyazaki MD ,&nbsp;Kiyohide Komuta MD ,&nbsp;Kouji Azuma MD ,&nbsp;Satoshi Tanaka MD ,&nbsp;Toshie Niki MD, PhD ,&nbsp;Atsushi Kumanogoh MD, PhD","doi":"10.1016/j.jtocrr.2025.100891","DOIUrl":"10.1016/j.jtocrr.2025.100891","url":null,"abstract":"<div><h3>Introduction</h3><div>Evidence of immune checkpoint inhibitors (ICIs) combined with chemotherapy for older patients with NSCLC is limited. This real-world study compared the efficacy and safety of atezolizumab plus chemotherapy (ACT) with those of pembrolizumab plus chemotherapy (PCT) for older patients with advanced nonsquamous NSCLC.</div></div><div><h3>Methods</h3><div>This multicenter, retrospective study included 288 patients 65 years or older with advanced or recurrent nonsquamous NSCLC who received PCT or ACT as first-line treatment at 13 institutions in Japan. After one-to-one propensity score matching, overall survival (OS), the incidence of grade 3 or higher treatment-related adverse events, and all-grade pneumonitis of the PCT and ACT groups were compared.</div></div><div><h3>Results</h3><div>After propensity score matching, 54 patients were included in each of the groups. OS did not significantly differ between the PCT and ACT groups. The median OS was 16.6 months for both groups. Compared with the PCT group, the ACT group had a hazard ratio of 1.09 (95% confidence interval [CI]: 0.68–1.74; <em>p</em> = 0.7). Grade 3 or higher adverse events occurred in 40.7% and 33.3% of patients in the PCT and ACT groups, respectively (<em>p</em> = 0.55). The incidence of treatment-related pneumonitis of the PCT group was significantly higher (29.6%, including 11 grade ≥3 cases) than that of the ACT group (5.6%, including two grade ≥3 cases) (<em>p</em> = 0.002).</div></div><div><h3>Conclusions</h3><div>ACT may be associated with a more favorable safety profile than that of PCT for the Japanese population; therefore, ACT could be considered a treatment option for older patients with advanced nonsquamous NSCLC.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 11","pages":"Article 100891"},"PeriodicalIF":3.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}