Lung Cancer最新文献

{"title":"AGREE-II appraisal of lung cancer management clinical practice guidelines by the OPTIMA consortium","authors":"Sindhu Bhaarrati Naidu ,&nbsp;Amyn Bhamani ,&nbsp;Charlotte Murray ,&nbsp;Katharina Beyer ,&nbsp;Rebecca C. Rancourt ,&nbsp;Thorben Witte ,&nbsp;Wouter H. van Geffen ,&nbsp;Ilona Tietzova ,&nbsp;Armin Frille ,&nbsp;Adrien Costantini ,&nbsp;Monika Schäfer ,&nbsp;Steven MacLennan ,&nbsp;Hagen Krüger ,&nbsp;Solveiga Žibaitė ,&nbsp;James N’Dow ,&nbsp;Sara Jane MacLennan ,&nbsp;Monique J. Roobol ,&nbsp;Sam M Janes ,&nbsp;Neal Navani ,&nbsp;Muhammad Imran Omar ,&nbsp;Torsten Blum","doi":"10.1016/j.lungcan.2025.108610","DOIUrl":"10.1016/j.lungcan.2025.108610","url":null,"abstract":"<div><h3>Introduction</h3><div>Amongst all cancers, lung cancer is the leading cause of mortality worldwide and has the highest economic burden in the European Union. With rapidly evolving treatments, clinicians must keep up-to-date with the latest recommendations to ensure their patients receive the best care. Clinical practice guidelines support decision-making and improve care. The OPTIMA consortium aimed to identify and critically appraise relevant lung cancer clinical practice guidelines commonly used in Europe.</div></div><div><h3>Methods</h3><div>Clinical practice guidelines were identified through expert consensus and cross-checked against the International Guidelines Library. Two assessors independently appraised each guideline using the AGREE-II tool. Guideline contents including guideline characteristics and composition of panel were also reviewed.</div></div><div><h3>Results</h3><div>We identified 21 guidelines. National UK and German lung cancer guidelines received the highest overall scores (7/7). Guidelines scored highest on clarity (median score 80.6%) while stakeholder involvement and applicability were the lowest scoring domains (median 50.0% each). The median intraclass correlation coefficient for all guidelines was 0.95 (interquartile range (IQR) 0.92–0.99), representing excellent inter-rater agreement.</div><div>Differences between guidelines included number of specialties involved in development and guideline recommendations. Five (23.8%) included a patient or public representative and only one specified patient-reported outcome measures. Few guidelines considered how to optimise patients for treatment such as through nutrition assessment (n = 4, 19.0%) and prehabilitation (n = 3, 14.3%).</div></div><div><h3>Conclusion</h3><div>We identified and critically appraised 21 European lung cancer guidelines published between 2009 and 2025. Key recommendations for improvement include inclusion of diverse specialities and patient representatives in guideline development and addressing barriers to implementation.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"205 ","pages":"Article 108610"},"PeriodicalIF":4.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival and prognostic factors of HER2-mutant advanced non-small cell lung cancer with brain metastases","authors":"Qian Zhang ,&nbsp;Yehao Yang ,&nbsp;Mingying Xie ,&nbsp;Zichao Zhou ,&nbsp;Haicheng Wu ,&nbsp;Wanchen Zhai ,&nbsp;Yunfei Chen ,&nbsp;Kaiyan Chen ,&nbsp;Shichao Zhou ,&nbsp;Hui Li ,&nbsp;Yun Fan","doi":"10.1016/j.lungcan.2025.108616","DOIUrl":"10.1016/j.lungcan.2025.108616","url":null,"abstract":"<div><h3>Background</h3><div>Brain metastases (BM) represent a common complication in non-small-cell lung cancer (NSCLC) with human epidermal growth factor receptor 2 (<em>HER2</em>) mutations. We aimed to characterize the BM incidence and its association with genetic subtypes, and to analyze treatment outcomes and prognostic factors in this patient population.</div></div><div><h3>Methods</h3><div>Between July 2018 and July 2023, we retrospectively screened 6536 patients with advanced NSCLC. A total of 183 patients with <em>HER2</em>-mutant NSCLC were identified, of whom 91 had BM. The primary study endpoint was overall survival (OS).</div></div><div><h3>Results</h3><div>The median follow-up period was 18.1 months (range 5.0–39.7) at the cut-off date of December 28, 2023. Incidence of BM at diagnosis was 24.6 % (45/183), and overall BM incidence was 49.7 % (91/183). There was no significant difference in the lifetime incidence of BM between the <em>HER2</em> exon20 YVMA insertion and non-YVMA insertion subtypes (p = 0.558). The median OS of 91 patients with BM was significantly lower than that of patients without BM (14.8 vs. 23.2 months, p &lt; 0.001). All patients with BM received chemotherapy-based treatments as first-line treatment. For second or later-line treatment, 28 patients (30.8 %) received antibody-drug conjugates (ADCs) and 17 patients (18.7 %) tyrosine kinase inhibitors (TKIs). Patients who had received ADC treatments demonstrated superior OS compared to those who had received TKI treatments or those who only received chemotherapy-based treatments (18.4 vs. 13.2 vs. 13.8 months, p = 0.008). Additionally, brain radiotherapy was significantly associated with improved survival outcomes (16.9 vs. 12.3 months, p = 0.001). Multivariate analysis identified that ADC treatments, brain radiotherapy, ECOG PS scores, and BM-related symptoms were independent prognostic factors (p &lt; 0.05 for all).</div></div><div><h3>Conclusion</h3><div>The BM incidence in <em>HER2</em>-mutated NSCLC is high and similar across genetic subtypes. ADC treatments may potentially contribute to prolonged OS for patients with <em>HER2</em>-mutated NSCLC and BM. Besides, brain radiotherapy could confer significant OS benefits.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"205 ","pages":"Article 108616"},"PeriodicalIF":4.5,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144213219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ARID1A mutational status in non-small cell lung cancer: from molecular pathology to clinical implications with a focus on the relationships with EGFR","authors":"Claudia Di Lecce ,&nbsp;Serena Eccher ,&nbsp;Michele Simbolo ,&nbsp;Alessandra Cocomazzi ,&nbsp;Maria L. Piredda ,&nbsp;Anna Caliò ,&nbsp;Luca Cima ,&nbsp;Enrico Munari ,&nbsp;Nicola Veronese ,&nbsp;Alice Avancini ,&nbsp;Fabrizio Zanconati ,&nbsp;Michele Milella ,&nbsp;Aldo Scarpa ,&nbsp;Sara Pilotto ,&nbsp;Lorenzo Belluomini ,&nbsp;Claudio Luchini","doi":"10.1016/j.lungcan.2025.108594","DOIUrl":"10.1016/j.lungcan.2025.108594","url":null,"abstract":"<div><div>Lung cancer is the most frequently diagnosed malignancy worldwide and remains the leading cause of cancer-related mortality. Non-small-cell lung cancer (NSCLC) is the most prevalent type of lung cancer, with epidermal growth factor receptor (<em>EGFR</em>) gene mutations being among the most frequently reported. ARID1A (AT-Rich Interactive Domain 1A), a key component of the switch/sucrose non-fermentable (SWI/SNF) chromatin remodeling complex, has emerged as a tumor suppressor in multiple cancers and is mutated in approximately 8 % of lung cancers, primarily as a loss-of-function (LOF) alteration, which allows the gene to be considered a potential molecular marker, predictive of poor NSCLC prognosis. Co-occurrence of <em>ARID1A</em> LOF mutations and <em>EGFR</em> alterations presents complex biological and therapeutic challenges. <em>ARID1A</em> LOF mutations negatively affect the efficacy of EGFR tyrosine kinase inhibitors (EGFR-TKIs) via several molecular mechanisms, including the aberrant activation of the phosphoinositide 3-kinase/serine-threonine kinase (PI3K/AKT) signaling pathway. This leads to decreased apoptosis, increased tumor angiogenesis, enhanced proliferation, and greater metastatic potential. On the other hand, <em>ARID1A</em> LOF mutations have emerged as promising predictive biomarkers for favorable responses to immune checkpoint inhibitors (ICIs). The underlying mechanisms include modulation of epithelial-to-mesenchymal transition (EMT), alterations in the tumor immune microenvironment (TIME), impaired mismatch repair (MMR) function, increased tumor mutation burden (TMB), enhanced neoantigen presentation, and upregulation of programmed death ligand 1 (PD-L1) and type I interferon (IFN-I) expression. These findings highlight the dual role of <em>ARID1A</em> mutations as prognostic and predictive biomarkers, underscoring the need for further investigation into their complex biological and therapeutic implications.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"205 ","pages":"Article 108594"},"PeriodicalIF":4.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144196276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel strategies for rare oncogenic drivers in non-small-cell lung cancer: An update from the 2024 Annual ESMO meeting","authors":"J.W.T. van der Wel,&nbsp;A.J. de Langen","doi":"10.1016/j.lungcan.2025.108490","DOIUrl":"10.1016/j.lungcan.2025.108490","url":null,"abstract":"<div><div>Across the landscape of oncogene-addicted non-small-cell lung cancer (NSCLC), various tyrosine kinase inhibitors (TKIs) have been introduced in the last twenty years.</div><div>During the 2024 Annual ESMO meeting new therapeutic options were presented for EGFR exon 20 insertion mutation, ALK fusion and ROS1 fusion positive advanced stage NSCLC. For EGFR exon 20 insertion mutation positive NSCLC, results from REZILIENT-1, a single arm phase II study with zipalertinib, were presented, showing an objective response rate (ORR) of 50% in patients that were pretreated with amivantamab, and 25% in patients pretreated with amivantamab and an EGFR exon 20 insertion-directed TKI. The vast majority of these patients also received platinum-doublet chemotherapy.</div><div>For ALK, results from ALKOVE-1, a single arm phase I/II study with NVL-655, a next generation ALK TKI, were presented. The ORR was 35 % in patients pretreated with ≥ 2 ALK TKIs including lorlatinib and 57 % in patients pretreated with ≥ 1 ALK TKI, excluding lorlatinib. The median number of prior anticancer therapies was 3. Intracranial responses were seen in lorlatinib naïve- and lorlatinib pretreated patients and toxicity was manageable. In addition, results of the first-line randomized phase III INSPIRE study were presented, in which iruplinalkib, an ALK and ROS1 selective TKI, is being evaluated versus crizotinib. Iruplinalkib showed a superior median PFS (36.8 versus 14.55 months for crizotinib), but no difference in 36-month overall survival (OS) rate.</div><div>Finally, results from ARROS-1, a single arm phase I/II study with zidesamtinib, a ROS1 selective and TRK-sparing TKI, were presented. An ORR of 73% was obtained in patients that were pretreated with crizotinib and an ORR of 38% in patients pretreated with repotrectinib. In this review, we will discuss the relevant study results presented at ESMO 2024 for these three genomic drivers and hypothesize on their respective place in the sequence of treatment options.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"204 ","pages":"Article 108490"},"PeriodicalIF":4.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Reply to comment on “Long-term outcomes of neoadjuvant gefitinib in resectable stage II-IIIA non-small cell lung cancer: A phase II, prospective cohort study”","authors":"Zhanming Ma ,&nbsp;Yang Zhang","doi":"10.1016/j.lungcan.2025.108537","DOIUrl":"10.1016/j.lungcan.2025.108537","url":null,"abstract":"","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"204 ","pages":"Article 108537"},"PeriodicalIF":4.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “A reproducibility study on invasion in small pulmonary adenocarcinoma according to the WHO and a modified classification, supported by biomarkers” [Lung Cancer 199 (2025) 108060]","authors":"Erik Thunnissen ,&nbsp;Hans Blaauwgeers ,&nbsp;Federica Filipello ,&nbsp;Birgit Lissenberg-Witte ,&nbsp;Yuko Minami ,&nbsp;Masayuki Noguchi ,&nbsp;John Le Quesne ,&nbsp;Mauro Giulio Papotti ,&nbsp;Douglas B. Flieder ,&nbsp;Giuseppe Pelosi ,&nbsp;Irene Sansano ,&nbsp;Sabina Berezowska ,&nbsp;Aleš Ryška ,&nbsp;Luka Brcic ,&nbsp;Noriko Motoi ,&nbsp;Yukio Nakatani ,&nbsp;Christiane Kuempers ,&nbsp;Paul Hofman ,&nbsp;Veronique Hofman ,&nbsp;Vibeke Grotnes Dale ,&nbsp;Albrecht Stenzinger","doi":"10.1016/j.lungcan.2025.108488","DOIUrl":"10.1016/j.lungcan.2025.108488","url":null,"abstract":"","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"204 ","pages":"Article 108488"},"PeriodicalIF":4.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “Long-term outcomes of neoadjuvant gefitinib in resectable stage II-IIIA non-small cell lung cancer: A phase II, prospective cohort study”","authors":"Bin Zhang ,&nbsp;Jinlong Zhang","doi":"10.1016/j.lungcan.2025.108515","DOIUrl":"10.1016/j.lungcan.2025.108515","url":null,"abstract":"","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"204 ","pages":"Article 108515"},"PeriodicalIF":4.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed central nervous system progression with atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer (LU23-15)","authors":"Arif Hakan Önder","doi":"10.1016/j.lungcan.2025.108536","DOIUrl":"10.1016/j.lungcan.2025.108536","url":null,"abstract":"","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"204 ","pages":"Article 108536"},"PeriodicalIF":4.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144203603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and clinical validation of a prognostic algorithm for stroma-tumor ratio quantification in non-small cell lung cancer","authors":"Waleed K.M. Ahmad ,&nbsp;Tillmann Bedau ,&nbsp;Yuan Wang ,&nbsp;Sebastian Michels ,&nbsp;Anna Rasokat ,&nbsp;Jürgen Wolf ,&nbsp;Matthias Heldwein ,&nbsp;Simon Schallenberg ,&nbsp;Alexander Quaas ,&nbsp;Reinhard Büttner ,&nbsp;Yuri Tolkach","doi":"10.1016/j.lungcan.2025.108613","DOIUrl":"10.1016/j.lungcan.2025.108613","url":null,"abstract":"<div><h3>Background and Aim</h3><div>Lung cancer is the leading cause of cancer-related mortality worldwide, highlighting the importance of refining diagnostic modalities. This study’s main focus is the development of a digital pathology, prognostic algorithm for fully automatized quantification of stroma-tumor ratio (STR) in patients with resectable non-small cell lung cancer (NSCLC).</div></div><div><h3>Materials and Methods</h3><div>The developed STR algorithm is built upon a powerful multi-class tissue segmentation algorithm that generates precise maps of the full tumor region. One retrospective exploration cohort of NSCLC patients (n = 902) and three validation cohorts (n = 784) of patients with lung adenocarcinoma (LUAD) and squamous cell carcinoma (LUSC) were included to identify and validate optimal prognostic cut-offs and different risk stratification methods with regard to different clinical endpoints: overall survival (OS), cancer-specific survival (CSS) and progression-free survival (PFS).</div></div><div><h3>Results</h3><div>For LUAD, we show that the minimal STR value for the whole case is decisive for prognostic evaluation. Different approaches (single STR cut-off, multiple STR cut-offs, using STR as a continuous parameter) allow for robust stratification of patients into prognostic risk groups, independent of the classical clinicopathological variables and conventional histological grading. For LUSC, STR may assist in identifying a small subset of patients with unfavorable prognosis (based on the maximum STR for the whole case), however, its prognostic impact varies between cohorts.</div></div><div><h3>Conclusion</h3><div>STR quantification in LUAD NSCLC subtype shows a promising role as a prognostic biomarker. It can be easily implemented in routine diagnostics and could be considered as a component of advanced prognostic systems in LUAD. Our results in LUSC cohorts suggest that STR quantification in its current implementation is of limited value in this subtype.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"205 ","pages":"Article 108613"},"PeriodicalIF":4.5,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prognostic impact of extra-alveolar invasion in lung adenocarcinoma","authors":"Masaki Suzuki ,&nbsp;Aya Shinozaki-Ushiku ,&nbsp;Shinji Yuhara ,&nbsp;Masaaki Nagano ,&nbsp;Masaaki Sato ,&nbsp;Tetsuo Ushiku","doi":"10.1016/j.lungcan.2025.108612","DOIUrl":"10.1016/j.lungcan.2025.108612","url":null,"abstract":"<div><h3>Background</h3><div>Recent studies in lung cancer pathology have focused on histological patterns related to prognosis, such as spread through air spaces (STAS) and histological grading. In contrast, the anatomical depth of invasion of lung cancer has not been well studied, and currently, only visceral pleura and main bronchus are the lung-specific structures that determine the T category of lung cancer.</div></div><div><h3>Methods</h3><div>We classified lung tissues into alveolar and extra-alveolar regions and investigated the prognostic impact of extra-alveolar invasion (EX) in 178 non-mucinous lung adenocarcinoma cases that underwent complete resection. EX was defined as periarterial, peribronchial/peribronchiolar, or interlobular septal invasion.</div></div><div><h3>Results</h3><div>In the prognostic analysis of recurrence-free survival (RFS), all three EX factors were associated with poor prognosis, with EX identified as an independent prognostic factor. RFS in the pT1 EX(+) group was significantly shorter than that in the pT1 EX(−) group and was comparable to that in the pT2 group. The pT1 EX(−) group showed no lymph node metastasis at the time of surgery and no recurrence, regardless of invasive size, STAS status, or histological grade. RFS in the EX(+)/STAS(−) group was significantly shorter than that in the EX(−) group, and was better than that in the EX(+)/STAS(+) group. RFS in the EX(+)/G2 group was shorter than that in the EX(+)/G1 group, and was similar to that in the EX(+)/G3 group.</div></div><div><h3>Conclusion</h3><div>EX was found to be an independent prognostic factor which emphasizes the importance of depth of invasion in non-mucinous lung adenocarcinomas. Further investigation is needed to verify the validity of incorporating EX into the pathological T factor in future classification.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"205 ","pages":"Article 108612"},"PeriodicalIF":4.5,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}