Lung Cancer最新文献

{"title":"Reassessing pembrolizumab dosing in NSCLC for methodological and clinical accuracy – Author’s reply","authors":"Geeske F. Grit , Peter G.M. Mol , Doranne Hilarius","doi":"10.1016/j.lungcan.2025.108477","DOIUrl":"10.1016/j.lungcan.2025.108477","url":null,"abstract":"","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108477"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534173","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 “Real-world treatment sequencing and effectiveness of second- and third-generation ALK tyrosine kinase inhibitors for ALK-positive advanced non-small cell lung cancer” [Lung Cancer 195 (2024) 107919]","authors":"Jessica R. Bauman , Geoffrey Liu , Isabel Preeshagul , Stephen V. Liu , Barbara Melosky , Devin Abrahami , Benjamin Li , Despina Thomaidou , Kirsten Duncan , Stan Krulewicz , Martin Rupp , Jessica J. Lin","doi":"10.1016/j.lungcan.2025.108441","DOIUrl":"10.1016/j.lungcan.2025.108441","url":null,"abstract":"","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"201 ","pages":"Article 108441"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Real-world comparative effectiveness of sotorasib versus docetaxel in second line and beyond among patients with advanced non-small cell lung cancer (NSCLC)” [Lung Cancer 197 (2024) 107960]","authors":"Melissa Johnson , Diana Younan , Shia T. Kent , Marco Mesa Frias , M.Alan Brookhart , Akhila Balasubramanian , Alexander Spira","doi":"10.1016/j.lungcan.2025.108440","DOIUrl":"10.1016/j.lungcan.2025.108440","url":null,"abstract":"","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"201 ","pages":"Article 108440"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective cohort study of Suture-Line recurrence and clinical outcomes in stage 1A Non-Small cell lung cancer","authors":"Louis Gros ,&nbsp;Rowena Yip ,&nbsp;Raja M. Flores ,&nbsp;Jiafang Zhang ,&nbsp;Natela Paksashvili ,&nbsp;Lijing Zhang ,&nbsp;Lyu Lyu ,&nbsp;Siyang Cai ,&nbsp;Emanuela Taioli ,&nbsp;David F. Yankelevitz ,&nbsp;Claudia I. Henschke ,&nbsp;for the IELCART Investigators","doi":"10.1016/j.lungcan.2025.108465","DOIUrl":"10.1016/j.lungcan.2025.108465","url":null,"abstract":"<div><h3>Background</h3><div>Increased lung cancer screening has made early-stage non-small-cell lung cancer (NSCLC) more common, with lung-sparing surgery as the standard curative treatment. Our study evaluated patients who underwent surgery for pathologic stage 0/1A NSCLC and presented with suture-line recurrences—either isolated or with additional findings—and compared these patients to other types of recurrence.</div></div><div><h3>Methods</h3><div>We analyzed 653 patients with pathologic stage 0/1A NSCLC from the IELCART cohort (2016–2023). Recurrences were categorized by the presence or absence of suture line involvement, and survival outcomes were assessed.</div></div><div><h3>Findings</h3><div>Among 653 patients (median age 69), 44 (11.3 %) experienced recurrences, including 22 suture-line recurrences. Sublobar resections (19/22 vs. 11/22, p = 0.01) and smaller margins (8 mm vs. 20 mm, p &lt; 0.001) were more frequent in patients with suture-line recurrences. Of the 22 suture-line recurrences, 13 were isolated, and 9 had additional findings. Isolated recurrences were diagnosed later (31.0 vs. 14.0 months, p = 0.01) and treated with surgery (6/13) or radiotherapy (7/13), both well-tolerated. Patients with isolated suture-line recurrences demonstrated better survival outcomes compared to all other recurrence types (overall survival: 72.0 % vs. 45.7 %, p = 0.02; lung cancer-specific survival: 90.0 % vs. 76.1 %, p = 0.19).</div></div><div><h3>Interpretation</h3><div>Recurrences after stage 0/1A lung cancer surgery are rare, with half involving the suture line. Suture-line recurrences arise around two years post-surgery, often following sublobar resections with resection margins under 1 cm. For isolated suture-line recurrences, treatment with either radiotherapy and completion surgery were effective, yielding comparable outcomes and improved survival compared to any other recurrence types.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108465"},"PeriodicalIF":4.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534172","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":"Patterns and preoperative risk factors of occult lymph node metastasis in clinical stage I lung cancer","authors":"Young Ho Yang,&nbsp;Ha Eun Kim,&nbsp;Byung Jo Park,&nbsp;Jin Gu Lee,&nbsp;Dae Joon Kim,&nbsp;Chang Young Lee","doi":"10.1016/j.lungcan.2025.108461","DOIUrl":"10.1016/j.lungcan.2025.108461","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the patterns and preoperative risk factors of occult lymph node metastasis (OLNM) in patients with stage I lung cancer.</div></div><div><h3>Methods</h3><div>This retrospective study evaluated patients with clinical stage I lung cancer who underwent systematic lymph node dissection. OLNM frequency by lobe (upper/lower) and preoperative risk factors of OLNM were analyzed.</div></div><div><h3>Results</h3><div>Overall, 1512 patients (892 and 620 patients with upper and lower lobe cancers, respectively) were included. The rates of OLNM and skip metastasis were 11.2 % and 1.9 %, respectively. For N1 lymph nodes, the most common site of metastasis was the lobar lymph nodes (7.6 %), regardless of the cancer location, followed by the interlobar (2.9 %) and hilar (1.9 %) lymph nodes. For N2 lymph nodes, upper lobe cancers tended to metastasize to the superior mediastinum (4.2 % vs. 1.4 %, inferior mediastinum), while lower lobe cancers metastasized to the inferior mediastinum (5.0 % vs. 0.5 %, superior mediastinum). Smoking (hazard ration [HR]: 1.722, 95 % confidence interval [CI]: 1.206–2.460), non-peripheral location (HR: 2.374, 95 % CI: 1.663–3.389), maximal tumor size &gt; 2 cm (HR: 2.335, 95 % CI: 1.488–3.663), consolidation/tumor (C/T) ratio &gt; 0.75 (HR: 16.958, 95 % CI: 7.839–36.687), and pleural abutting (HR: 1.696, 95 % CI: 1.177–2.444) increased the risk of OLNM.</div></div><div><h3>Conclusion</h3><div>In stage I lung cancer, the most common site of metastasis is the lobar lymph nodes, regardless of tumor location. Therefore, when segmentectomy is performed, dissection of the lobar lymph node dissection is important for the intraoperative evaluation of lymph node metastasis. A C/T ratio &gt; 0.75 is the strongest preoperative risk factor of OLNM.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108461"},"PeriodicalIF":4.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143562341","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":"EGFR mutation status affects intra-tumoural heterogeneity of PD-L1 expression but not agreement between assays in resectable non-small cell lung cancer","authors":"Stephanie P.L. Saw ,&nbsp;Angela Takano ,&nbsp;Siqin Zhou ,&nbsp;Nwe Oo Hlaing ,&nbsp;Anne James ,&nbsp;Craig Joseph ,&nbsp;Gillianne G.Y. Lai ,&nbsp;Darren W.T. Lim ,&nbsp;Ravindran Kanesvaran ,&nbsp;Mei-Kim Ang ,&nbsp;Quan Sing Ng ,&nbsp;Amit Jain ,&nbsp;Wan Ling Tan ,&nbsp;Yi Lin Teh ,&nbsp;Aaron C. Tan ,&nbsp;Boon-Hean Ong ,&nbsp;Tony K.H. Lim ,&nbsp;Joe P.S. Yeong ,&nbsp;Sze Huey Tan ,&nbsp;Daniel S.W. Tan","doi":"10.1016/j.lungcan.2025.108463","DOIUrl":"10.1016/j.lungcan.2025.108463","url":null,"abstract":"<div><h3>Background</h3><div>The predictive value of PD-L1 to select patients for immunotherapy in resectable NSCLC remains imprecise, confounded by different assays used across trials and intra-tumoural heterogeneity (ITH). We sought to compare the concordance between 3 PD-L1 antibodies stratified by EGFR mutation status, evaluate ITH and implications on survival outcomes.</div></div><div><h3>Methods</h3><div>Tissue microarrays were constructed from stage IA-IIIA NSCLC with 3 tumour cores per patient. Tumour proportion score (TPS) was evaluated by 3 pathologists for SP263, SP142, 22C3 and analysed in tertiles of &lt; 1 %, 1–49 % and ≥ 50 %. ITH was defined as discordant TPS in ≥ 2/3 tumour cores. Cohen’s kappa test was used to assess agreement. Survival outcomes were estimated using Kaplan-Meier.</div></div><div><h3>Results</h3><div>A total of 561 patients were included, 59.5% (334/561) were EGFR-mutant. Stage IA comprised 45.5%(255/561), IB 24.1%(135/561), IIA 12.7%(71/561), IIB 4.5%(25/561) and IIIA 13.4%(75/561).</div><div>Across 1683 tumour cores, SP263 and 22C3 had the highest concordance (Kappa = 0.689), followed by 22C3 and SP142 (Kappa = 0.354), then SP263 and SP142 (Kappa = 0.284), similar between EGFR-mutant and EGFR-wildtype. Agreement between pathologists was almost perfect.</div><div>ITH by SP263 was observed in 14.1 % of EGFR-mutant versus 24.2 % in EGFR-wildtype(p = 0.002). Discordance was highest among TPS 1–49 % at 92.6 % (88/95) followed by ≥ 50 % at 37.8 % (14/37) and least among &lt; 1 % at 0 % (0/429) (p &lt; 0.001). For tumour cores scored 1–49 %, 63 %/70 % of adjacent cores were scored &lt; 1 % for EGFR-wildtype/mutant respectively. Histological grade was the only independent predictor of PD-L1 ITH on multivariable analysis. PD-L1 ITH was not associated with survival on multivariable analysis.</div></div><div><h3>Conclusion</h3><div>PD-L1 scoring by SP263 and 22C3 are interchangeable but not SP142 regardless of EGFR status. PD-L1 ITH was more common in EGFR-wildtype versus EGFR-mutant tumours. Extra care should be taken to select the most representative tumour core for tumours with high histological grade or TPS 1–49% as this may influence <em>peri</em>-operative treatment decisions.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108463"},"PeriodicalIF":4.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143527481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"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;Fangqiu Fu ,&nbsp;Yang Zhang ,&nbsp;Haiquan Chen","doi":"10.1016/j.lungcan.2025.108457","DOIUrl":"10.1016/j.lungcan.2025.108457","url":null,"abstract":"<div><h3>Background</h3><div>Our previous study has showed the safety and efficacy of preoperative gefitinib in patients with stage II-IIIA resectable non–small cell lung cancer (NSCLC). This study aimed to report the long-term survival analysis and recurrent patterns.</div></div><div><h3>Methods</h3><div>This was a single-arm, phase II clinical trial. Patients with resectable stage II-IIIA NSCLC harboring EGFR exon 19 deletion or exon 21 L858R mutations were enrolled. Patients were administrated with preoperative gefitinib (250 mg once daily for 42 days), followed by surgical resection. The primary endpoint was objective response rate (ORR); secondary endpoints included the rate of major pathologic response (MPR), disease-free survival (DFS), overall survival (OS). MPR was defined as the presence of no more than 10 % viable tumor. Chi-square test was used to assess the differences in CNS recurrence rates and recurrent patterns.</div></div><div><h3>Results</h3><div>Of the 33 intention-to-treat patients, ORR was 54.5 % (95 % confidence interval (CI), 37.7–70.7), and the rate of MPR was 24.2 % (95 % CI, 11.9–40.4). Among the investigated 28 patients, the median follow-up was 108.5 months. The median OS was 89.8 months (95 % CI, 44.37–NC), and the median DFS was 36.4 months (95 % CI, 18.9–NC). In addition, MPR continued to indicate significantly improved DFS, as well as OS (DFS, <em>p</em> = 0.015; OS, <em>p</em> = 0.037). The neoadjuvant gefitinib group showed prolonged DFS and OS than platinum doublet group (hazard ratio (HR) = 1.71, 95 % CI, 1.02–2.85, <em>p</em> = 0.038; and HR = 2.31; 95 % CI, 1.28–4.16, <em>p</em> = 0.0044, respectively). There was a significant difference in the distant recurrence patterns between the two groups (<em>p</em> = 0.032). Moreover, the gefitinib group showed similar overall brain metastasis rate than platinum doublet group (21.4 % versus 27.5 %).</div></div><div><h3>Conclusions</h3><div>With satisfying prognosis benefits and acceptable brain metastasis rate in long-term follow-up, gefitinib exhibited clinical viability for operable stage II-IIIA <em>EGFR</em>-mutant NSCLC over chemotherapy in the neoadjuvant setting. MPR was significantly associated with both prolonged DFS and OS, manifesting its potential as an essential endpoint for future neoadjuvant trials.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"201 ","pages":"Article 108457"},"PeriodicalIF":4.5,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474235","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":"Gefitinib for EGFR mutated lung adenocarcinoma during pregnancy: A case report with 5-Year Follow-Up","authors":"Merouane Messekher ,&nbsp;Florent Fuchs ,&nbsp;Maliha Badr ,&nbsp;Jean-Louis Pujol","doi":"10.1016/j.lungcan.2025.108456","DOIUrl":"10.1016/j.lungcan.2025.108456","url":null,"abstract":"<div><div>We report the case of a 37-year-old pregnant woman at 19 weeks of gestation who was diagnosed with a stage M1b <em>EFGR</em>^mut lung adenocarcinoma, in 2019. After a right upper and middle bilobectomy (T3N1 and R0 pathological status) and a complete cerebellar metastasis resection, she was treated with gefitinib, which offered her a prolonged recurrence-free survival without any negative consequence for the fetal development or the future development of her now 5- year- old child.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108456"},"PeriodicalIF":4.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674259","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 randomised non-comparative phase II study of atezolizumab, bevacizumab and chemotherapy in EGFR-mutant NSCLC with acquired resistance – The ETOP 15-19 ABC-lung trial","authors":"R.A. Soo ,&nbsp;K. Vervita ,&nbsp;M. Früh ,&nbsp;B.C. Cho ,&nbsp;M. Majem ,&nbsp;D. Rodriguez Abreu ,&nbsp;K. Ribi ,&nbsp;A. Callejo ,&nbsp;T. Moran ,&nbsp;M. Domine Gomez ,&nbsp;M. Provencio ,&nbsp;A. Addeo ,&nbsp;J.Y. Han ,&nbsp;A.L. Ortega Granados ,&nbsp;M. Reck ,&nbsp;A. Blasco ,&nbsp;R. Garcia Campelo ,&nbsp;M.A. Sala González ,&nbsp;C. Britschgi ,&nbsp;H. Roschitzki-Voser ,&nbsp;R.A. Stahel","doi":"10.1016/j.lungcan.2025.108454","DOIUrl":"10.1016/j.lungcan.2025.108454","url":null,"abstract":"<div><h3>Background</h3><div>ABC-lung explores the potential effect of combining atezolizumab and bevacizumab with either carboplatin/paclitaxel (ABCPac) or pemetrexed (ABPem) in patients with <em>EGFR</em>-mutant NSCLC, resistant to tyrosine kinase inhibitors (TKIs).</div></div><div><h3>Methods</h3><div>ABC-lung is a 1:1 randomised, non-comparative, phase II trial, stratified by prior treatment with a third-generation EGFR TKI, evaluating atezolizumab (1200 mg, Q3W) and bevacizumab (15mg/kg, Q3W) with either 4-6 cycles of carboplatin (AUC5, Q3W) and paclitaxel (175-200<!--> <!-->mg/m2, Q3W) or pemetrexed (500 mg/m2, Q3W) until progression (PD). The study aimed to improve the 1-year progression-free survival (PFS) rate from 18% to 37%, assessed per RECISTv1.1, separately in each arm. To reject the null hypothesis, at least 14 of 45 evaluable patients in each arm needed to be progression-free at 1-year (power 83%, 1-sided a=0.023). Secondary endpoints included overall survival (OS), objective response rate (ORR), PFS, quality of life (QoL) and adverse events (AEs).</div></div><div><h3>Results</h3><div>Between 09/2020 and 09/2022, 95 patients were randomized (ABCPac:45; ABPem:50) with median follow-up time of 19 months. From the evaluable patients, 9 in ABCPac and 11 in ABPem arms reached 1-year without progression, lower than the success criterion of 14<!--> <!-->patients. Median PFS was 6.4 months in ABCPac and 7.6 months in the ABPem arms, while median OS was 15.4 months and 15.6 months, respectively. Grade ≥3 treatment-related AEs were experienced by 50% and 42% of patients in ABCPac and ABPem arms, respectively, while no grade 5 AEs were recorded.</div></div><div><h3>Conclusions</h3><div>The observed 1-year PFS rate with atezolizumab, bevacizumab in combination with either carboplatin-paclitaxel or pemetrexed was below the aspired rate of 37% in both arms. The safety is consistent with the known toxicity profiles.</div><div>Clinical trial identification: NCT04245085.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108454"},"PeriodicalIF":4.5,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510872","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":"Kyoungmin Lee ,&nbsp;Tae-Hwan Kim ,&nbsp;Sung Yong Lee ,&nbsp;Yun-Gyoo Lee ,&nbsp;Juwhan Choi ,&nbsp;Jin-Hyuk Choi ,&nbsp;Jung Yoon Choi ,&nbsp;Ah-reum Lim ,&nbsp;Jung Sun Kim ,&nbsp;Ji Won Lee ,&nbsp;Yoon Ji Choi ,&nbsp;Ji Hyun Park ,&nbsp;Yoon Namgung ,&nbsp;Hee Kyung Ahn ,&nbsp;Eun Joo Kang","doi":"10.1016/j.lungcan.2025.108455","DOIUrl":"10.1016/j.lungcan.2025.108455","url":null,"abstract":"<div><h3>Background</h3><div>The combination of atezolizumab with etoposide and carboplatin (AECb) has become a new standard of care for extensive-stage small-cell lung cancer (ES-SCLC). This study evaluates its impact on central nervous system (CNS) progression, specifically brain metastases.</div></div><div><h3>Method</h3><div>We analyzed the outcomes of 550 ES-SCLC patients who received first-line therapy between 2016 and 2022, focusing on time to intracranial progression (TTicP), progression-free survival (PFS), and overall survival (OS).</div></div><div><h3>Results</h3><div>Of the 550 patients, 247 (44.9 %) received AECb, while 303 (55.1 %) received conventional chemotherapy (CTx). Intracranial progression occurred in 179 patients (32.5 %), with the AECb group showing a significantly prolonged TTicP compared to the CTx group (median 24.4 vs. 14.3 months; p = 0.038). In patients without brain metastasis at diagnosis (n = 408), TTicP was also longer in the AECb group (27.2 vs. 15.3 months; p = 0.016). This benefit persisted even after excluding patients who underwent prophylactic cranial irradiation (PCI) (27.2 vs. 15.2 months; p = 0.02) (n = 394). These findings remained consistent after adjusting for age, initial metastatic site, and PCI. Additionally, the AECb group showed improved PFS (5.0 vs. 4.7 months; p = 0.004) and OS (11.1 vs. 9.8 months; p = 0.003).</div></div><div><h3>Conclusion</h3><div>Our findings suggest that the AECb regimen is superior to conventional chemotherapy in delaying CNS progression and controlling systemic disease in ES-SCLC. These results support the AECb regimen as the new standard of care. Further research is needed to explore the mechanisms behind these improved CNS outcomes and to reassess the necessity of PCI in this treatment era.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"201 ","pages":"Article 108455"},"PeriodicalIF":4.5,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464931","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}