Lung Cancer最新文献

{"title":"Corrigendum to “A Single-Centre Study on the Impact of Co-Mutations on Osimertinib Efficacy in EGFR-Mutated NSCLC” [Lung Cancer 200(Supplement 1) (February 2025) 108218]","authors":"Bethany Wyatt, Lilian Cheung, Joss Adams, Shawn Ellis","doi":"10.1016/j.lungcan.2025.108582","DOIUrl":"10.1016/j.lungcan.2025.108582","url":null,"abstract":"","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"205 ","pages":"Article 108582"},"PeriodicalIF":4.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144631994","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":"Durvalumab plus irinotecan + cisplatin for untreated extensive-stage small cell lung cancer: REBORN, phase II study (WJOG13520L)","authors":"Motoko Tachihara ,&nbsp;Hiroyasu Shoda ,&nbsp;Yuki Akazawa ,&nbsp;Takayo Ota ,&nbsp;Masahide Oki ,&nbsp;Yuki Sato ,&nbsp;Shunichi Sugawara ,&nbsp;Satoshi Ikeda ,&nbsp;Toshihide Yokoyama ,&nbsp;Hiroyasu Kaneda ,&nbsp;Shoichi Itoh ,&nbsp;Akihiro Bessho ,&nbsp;Nobuyuki Katakami ,&nbsp;Satoshi Morita ,&nbsp;Kazuhiko Nakagawa ,&nbsp;Isamu Okamoto ,&nbsp;Nobuyuki Yamamoto","doi":"10.1016/j.lungcan.2025.108637","DOIUrl":"10.1016/j.lungcan.2025.108637","url":null,"abstract":"<div><h3>Introduction</h3><div>PD-L1 inhibitors combined etoposide-platinum (EP) are standard first-line treatments for extensive-stage small-cell lung cancer (ES-SCLC). However, their efficacy remains suboptimal. Irinotecan-cisplatin (IP) is optional regimen for ES-SCLC, and irinotecan has shown potential immunostimulatory activity. This study evaluated the efficacy and safety of IP plus durvalumab in untreated ES-SCLC.</div></div><div><h3>Methods</h3><div>Eligible patients (aged 20–74 years; PS 0–1 received four cycles of IP (irinotecan 60 mg/m², days 1,8,15 and cisplatin 60 mg/m², day 1) with durvalumab 1500 mg, followed by durvalumab 1500 mg every 4 weeks. Primary endpoint was the 12-month progression-free survival (PFS) rate, assessed by an independent central review (ICR).</div></div><div><h3>Results</h3><div>Between May 2021 and Nov 2022, 42 patients (median age, 66 years; 76.2 % were male; 31.0 % had PS 0) were enrolled. The 12-month PFS rate by ICR was 18.8 % (90 % CI, 9.3–30.8 %), with a median PFS of 5.7 months (95 % CI, 4.9–7.6 months). Median overall survival (OS) was 16.9 months (95 % CI, 11.8–NE), and the 12-month OS rate was 65.8 % (95 % CI, 49.1–78.1). Confirmed overall response rate (ORR) was 65.9 %, and disease control rate (DCR) was 85.4 %. Grade ≥3 adverse events (AEs) occurred in 73.8 %, including two grade 5 (2.4 %; pneumonitis and hepatitis). Pneumonitis occurred in 4.8 % (grade 1 and 5), while diarrhea of grade 3 or more occurred in 7.1 % patients.</div></div><div><h3>Conclusion</h3><div>The REBORN study did not demonstrate the expected efficacy of IP plus durvalumab in untreated ES-SCLC, with its efficacy and safety generally comparable to those of EP plus durvalumab.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"206 ","pages":"Article 108637"},"PeriodicalIF":4.5,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519030","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":"Advances in the treatment of brain metastases in EGFR-mutant non-small cell lung cancer","authors":"Haoxin Wang ,&nbsp;Lu Wang ,&nbsp;Nan Gao ,&nbsp;Honglin Li ,&nbsp;Feiran Yang ,&nbsp;Zongkai Liu ,&nbsp;Huijie Li ,&nbsp;Xiurong Li","doi":"10.1016/j.lungcan.2025.108641","DOIUrl":"10.1016/j.lungcan.2025.108641","url":null,"abstract":"<div><div>Non-small cell lung cancer (NSCLC) is the predominant subtype of lung cancer, and brain metastasis (BM) is a frequent and serious complication that significantly impacts patients’ survival and quality of life. EGFR mutations play a crucial role in the progression of NSCLC, particularly the Ex19del and L858R mutations. This paper comprehensively explores the pathological mechanisms of BM in EGFR-mutant NSCLC, covering key aspects such as tumor cell invasion, epithelial-mesenchymal transition (EMT), exosome secretion, and blood–brain barrier (BBB) disruption. It also discusses the classification of EGFR mutations and the strategies used in targeted therapy. Notably, third-generation EGFR tyrosine kinase inhibitors (EGFR-TKIs), like osimertinib, have shown remarkable efficacy in treating BM. The paper further explores the potential of combination therapy, immunotherapy, and local treatment options. Despite significant progress, drug resistance mechanisms remain complex. The development of fourth-generation EGFR-TKIs and antibody-drug conjugates (ADCs) offers new solutions to overcome resistance. In addition, dynamic monitoring of circulating tumor DNA (ctDNA) and analysis of cerebrospinal fluid (CSF) can facilitate the early detection of molecular progression and guide precision treatment decisions. In the future, it is essential to optimize combination therapy strategies through multi-disciplinary collaboration, integrating genomics, imaging, and clinical characteristics to enhance efficacy and safety, improve clinical practice, and ultimately elevate patients’ quality of life.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"206 ","pages":"Article 108641"},"PeriodicalIF":4.5,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513742","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 effectiveness of pembrolizumab maintenance with or without pemetrexed after induction treatment for advanced non-squamous Non–Small-Cell Lung cancer","authors":"Bas JM Peters ,&nbsp;Esmée van Geffen ,&nbsp;Doranne Hilarius ,&nbsp;Stephan Böhringer ,&nbsp;Juliëtte Zwaveling ,&nbsp;Esther Dronkers ,&nbsp;Cor H van der Leest ,&nbsp;Hans JM Smit","doi":"10.1016/j.lungcan.2025.108642","DOIUrl":"10.1016/j.lungcan.2025.108642","url":null,"abstract":"<div><h3>Introduction</h3><div>The recommended first line treatment for advanced non-squamous non-small cell lung cancer (NSCLC) without oncogenic driver mutations is pemetrexed/platinum and pembrolizumab. However, the added survival benefit of pemetrexed as maintenance treatment when combined with pembrolizumab remains unclear. This study evaluates the variation in pemetrexed use and its effectiveness when combined with pembrolizumab in maintenance therapy.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted using data from the Dutch Medication Audit (DMA) and the Dutch Lung Cancer Audit – Lung Oncology (DLCA-L) registries. All patients with a new diagnosis of NSCLC who started pembrolizumab and pemetrexed (and platinum) treatment and had at least one prescription of pembrolizumab maintenance (with/without pemetrexed) treatment between 2017–2024 were included. Patients receiving maintenance therapy with pembrolizumab monotherapy or pembrolizumab combined with pemetrexed were compared. Overall survival (OS) was assessed using Kaplan-Meier analysis and Cox proportional hazards models, adjusting for demographics, ECOG performance status, PD-L1 expression, and hospital type.</div></div><div><h3>Results</h3><div>Among 2333 patients, 548 (23.5%) received pembrolizumab monotherapy, and 1785 (76.5%) received both pembrolizumab and pemetrexed during maintenance therapy. Wide variation in pemetrexed use across hospitals was noted. The median OS was 21.0 months (95% CI 18.8–29.2) for pembrolizumab and 18.2 months (95% CI 16.4–19.6) for pembrolizumab/pemetrexed, with an adjusted hazard ratio of 0.91 (95% CI 0.78–1.05).</div></div><div><h3>Conclusions</h3><div>In this large real-world cohort, pemetrexed did not provide additional survival benefit in maintenance therapy when combined with pembrolizumab. These findings question the routine use of pemetrexed in the maintenance phase of pembrolizumab-based regimens as suggested by treatment guidelines.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"206 ","pages":"Article 108642"},"PeriodicalIF":4.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513743","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":"Transforming lung cancer diagnosis: the role of robotic-assisted bronchoscopy in early detection and staging","authors":"Sebastian Fernandez-Bussy ,&nbsp;Rodrigo Funes-Ferrada ,&nbsp;Alejandra Yu Lee- Mateus ,&nbsp;Bryan F. Vaca-Cartagena ,&nbsp;Alanna Barrios-Ruiz ,&nbsp;Sofia Valdes-Camacho ,&nbsp;Neal M. Patel ,&nbsp;Bryan C. Husta ,&nbsp;Britney N. Hazelett ,&nbsp;Mohamed I. Ibrahim ,&nbsp;Kelly S. Robertson ,&nbsp;Ryan M. Chadha ,&nbsp;David Abia-Trujillo","doi":"10.1016/j.lungcan.2025.108646","DOIUrl":"10.1016/j.lungcan.2025.108646","url":null,"abstract":"<div><h3>Introduction</h3><div>Minimally invasive techniques, including CT-guided transthoracic biopsy (CTTB) and robotic-assisted bronchoscopy (RAB), play a crucial role in diagnosing peripheral pulmonary lesions suspected of lung cancer. This article aims to assess differences in primary lung cancer diagnosis and staging between patients undergoing ssRAB with shape-sensing RAB (ssRAB) and CTTB.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 407 patients who underwent CTTB (2017–2020) and 556 who underwent ssRAB (2020–2023) at a single institution. Propensity score matching (1:1) was applied to balance baseline covariates. Outcomes included cancer stage at diagnosis, procedural safety, and hospital metrics. Logistic regression and descriptive statistics were used to analyze differences.</div></div><div><h3>Results</h3><div>After matching, 148 patients per group were analyzed. Patients in the ssRAB group were more frequently diagnosed at an early stage compared to the CTTB group (OR = 3.02, 95 % CI: 1.83–5.04, p &lt; 0.001). ssRAB demonstrated significantly lower rates of pneumothorax (3.38 % vs. 44.59 %, p &lt; 0.001) and hospital admissions (5.41 % vs. 19.59 %, p &lt; 0.001). Despite longer procedural times, ssRAB reduced hospital stays by 34 min (p &lt; 0.001). Diagnostic yield for malignancy was comparable between ssRAB and CTTB (86.48 % vs. 89.18 %, p = 0.594).</div></div><div><h3>Conclusion</h3><div>ssRAB significantly improves early-stage lung cancer detection and reduces procedural risks, offering a safer, patient-centered approach. Its integration into diagnostic pathways represents a transformative advancement in lung cancer care. Further studies are warranted to confirm its broader impact across diverse healthcare settings.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"206 ","pages":"Article 108646"},"PeriodicalIF":4.5,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522656","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":"Relationship between clinicopathological characteristics and PET/CT uptake in lung cancer: [18F]FAPI versus [18F]FDG","authors":"Kailin Qiao ,&nbsp;Tao Zhou ,&nbsp;Yinjun Dong ,&nbsp;Ning Liu ,&nbsp;Zhendan Wang ,&nbsp;Yuchun Wei ,&nbsp;Shuanghu Yuan","doi":"10.1016/j.lungcan.2025.108645","DOIUrl":"10.1016/j.lungcan.2025.108645","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to characterize the relationships between parameters of [¹⁸F]fibroblast activation protein inhibitor (FAPI) and [¹⁸F]fluorodeoxyglucose (FDG) uptake in primary lung cancer lesions on positron emission tomography/computed tomography (PET/CT) and the clinicopathological features of lung cancer patients.</div></div><div><h3>Methods</h3><div>In this secondary analysis of a prospective trial, from December 2020 to January 2022, 62 patients with pathologically confirmed lung cancer were recruited continuously at a single center, and matched [¹⁸F]FAPI and [¹⁸F]FDG PET/CT examinations were performed, within 7 days but at least 20 h apart.</div></div><div><h3>Results</h3><div>Analysis of the paired [¹⁸F]FAPI and [¹⁸F]FDG PET/CT scanning results of 62 lung cancer patients showed significant differences in [¹⁸F]FAPI uptake among different clinical stages (maximum standardized uptake value [SUVmax], <em>p</em> = 0.017, peak standardized uptake value [SUVpeak], <em>p</em> = 0.018, tumor-to-background ratio [TBR], <em>p</em> = 0.015) and different histological types (SUVmax, <em>p</em> = 0.039, SUVpeak, <em>p</em> = 0.034, TBR, <em>p</em> = 0.012), but no corresponding differences in [¹⁸F]FDG uptake (all <em>p</em> &gt; 0.05). Compared with patients with a programmed cell death ligand 1 (PD-L1) tumor proportion score (TPS) ≥ 1 %, patients with a TPS &lt; 1 % had a higher FAPI-avid tumor volume (FTV) of [¹⁸F]FAPI (<em>p</em> = 0.041) and a higher metabolic tumor volume (MTV) of [¹⁸F]FDG (<em>p</em> = 0.029). Compared with patients with Ki-67 score &lt; 50 %, patients with Ki-67 score ≥ 50 % had higher SUVmax, SUVpeak, and total lesion glycolysis (TLG) of [¹⁸F]FDG (<em>p</em> = 0.027, 0.025, and 0.021, respectively).</div></div><div><h3>Conclusion</h3><div>Our results indicate that [¹⁸F]FAPI and [¹⁸F]FDG uptake are related to different clinicopathological features of lung cancer, providing insights supporting a more comprehensive understanding of the characteristics of lung cancer.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"206 ","pages":"Article 108645"},"PeriodicalIF":4.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611659","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":"MRD status combined with TNM staging optimizes postoperative prognostic stratification in non-small cell lung cancer: a meta-analysis and systematic review","authors":"Yu Shi ,&nbsp;Rongrong Chen ,&nbsp;Yuanyuan Xiong ,&nbsp;Ruixuan Geng ,&nbsp;Chao Guo ,&nbsp;Lei Liu ,&nbsp;Yeye Chen ,&nbsp;Yingyi Wang","doi":"10.1016/j.lungcan.2025.108634","DOIUrl":"10.1016/j.lungcan.2025.108634","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate survival differences based on MRD status at different landmarks and tumor staging in patients with early-stage non-small cell lung cancer (NSCLC) following surgical resection. <strong>Methods:</strong> Data from six studies including 867 early-stage NSCLC patients who underwent surgery were summarized. Patients were grouped according to MRD status at different detection time points and tumor staging. Survival differences among subgroups were evaluated using the Kaplan-Meier method, and statistical significance was determined through the log-rank test.</div></div><div><h3>Result</h3><div>MRD-negative patients exhibit significantly better RFS and OS compared to MRD-positive patients. Based on MRD status at 3–7 days and 30 days post-surgery, combined with TNM staging, we propose a novel four-category prognostic stratification system centered on post-surgery dual-detection timepoints. This stratification system outperforms the traditional TNM staging and is divided into four groups: <strong>Group A:</strong> Post-surgery dual-negative with Stage I disease; <strong>Group B:</strong> Post-surgery dual-negative with Stage II disease; <strong>Group C:</strong> Post-surgery dual-negative with Stage III disease or MRD-positive at 3–7 days but negative at 30 days post-surgery （positive-to-negative conversion)；<strong>Group D:</strong> Post-surgery dual-positive or MRD-negative at 3–7 days but positive at 30 days post-surgery (negative-to-positive conversion).The RFS outcomes are ranked as Group A &gt; Group B &gt; Group C &gt; Group D. Notably, Group D has worse RFS than Stage III patients.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"206 ","pages":"Article 108634"},"PeriodicalIF":4.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501009","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":"Acquired SMARCA4 alterations: An uncommon contributor to cancer progression in lung adenocarcinomas","authors":"Andréanne Gagné ,&nbsp;Joao Victor M. Alessi ,&nbsp;Biagio Ricciuti ,&nbsp;Giuseppe Lamberti ,&nbsp;Mark M. Awad ,&nbsp;Lynette M. Sholl","doi":"10.1016/j.lungcan.2025.108644","DOIUrl":"10.1016/j.lungcan.2025.108644","url":null,"abstract":"<div><h3>Introduction</h3><div><em>SMARCA4</em> inactivation occurs in a subset of non-small cell lung carcinomas (NSCLC) and undifferentiated thoracic tumors, typically as an early clonal alteration in smokers. While rarely observed as an acquired event, the frequency and significance remain unclear. Given the aggressive nature of <em>SMARCA4-</em>deficient thoracic tumors, we hypothesized that <em>SMARCA4</em> inactivation could represent a mechanism of progression and resistance following therapy.</div></div><div><h3>Material and methods</h3><div>We report an index case of a patient with surgically-resected lung adenocarcinoma acquiring a <em>SMARCA4</em> alteration at progression. We then conducted a retrospective analysis of 4154 patients with tumor genomic profiles, identifying NSCLC patients ≥ 2 sequencing tests. Clonally-related samples with pathogenic <em>SMARCA4</em> mutations were further investigated alongside clinical and histopathologic features at each timepoint.</div></div><div><h3>Results</h3><div>Of 354 patients with ≥ 2 clonally-related tumor samples, seven (2.0 %) acquired a pathogenic <em>SMARCA4</em> mutation following systemic therapy for advanced or recurrent disease. Median age was 60 years; 57 % were women and 71 % never smokers. Oncogenic drivers (<em>EGFR</em>, <em>ERBB2</em>, <em>ROS1</em>, <em>KRAS</em>, and <em>BRAF</em>) were identified in 6/7 (86 %) cases. All patients in the retrospective cohort received intervening systemic therapy, either tyrosine kinase inhibitors or chemoimmunotherapy. In 5/7 cases, <em>SMARCA4</em> acquisition was observed in association with an increase in tumor mutational burden, often with APOBEC signatures. In 2/7 cases, <em>SMARCA4</em> acquisition corresponded with worsening tumor grade and loss of TTF1/Napsin A expression.</div></div><div><h3>Conclusion</h3><div>Acquired pathogenic <em>SMARCA4</em> mutations are rare but may emerge under systemic therapy pressure, often alongside increased TMB. Morphologic changes accompanying the loss of <em>SMARCA4</em> expression suggest pathobiological significance in select cases.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"206 ","pages":"Article 108644"},"PeriodicalIF":4.5,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513612","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":"Long term side effects after volumetric modulated arc therapy to the pleura in patients with malignant pleural mesothelioma","authors":"Vishruta Dumane ,&nbsp;Juliana Runnels ,&nbsp;Raja Flores ,&nbsp;Andrea Wolf ,&nbsp;Weijia Fu ,&nbsp;Madhu Mazumdar ,&nbsp;Thomas Marron ,&nbsp;Jorge Gomez ,&nbsp;Kenneth Rosenzweig","doi":"10.1016/j.lungcan.2025.108639","DOIUrl":"10.1016/j.lungcan.2025.108639","url":null,"abstract":"<div><h3>Purpose</h3><div>Lung-sparing pleurectomy/decortication (P/D) is the primary surgical approach for malignant pleural mesothelioma (MPM), and combining it with other therapies enhances patient outcomes.<!--> <!-->This report presents the extended follow-up results of MPM patients who underwent P/D and received volumetric modulated arc therapy (VMAT).</div></div><div><h3>Methods</h3><div>From 2010 to 2021, 81 patients with biopsy-proven malignant pleural mesothelioma, all post-P/D with two intact lungs, were retrospectively analyzed. Some patients received either induction or post-radiation chemotherapy. The target volume was the entire hemithorax, excluding the ipsilateral lung, aiming for 50.4 Gy (1.8 Gy fractions), with a mean lung dose of &lt;20 Gy. Kaplan-Meier analysis determined overall survival (OS) and progression-free survival (PFS). Pulmonary, cardiac, and gastrointestinal events (≥1 year follow-up) were scored using Common Terminology Criteria for Toxicity and Adverse Event Reporting version 5.0 (CTCAE V5.0).</div></div><div><h3>Results</h3><div>Of the 81 patients, 45 (55.6 %) had ≥1 year of follow-up, median 2.2 years (26 months). Median OS was 14.2 months (95 % CI, 12.1–21) and PFS was 9.1 months (95 % CI, 7.7–12.5). The Kaplan-Meier OS rates were 60.5 % at 1 year, 33.3 % at 2 years; PFS rates were 40.7 % at 1 year, 19.8 % at 2 years. Seven patients (8.6 %) had grade 3 radiation<!--> <!-->pneumonitis, all resolving with care, and 1 patient experienced grade 3 pericarditis. No grade 3 gastrointestinal events occurred, and no grade 4 or 5 events were seen.</div></div><div><h3>Conclusions</h3><div>This study represents the largest retrospective cohort and longest follow-up to date assessing the safety of VMAT. Pleural VMAT proves safe, lacking unexpected long term severe side effects. Future research including treatment plan dose prediction, and advanced deployment techniques will aim to broaden mesothelioma radiotherapy delivery.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"206 ","pages":"Article 108639"},"PeriodicalIF":4.5,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144491153","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":"Application of endobronchial ultrasound-guided cryobiopsy for centrally located intrapulmonary lesions: A retrospective cohort study","authors":"Toshiyuki Nakai ,&nbsp;Sayaka Tanaka ,&nbsp;Hiroaki Nagamine ,&nbsp;Atsushi Miyamoto ,&nbsp;Misako Nishimura ,&nbsp;Yoshiya Matsumoto ,&nbsp;Kanako Sato ,&nbsp;Kazuhiro Yamada ,&nbsp;Tetsuya Watanabe ,&nbsp;Kazuhisa Asai ,&nbsp;Yuji Matsumoto ,&nbsp;Yu Mikami ,&nbsp;Tomoya Kawaguchi","doi":"10.1016/j.lungcan.2025.108636","DOIUrl":"10.1016/j.lungcan.2025.108636","url":null,"abstract":"<div><h3>Background and objective</h3><div>Endobronchial ultrasound-guided cryobiopsy (EBUS-cryo) enables the collection of high-quality specimens from lymphadenopathy. Expanding its application to intrapulmonary lesions may provide sufficient tissue quality and quantity for lung tumors. Therefore, we introduced EBUS-cryo through the tract created by EBUS-transbronchial needle aspiration (TBNA) for centrally located intrapulmonary lesions (CLILs) and evaluated its diagnostic utility, safety, and tissue sampling capability for CLILs.</div></div><div><h3>Methods</h3><div>Consecutive patients who underwent EBUS-cryo following EBUS-TBNA to diagnose CLILs at Osaka Metropolitan University Hospital between March 2023 and December 2024 were retrospectively analyzed. An expert pathologist assessed the quality and area of all tissue specimens, grading quality on a six-point scale (1–6), where scores of ≥ 5 defined as high quality. The tissue specimens’ quality, area, and diagnostic performance of each biopsy technique were compared.</div></div><div><h3>Results</h3><div>Of the 74 cases, 70 successful cases were included in the analysis. The diagnostic yields of EBUS-cryo and EBUS-TBNA were 95.7 % and 91.4 %, respectively (<em>P</em> = 0.51). Moderate bleeding occurred in 5.7 %; however, no severe complications were observed. The mean quality score and specimen area were higher with EBUS-cryo than with EBUS-TBNA (quality: 4.84 ± 1.31 vs. 2.27 ± 1.09, <em>P</em> &lt; 0.001; area: 5.90 ± 3.06 mm² vs. 4.10 ± 3.51 mm², <em>P</em> &lt; 0.001). The retrieval rate of high-quality specimens was higher with EBUS-cryo than with EBUS-TBNA (177/243, 72.8 % vs. 10/227, 4.4 %; <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Application of EBUS-cryo to CLILs offers high diagnostic utility, acceptable safety, and superior tissue sampling capability.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"205 ","pages":"Article 108636"},"PeriodicalIF":4.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470599","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}