Lung Cancer最新文献

{"title":"Advanced-stage ALK-positive non–small-cell lung cancer (NSCLC) patients: Real-world treatment patterns and outcomes from the Italian biomarker ATLAS database","authors":"Maria Lucia Reale ,&nbsp;Daniela Scattolin ,&nbsp;Antonio Vitale ,&nbsp;Francesco Passiglia ,&nbsp;Salvatore Grisanti ,&nbsp;Marianna Macerelli ,&nbsp;Domenico Galetta ,&nbsp;Claudio Sini ,&nbsp;Gabriele Minuti ,&nbsp;Fabrizio Citarella ,&nbsp;Elisa Roca ,&nbsp;Francesco Agustoni ,&nbsp;Alessandra Dodi ,&nbsp;Diego Cortinovis ,&nbsp;Lorenzo Belluomini ,&nbsp;Serena Ricciardi ,&nbsp;Antonello Veccia ,&nbsp;Elio Gregory Pizzutilo ,&nbsp;Vieri Scotti ,&nbsp;Greta Alì ,&nbsp;Giulia Pasello","doi":"10.1016/j.lungcan.2025.108762","DOIUrl":"10.1016/j.lungcan.2025.108762","url":null,"abstract":"<div><h3>Background</h3><div>Treatment of advanced <em>ALK</em> + NSCLC has improved with increasingly effective ALK tyrosine-kinase inhibitors (TKIs). We report <em>real-world</em> treatment patterns and outcomes from the Italian ATLAS registry.</div></div><div><h3>Methods</h3><div>Clinical-pathological and treatment data were retrospectively and prospectively collected from 37 Italian centers.</div></div><div><h3>Results</h3><div>463 <em>ALK</em> + advanced NSCLC patients treated from 2019 to 2024 were included. 431 (93 %) patients received 1st line (1L) ALK TKIs, mostly alectinib (82.5 %). 1L treatment choice, reported in 142 cases, was driven by drug access as first (31 %) or subsequent lines (40.1 %) and by safety (21.8 %). Among 382 patients receiving 1L alectinib overall survival (OS) rate was 88.7 % and 73.3 % at 24 and 60 months, respectively. Median progression-free survival (mPFS) was 43.1 months (95 %CI: 29.5–57.0). Brain was a new site of progression in 11 (3.6 %) patients. Intracranial PFS rate was 73.1 % and 59.1 % at 24 and 36 months with a 64.7 % intracranial response rate. Grade ≥ 3 adverse events occurred in 41 (10.7 %) patients, mainly hepatic toxicity (13, 3.4 %) and asthenia (5, 1.3 %). At progression tissue and/or liquid biopsy were performed in 28 (23.5 %) and 20 (16.8 %) cases, respectively. Out of 80 patients receiving 2nd line therapy after alectinib, 67 (83.8 %) received lorlatinib achieving mPFS 7.5 (95 % CI: 6.2–8.8) and mOS 26.4 months (95 % CI: 19.1–33.7). 17 (15.5 %) patients died without second line therapy.</div></div><div><h3>Conclusions</h3><div>Real-world data confirm the effectiveness and safety of alectinib, used as preferred upfront ALK-TKI. The recent 1L lorlatinib approval might change this scenario. Tissue/liquid biopsy at disease progression are underperformed in clinical practice.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"209 ","pages":"Article 108762"},"PeriodicalIF":4.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181421","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 platinum-etoposide in the first-line treatment of extensive-stage small cell lung cancer (CANTABRICO): A single-arm clinical trial","authors":"Dolores Isla ,&nbsp;Jon Zugazagoitia ,&nbsp;Edurne Arriola ,&nbsp;Rosario García-Campelo ,&nbsp;Cristina Martí Blanco ,&nbsp;María Pilar Diz-Taín ,&nbsp;Marta López-Brea ,&nbsp;Alberto Luis Moreno-Vega ,&nbsp;Luis León-Mateos ,&nbsp;Juana Oramás ,&nbsp;Vanesa Gutiérrez-Calderón ,&nbsp;Margarita Majem ,&nbsp;Alfredo Sánchez-Hernández ,&nbsp;Carlos Aguado ,&nbsp;Ruth Alvarez-Cabellos ,&nbsp;Bartomeu Massutí ,&nbsp;Amaia Moreno ,&nbsp;José-Luis Fírvida-Pérez ,&nbsp;Javier Valdivia ,&nbsp;Marta González-Cordero ,&nbsp;Luis Paz-Ares","doi":"10.1016/j.lungcan.2025.108763","DOIUrl":"10.1016/j.lungcan.2025.108763","url":null,"abstract":"<div><h3>Background</h3><div>Immunotherapy trials involving patients with extensive-stage small cell lung cancer (ES-SCLC) from real-world clinical practice are needed. We aimed to evaluate the safety and effectiveness of durvalumab plus platinum-etoposide as a first-line treatment in a real-world population of patients with ES-SCLC.</div></div><div><h3>Patients and methods</h3><div>A prospective, single-arm study was conducted in adult patients who had histologically or cytologically confirmed ES-SCLC and a WHO/ECOG PS of 0–2 (a maximum of 30 % of patients with a PS of 2 were allowed). Patients received durvalumab plus platinum-etoposide for up to 6 cycles, followed by durvalumab every 4 weeks as a single agent. The primary outcomes included the incidence of grade ≥ 3 adverse events (AEs) and immune-mediated AEs (imAEs).</div></div><div><h3>Results</h3><div>Between December 2020 and April 2021, 101 patients were included in this trial. Grade 3 or higher AEs occurred in 77 patients (76.2 %) and were considered treatment-related in 58 patients (57.4 %). Thirty-eight patients (37.6 %) reported at least one imAE, all of which were considered treatment related. Among the 82 imAEs reported during the study, 68 (82.9 %) were grade 1–2. The median overall survival was 9.6 months (95 % CI, 7.8 to 11.3), and the 12-month and 24-month overall survival rates were 40.7 % (31.1 % to 50.3 %) and 25.4 % (95 % CI, 16.8 % to 34.0 %), respectively.</div></div><div><h3>Conclusions</h3><div>This phase 3B trial suggests that first-line treatment of patients with ES-SCLC with an initial regimen of up to six cycles of durvalumab plus platinum-etoposide followed by maintenance with durvalumab is feasible providing more options in daily clinical practice for the management of these patients depending on their characteristics..</div><div>Trial registration: NCT04712903.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"209 ","pages":"Article 108763"},"PeriodicalIF":4.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206763","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":"Evaluating docetaxel effectiveness in KRAS G12C-mutated NSCLC: insights from a Real-World cohort","authors":"Matthias Scheffler ,&nbsp;Lia Tzala ,&nbsp;Karly Louie ,&nbsp;Thorsten Persigehl ,&nbsp;Simon Lennartz ,&nbsp;Katarina Öhrling ,&nbsp;Julia Gehrman ,&nbsp;Lea Ruge ,&nbsp;Felix John ,&nbsp;Anna Rasokat ,&nbsp;Anna Kron ,&nbsp;Michaela Potzner ,&nbsp;Sabine Merkelbach-Bruse ,&nbsp;Reinhard Buettner ,&nbsp;Udo Siebolts ,&nbsp;Jürgen Wolf","doi":"10.1016/j.lungcan.2025.108768","DOIUrl":"10.1016/j.lungcan.2025.108768","url":null,"abstract":"<div><h3>Background</h3><div>Specific <em>KRAS</em> G12C inhibitors have reached the stage of targeted therapy for non-small cell lung cancer (NSCLC). However, there is a dearth of real-world data in the context of immune checkpoint blockade and docetaxel effectiveness in NSCLC patients with <em>KRAS</em> G12C mutations. This study was designed to address this gap in knowledge by analyzing a real-world cohort of patients with <em>KRAS</em> G12C mutations treated with docetaxel in the era of immune-checkpoint-blockade availability.</div></div><div><h3>Patients and Methods</h3><div>The Network Genomic Medicine (NGM) database was queried to identify patients with <em>KRAS</em> G12C mutations who had been treated with docetaxel monotherapy or combinations between July 1st, 2015, and December 31st, 2019.</div></div><div><h3>Results</h3><div>The median rwOS was 7.6 months (95 % CI: 6.5–14.5), with improved outcomes observed for docetaxel plus nintedanib (10.4 months) compared to docetaxel monotherapy (6.5 months). The rwPFS was 3.4 months overall, with combination therapy showing marginally superior efficacy (4.3 vs. 2.2 months). The presence of concomitant mutations in <em>STK11</em> and <em>KEAP1</em> was associated with inferior outcomes, whereas elevated PD-L1 expression was associated with enhanced rwOS. Notably, the inclusion of patients with ECOG 2 or higher underscored the unfavorable outcomes observed in this subgroup, which is typically excluded from pivotal trials.</div></div><div><h3>Conclusion</h3><div>The effectiveness of docetaxel, administered with or without antiangiogenic agents, was found to be limited in a real-world setting of non-small cell lung cancer (NSCLC) patients with a <em>KRAS</em> G12C mutation, emphasizing the need for novel therapies. Comprehensive molecular profiling remains crucial for optimizing treatment outcomes in this heterogeneous subgroup.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"209 ","pages":"Article 108768"},"PeriodicalIF":4.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199915","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":"An umbrella review of meta-analyses on smoking cessation and cancer survival: a brief report","authors":"Fausto Petrelli ,&nbsp;Antonio Ghidini ,&nbsp;Mauro Rossitto ,&nbsp;Lorenzo Dottorini ,&nbsp;Francesco Tarantini","doi":"10.1016/j.lungcan.2025.108753","DOIUrl":"10.1016/j.lungcan.2025.108753","url":null,"abstract":"<div><div>Smoking cessation at or around the time of cancer diagnosis is associated with significant improvements in survival across multiple tumor types. This umbrella review of 12 meta-analyses demonstrates that patients who quit smoking post-diagnosis have a 15–29% reduction in mortality in lung cancer, a 20% reduction in head and neck cancers, and a 24% reduction in colorectal cancer. Suggestive benefits were also observed in breast, bladder, and gastrointestinal cancers. The strongest evidence supports the prognostic value of cessation in lung and colorectal cancers. These findings underscore the clinical importance of integrating structured tobacco cessation interventions into routine oncologic care, not only for long-term disease prevention but also to improve survival outcomes in patients already diagnosed with cancer. Despite the consistency of benefit, cessation support remains underutilized in oncology settings. Addressing this gap represents a critical and actionable step toward improving cancer prognosis with minimal toxicity and high cost-effectiveness.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"208 ","pages":"Article 108753"},"PeriodicalIF":4.4,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154994","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":"Attrition with adjuvant, neoadjuvant, and perioperative immunotherapy-based treatment protocols in patients with resectable non-small-cell lung cancer. A meta-analysis of prospective trials","authors":"Francesco Guerrera ,&nbsp;Filippo Tommaso Gallina ,&nbsp;Eleonora Balzani ,&nbsp;Francesca Ambrosi ,&nbsp;Alessandro Di Federico ,&nbsp;Eleonora Faccioli ,&nbsp;Giorgio Facheris ,&nbsp;Roberto Ferrara ,&nbsp;Alessandra Ferro ,&nbsp;Federica Filipello ,&nbsp;Raffaele Giusti ,&nbsp;Carlo Greco ,&nbsp;Marco Mammana ,&nbsp;Daniele Marinelli ,&nbsp;Antonio Nuccio ,&nbsp;Alessandra Pittaro ,&nbsp;Matteo Sepulcri ,&nbsp;Giuseppe Viscardi ,&nbsp;Pietro Bertoglio","doi":"10.1016/j.lungcan.2025.108760","DOIUrl":"10.1016/j.lungcan.2025.108760","url":null,"abstract":"<div><h3>Background</h3><div>The use of immunotherapy (IOT) in treating non-small-cell lung cancer (NSCLC) has revolutionized care standards. However, full compliance with neoadjuvant, perioperative, and adjuvant treatment protocols remains a challenge. This study aims to evaluate compliance rates with IOT-based protocols in neoadjuvant, adjuvant, and perioperative settings.</div></div><div><h3>Methods</h3><div>A systematic review and <em>meta</em>-analysis were conducted on prospective clinical trials involving preoperative, perioperative, and postoperative IOT protocols in resectable NSCLC up to December 2024. Primary outcomes included compliance with medical treatment (e.g., omission of therapy rate, incomplete therapy rate, and omission of surgery rate), surgical outcomes (R0 resection rate), and post-treatment severe adverse events (AEs).</div></div><div><h3>Results</h3><div>A total of 30 studies, with 10,493 patients, were included. In the neoadjuvant settings, 26 studies (16 neoadjuvant; 10 perioperative) investigated IOT alone or in combination with chemotherapy. Almost all patients received at least one therapy administration, while 11.3 % experienced incomplete cycles. Surgery was not performed in 16.1 % of cases, and an R0 resection was achieved in 80.5 % of patients. Grade ≥ 3 AEs were observed in 67.7 % of patients. In the adjuvant setting, 14 studies evaluated IOT (4 adjuvant; 10 perioperative). Complete omission of adjuvant therapy occurred in 9,6 % of patients, while 34,6 % required a discontinuation or cycle reduction. Grade ≥ 3 were AEs observed in 19.0 % of patients. Overall protocol compliance was superior in neoadjuvant protocols (effect size: 0.78 [IC 95 %: 0.70–0.85]) compared to adjuvant protocols (effect size: 0.61 [IC 95 %: 0.53–0.69]) and perioperative protocols (effect size: 0.49 [IC 95 %: 0.43–0.55]). However, perioperative protocols showed similar compliance and Grade ≥ 3 AE rates compared to preoperative and postoperative protocols.</div></div><div><h3>Conclusions</h3><div>Compliance with treatment protocols in NSCLC remains a critical factor, particularly for radical surgery candidates. This study represents a landmark effort in synthesizing comprehensive data on compliance with immunotherapy protocols in resectable NSCLC. Improving protocol compliance through tailored strategies and multidisciplinary coordination is essential to maximize the therapeutic potential of immunotherapy in resectable NSCLC and enhance patient outcomes.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"209 ","pages":"Article 108760"},"PeriodicalIF":4.4,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223031","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":"Unveiling the molecular and clinical risk landscape of second primary lung cancer in resected non-small cell lung cancer","authors":"Chihiro Takemura ,&nbsp;Tatsuya Yoshida ,&nbsp;Yukihiro Yoshida ,&nbsp;Ryoko Inaba Higashiyama ,&nbsp;Hidehito Horinouchi ,&nbsp;Hiroshi Igaki ,&nbsp;Noboru Yamamoto ,&nbsp;Yasushi Yatabe ,&nbsp;Shun-ichi Watanabe","doi":"10.1016/j.lungcan.2025.108750","DOIUrl":"10.1016/j.lungcan.2025.108750","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer (LC) survivors have a 4–6-fold higher risk of developing a second primary LC than the general population. In prospective multicenter studies, 15–17 % of patients undergoing surgical resection for LC develop a second malignancy, often in the lung, with risk persisting beyond 5 years. We characterized its incidence and risk factors, including genetic mutations, in a large retrospective cohort.</div></div><div><h3>Methods</h3><div>This study retrospectively analyzed 5,274 patients undergoing complete resection for non-small cell lung cancer at the National Cancer Center Hospital Tokyo between 2011 and 2023. Second primary LCs were identified using the Martini and Melamed criteria. We estimated cumulative incidence with the Fine–Gray competing–risk method, treating death as a competing event, and calculated sub–distribution hazard ratios (SHRs).</div></div><div><h3>Results</h3><div>The median follow-up was 4.4 years (range: 0–12). Overall, 365 (6.9 %) patients developed a second primary LC at a median interval of 4.1 years. Cumulative incidence from surgery was 0.7 % at 1 year, 6.1 % at 5 years, and 15.1 % at 10 years. Multivariate analysis identified heavy smoking history ([SHR]: 1.47, 95 % confidence interval [CI]: 1.07–2.30, <em>p</em> = 0.02), first status of multiple primary lung cancer (MPLC), defined as ≥ 2 synchronous tumors at baseline (SHR: 1.88, 95 % CI: 1.25–2.85, <em>p</em> = 0.002), and higher consolidation-to-tumor ratio (CTR) (SHR: 2.40, 95 % CI: 1.67–3.47, <em>p</em> &lt; 0.001) as independent risk factors. Among 1,292 (24.5 %) patients assessed for genetic mutations, 699 (13.2 %) harbored at least one clinically targetable driver mutation; however, mutation status did not affect risk of second primary LC (<em>p</em> = 0.46).</div></div><div><h3>Conclusions</h3><div>Heavy smoking history, first status of MPLC, and higher CTR increase the risk of second primary LC; mutation status does not. Patients with these features require intensified, long-term surveillance.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"208 ","pages":"Article 108750"},"PeriodicalIF":4.4,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118722","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 of treatment prior to death among those with lung cancer: A national study in a universal healthcare context","authors":"J. Gurney ,&nbsp;D. Ongley ,&nbsp;L. Cameron ,&nbsp;S. Costello ,&nbsp;A. Davies ,&nbsp;P. Dawkins ,&nbsp;C.G.C.A. Jackson ,&nbsp;J. Koea ,&nbsp;J. Stanley","doi":"10.1016/j.lungcan.2025.108761","DOIUrl":"10.1016/j.lungcan.2025.108761","url":null,"abstract":"<div><div>The intensity of cancer treatment delivered to patients in their final days of life will likely vary depending on many factors. This study examines interventional procedures, radiation therapy and systemic therapy receipt in the 30 days prior to death in a national cohort of lung cancer patients who were diagnosed and died between 2012–2019 (n = 14,822), and explores the extent to which this receipt differs depending on multiple sociodemographic and cancer-related factors. We found that the most common form of treatment was palliative radiation therapy (age std. proportion: 11 %), followed by palliative interventional procedures (6 %) and systemic therapy (5 %). Curative interventional procedures and curative radiation therapy were extremely rare prior to death (&lt;1%). Almost all palliative interventional procedures were drainage or pleurodesis procedures (99 %). Receipt of palliative radiation therapy and systemic therapy (but not interventional procedures) reduced with increasing age, and also with increasing comorbidity. Palliative interventional procedures and palliative radiation therapy were more likely among those with non-small cell lung cancers than other forms, while those with small-cell lung cancers were much more likely to receive systemic therapy toward the end of life. Our findings tentatively indicate that clinical services in New Zealand are appropriately reducing futile treatment toward the end of life, although more work is needed to explore this with more granularity than possible in the current study.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"208 ","pages":"Article 108761"},"PeriodicalIF":4.4,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149817","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":"Impact of tumor cell burden beyond the elastic layer on prognosis in T2aN0M0 non-small cell lung cancer with visceral pleural invasion","authors":"Kazuki Sugata ,&nbsp;Keiju Aokage ,&nbsp;Tetsuro Taki ,&nbsp;Kotaro Nomura ,&nbsp;Masashi Wakabayashi ,&nbsp;Tomohiro Miyoshi ,&nbsp;Kenta Tane ,&nbsp;Joji Samejima ,&nbsp;Yukiko Sasahara ,&nbsp;Michiko Nagamine ,&nbsp;Motohiro Kojima ,&nbsp;Shingo Sakashita ,&nbsp;Naoya Sakamoto ,&nbsp;Masahiro Tsuboi ,&nbsp;Genichiro Ishii","doi":"10.1016/j.lungcan.2025.108759","DOIUrl":"10.1016/j.lungcan.2025.108759","url":null,"abstract":"<div><h3>Objectives</h3><div>Visceral pleural invasion (VPI) is a key upstaging T-factor in non-small cell lung cancer (NSCLC). This study aimed to investigate the prognostic significance of VPI patterns.</div></div><div><h3>Material and Methods</h3><div>We retrospectively analyzed 107 participants pathologically diagnosed NSCLC (T2aN0M0) with VPI. Five VPI patterns were quantitatively evaluated and analyzed for their survival impact: (1) total tumor cell area beyond the elastic layer (TCA), (2) whole tumor area beyond the elastic layer (WTA), (3) minimum distance from the pleural surface to the tumor cell invading the pleura (min-DST), (4) maximum distance from the pleural surface to the deepest point of the invaginated elastic layer (max-DSI), and (5) density of tumor cells (DTC).</div></div><div><h3>Results</h3><div>Median values for TCA, WTA, min-DST, max-DSI, and DTC were 353,471 μm², 2,370,436 μm², 114 μm, 1,248 μm, and 19.2 %. Five-year recurrence-free survival (RFS) was significantly lower in participants with larger TCA and WTA (log-rank test). In univariable Cox regression analysis, smoking status, Eastern Cooperative Oncology Group performance status (ECOG PS), invasive component size, TCA, and WTA were significant predictors of RFS. In multivariable analysis, ECOG PS [HR = 2.475; 95 % CI, 1.049–5.838], invasive component size [HR = 2.347; 95 % CI, 1.137–4.845], and TCA [HR = 3.574; 95 % CI, 1.318–9.695] remained independent significant prognostic factors for RFS.</div></div><div><h3>Conclusion</h3><div>TCA may serve as a novel prognostic factor in NSCLC with VPI.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"208 ","pages":"Article 108759"},"PeriodicalIF":4.4,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145155079","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":"Efficacy and safety of consolidative thoracic radiotherapy for Extensive-Stage Small-Cell lung cancer in the era of immunotherapy: A Real-World study","authors":"Chaonan Zhang ,&nbsp;Wenqing Wang ,&nbsp;Nan Bi,&nbsp;Jianyang Wang,&nbsp;Wenyang Liu,&nbsp;Tao Zhang,&nbsp;Xin Wang,&nbsp;Zefen Xiao,&nbsp;Jima Lv,&nbsp;Qinfu Feng,&nbsp;Lei Deng,&nbsp;Zongmei Zhou","doi":"10.1016/j.lungcan.2025.108758","DOIUrl":"10.1016/j.lungcan.2025.108758","url":null,"abstract":"<div><h3>Background and purpose</h3><div>To evaluate the safety and efficacy of consolidative thoracic radiotherapy (cTRT) for extensive-stage small cell lung cancer (ES-SCLC) patients in the era of first-line chemoimmunotherapy.</div></div><div><h3>Materials and methods</h3><div>We retrospectively analyzed patients with ES-SCLC who accepted first-line platinum-based chemotherapy plus immunotherapy in our hospital from January 2018 to December 2021. CTRT was recommended for patients who achieved complete response (CR)/ partial response (PR) / stable disease (SD) after first-line systemic therapy. Patients were divided into cTRT and non-cTRT groups based on their receipt of cTRT. Categorical variables were compared using the Chi-squared test or Fisher’s exact test. Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan-Meier method, with comparisons by the log-rank test. Univariate and multivariate analyses were employed to identify prognostic factors for OS using the Cox proportional hazards model. Cumulative incidence of local regional progression (LRP) was calculated using the Fine-Gray competing risks regression model.</div></div><div><h3>Results</h3><div>We finally enrolled 100 patients in our cohort, comprising 48 patients who received cTRT and 52 who did not. The cTRT group exhibited significantly younger age distribution (72.9 % &lt;65 years vs. 50 % in non-cTRT, p = 0.019), limited metastatic sites (≤1 metastatic site: 66.7 % vs. 32.7 %, p &lt; 0.001), and fewer liver metastases (12.5 % vs. 32.7 %, p = 0.017), alongside higher PCI uptake rates (27.1 % vs 0 %, p = 0.001). The cTRT group had significantly longer median OS (26 vs. 17 months, p = 0.006) and PFS (10 vs. 6 months, p = 0.005) compared with the non-cTRT group. Multivariate analysis identified cTRT as the only prognostic factor correlated with improved OS (HR = 0.48, p = 0.04). The LRP at 1 year were 55.4 % and 22.3 % in the non-cTRT and cTRT group, respectively (p &lt; 0.001). 3 (6.3 %) patients had grade 3 radiation esophagitis and 5 (10.4 %) patients developed grade 1–2 radiation pneumonitis in the cTRT group.</div></div><div><h3>Conclusion</h3><div>The administration of cTRT is safe and holds potential benefits for ES-SCLC patients responding to first-line chemoimmunotherapy.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"208 ","pages":"Article 108758"},"PeriodicalIF":4.4,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149739","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":"Biological impact of chemotherapy during treatment with EGFR tyrosine kinase inhibitors for non-small cell lung cancer positive for EGFR activating mutations","authors":"Eiji Iwama ,&nbsp;Kazuko Sakai ,&nbsp;Taishi Harada ,&nbsp;Shintaro Kanda ,&nbsp;Shunichi Sugawara ,&nbsp;Toshihide Yokoyama ,&nbsp;Hirokazu Taniguchi ,&nbsp;Kaoru Tanaka ,&nbsp;Ryo Toyozawa ,&nbsp;Kenichi Koyama ,&nbsp;Yoshitaka Zenke ,&nbsp;Gen Kida ,&nbsp;Yasuhiko Nishioka ,&nbsp;Hiroshi Yokouchi ,&nbsp;Masayuki Hirose ,&nbsp;Kazuto Nishio ,&nbsp;Nobuyuki Yamamoto ,&nbsp;Yuichiro Ohe ,&nbsp;Isamu Okamoto","doi":"10.1016/j.lungcan.2025.108756","DOIUrl":"10.1016/j.lungcan.2025.108756","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this study was to explore the biological impact of chemotherapy during epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) treatment in individuals with non-small cell lung cancer (NSCLC).</div></div><div><h3>Methods</h3><div>Plasma and tumor tissue specimens were prospectively collected from NSCLC patients with <em>EGFR</em> activating mutations who participated in a randomized phase III study comparing EGFR-TKI therapy with or without inserted chemotherapy (JCOG1404/WJOG8214L). The specimens were analyzed for genetic mutations by droplet digital polymerase chain reaction analysis and next-generation sequencing.</div></div><div><h3>Results</h3><div>Two hundred patients were enrolled in this biomarker study, with 113 and 87 individuals receiving EGFR-TKI monotherapy and EGFR-TKI treatment plus inserted chemotherapy, respectively. Although progression-free survival (PFS) for EGFR-TKI monotherapy was shorter in patients with than in those without detectable <em>EGFR</em> activating mutations in cell-free DNA at baseline, inserted chemotherapy improved PFS compared with EGFR-TKI monotherapy for the former patients (median, 17.5 vs. 11.8 months). Inserted chemotherapy suppressed the number of alleles positive for activating and T790M mutations of <em>EGFR</em> in cell-free DNA at disease progression. The benefit of inserted chemotherapy relative to EGFR-TKI monotherapy was more apparent in patients with (median PFS, 18.8 vs. 13.5 months) than in those without detectable concurrent mutations of <em>TP53</em>.</div></div><div><h3>Conclusions</h3><div>Chemotherapy has the potential to suppress the development of EGFR-TKI resistance as well as to inhibit tumor growth for NSCLC positive for <em>EGFR</em> activating mutations. Our results provide biological insight into combination treatment with EGFR-TKIs and chemotherapy for such patients.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"208 ","pages":"Article 108756"},"PeriodicalIF":4.4,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096479","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}