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CRES3T: A single-arm confirmatory trial of S-1 plus cisplatin with concurrent radical-dose radiotherapy followed by surgery for superior sulcus tumors
IF 4.5 2区 医学
Lung Cancer Pub Date : 2025-03-19 DOI: 10.1016/j.lungcan.2025.108506
Kazuya Takamochi , Kenji Suzuki , Morihito Okada , Seiji Niho , Satoshi Ishikura , Shunsuke Oyamada , Takuhiro Yamaguchi , Hirotoshi Horio , Norihiko Ikeda , Fumihiro Tanaka , Satoshi Shiono , Tomohiro Haruki , Ichiro Yoshino , Hiroyuki Ito , Hidetaka Uramoto , Norihito Okumura , Hisashi Iwata , Hisashi Saji , Toshiya Fujiwara , Kazuhito Funai , Masahiro Tsuboi
{"title":"CRES3T: A single-arm confirmatory trial of S-1 plus cisplatin with concurrent radical-dose radiotherapy followed by surgery for superior sulcus tumors","authors":"Kazuya Takamochi ,&nbsp;Kenji Suzuki ,&nbsp;Morihito Okada ,&nbsp;Seiji Niho ,&nbsp;Satoshi Ishikura ,&nbsp;Shunsuke Oyamada ,&nbsp;Takuhiro Yamaguchi ,&nbsp;Hirotoshi Horio ,&nbsp;Norihiko Ikeda ,&nbsp;Fumihiro Tanaka ,&nbsp;Satoshi Shiono ,&nbsp;Tomohiro Haruki ,&nbsp;Ichiro Yoshino ,&nbsp;Hiroyuki Ito ,&nbsp;Hidetaka Uramoto ,&nbsp;Norihito Okumura ,&nbsp;Hisashi Iwata ,&nbsp;Hisashi Saji ,&nbsp;Toshiya Fujiwara ,&nbsp;Kazuhito Funai ,&nbsp;Masahiro Tsuboi","doi":"10.1016/j.lungcan.2025.108506","DOIUrl":"10.1016/j.lungcan.2025.108506","url":null,"abstract":"<div><h3>Purpose</h3><div>This multicenter single-arm confirmatory trial (CRES<sup>3</sup>T) investigated the efficacy and safety of S-1 + cisplatin and concurrent radical-dose radiotherapy followed by surgery in patients with a superior sulcus tumor.</div></div><div><h3>Methods</h3><div>Patients received induction therapy comprising three cycles of S-1 + cisplatin with concurrent radiotherapy (66 Gy in 33 fractions) followed by surgery. S-1 was administered orally at 40 mg/m<sup>2</sup> twice/day on days 1–14, with an intravenous infusion of cisplatin (60 mg/m<sup>2</sup>) on day 1. The primary endpoint was the 3-year overall survival rate; key secondary endpoints included progression-free survival rate, objective response rate, pathological complete response rate, and toxicity.</div></div><div><h3>Results</h3><div>Sixty-one patients with a superior sulcus non-small cell lung cancer received induction therapy. Radiological tumor invasion sites were the chest wall (n = 57), subclavian artery (n = 18), and subclavian vein (n = 10). Forty-nine patients underwent a lobectomy and combined resection of the involved structures. The objective and pathological complete response rates were 42 % (95 % confidence interval: 29–54 %) and 33 % (95 % confidence interval: 20–46 %), respectively. The 3-year overall survival and progression-free survival rates were 73.2 % (95 % confidence interval: 60.1–82.7 %) and 53.3 % (95 % confidence interval: 40.0–65.0 %), respectively. The patterns of first tumor relapse were locoregional only in one, distant metastasis only in 18, and both in four patients. Two pneumonia cases during induction therapy and one cardiac-arrest case on postoperative day 3 resulted in death.</div></div><div><h3>Conclusions</h3><div>Induction therapy using S-1 + cisplatin and concurrent radical-dose radiotherapy followed by surgery maximized local control and improved overall survival without impairing safety, potentially representing a new standard treatment.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108506"},"PeriodicalIF":4.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683201","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}
引用次数: 0
Lung cancer risk between maternal and paternal half-siblings points to main environmental causation and targets for prevention
IF 4.5 2区 医学
Lung Cancer Pub Date : 2025-03-18 DOI: 10.1016/j.lungcan.2025.108500
Kari Hemminki , Frantisek Zitricky , Kristina Sundquist , Jan Sundquist , Asta Försti , Akseli Hemminki
{"title":"Lung cancer risk between maternal and paternal half-siblings points to main environmental causation and targets for prevention","authors":"Kari Hemminki ,&nbsp;Frantisek Zitricky ,&nbsp;Kristina Sundquist ,&nbsp;Jan Sundquist ,&nbsp;Asta Försti ,&nbsp;Akseli Hemminki","doi":"10.1016/j.lungcan.2025.108500","DOIUrl":"10.1016/j.lungcan.2025.108500","url":null,"abstract":"<div><h3>Introduction</h3><div>Familial risk of lung cancer (LC) is at the level of many common cancers (ca 2.0) but as cigarette smoking is the main cause of LC, it has remained undefined to what extent smoking contributes to the familial risk. We take advantage of the natural experiment of divorce. In Sweden, it has been customary that children stay with their mother after divorce. We thus hypothesize that only maternal half-siblings share the childhood environment to the same extent than full siblings.</div></div><div><h3>Methods</h3><div>We used Swedish nation-wide data on family structures and cancers up to year 2021 to determined LC risk (standardized incidence ratio, SIR with 95% confidence intervals) in maternal and paternal half-siblings and in full siblings.</div></div><div><h3>Results</h3><div>Familial risk for LC in maternal half-siblings was 2.21 (1.76–2.77) which was not different from that of full siblings 2.23 (2.22–2.44). For paternal half-siblings the risk was 1.56 (1.21–2.01). For adenocarcinoma the risks were for full siblings 2.36 (2.23–2.51), for maternal half-siblings 2.55 (1.93–3.35) and for paternal half-siblings 1.33 (0.94–1.87).</div></div><div><h3>Conclusions</h3><div>The results showed that familial risk for LC was equal in full siblings and in maternal half-siblings; the risks for paternal half-siblings were lower and for adenocarcinoma significantly lower than those for full siblings. The results suggest that smoking is a major contributor to familial risk of LC in this setting. Smoking starts at an early age and anti-smoking campaigns should target childhood environment for prevention of smoking initiation.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108500"},"PeriodicalIF":4.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674334","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}
引用次数: 0
The diagnostic value of comprehensive next-generation sequencing for genetic mutations in suspected lung cancer cases with negative pathological cytology 在病理细胞学阴性的疑似肺癌病例中,下一代综合测序对基因突变的诊断价值。
IF 4.5 2区 医学
Lung Cancer Pub Date : 2025-03-18 DOI: 10.1016/j.lungcan.2025.108505
Yuka Goto , Satoshi Watanabe , Naohiro Yanagimura , Masashi Arita , Miyuki Sato , Koichiro Nozaki , Tomohiro Tanaka , Yu Saida , Makoto Maemondo , Kunihiko Kobayashi , Koichi Hagiwara , Toshiaki Kikuchi
{"title":"The diagnostic value of comprehensive next-generation sequencing for genetic mutations in suspected lung cancer cases with negative pathological cytology","authors":"Yuka Goto ,&nbsp;Satoshi Watanabe ,&nbsp;Naohiro Yanagimura ,&nbsp;Masashi Arita ,&nbsp;Miyuki Sato ,&nbsp;Koichiro Nozaki ,&nbsp;Tomohiro Tanaka ,&nbsp;Yu Saida ,&nbsp;Makoto Maemondo ,&nbsp;Kunihiko Kobayashi ,&nbsp;Koichi Hagiwara ,&nbsp;Toshiaki Kikuchi","doi":"10.1016/j.lungcan.2025.108505","DOIUrl":"10.1016/j.lungcan.2025.108505","url":null,"abstract":"<div><h3>Introduction</h3><div>In recent clinical practice, driver gene mutations have been tested using multiplex PCR or next-generation sequencing (NGS), which help determine treatment strategies for non-small cell lung cancer (NSCLC). We developed a new analysis system, the Mutation Investigator using Next-era Sequencer (MINtS), using NGS, which allows for the detection of gene mutations even in cytology specimens with low tumor cell content. Due to its high sensitivity, MINtS has the potential to detect gene mutations even in specimens that are pathologically negative for cancer. In the present study, we examined the utility of MINtS-based mutation detection in cytology-negative specimens.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the data of patients who were enrolled in the NEJ021A study, which was a prospective observational study investigating the performance of MINtS. Although NEJ021A was a multicenter study, we included only patients enrolled at Niigata University Medical and Dental Hospital.</div></div><div><h3>Results</h3><div>Cytology specimens from 486 patients with suspected lung cancer were analyzed using MINtS. Among the cytology-positive cases, driver gene mutations were detected in 37.3 % (93/249) of patients, whereas in cytology-negative cases, driver gene mutations were detected in 20.2 % (47/233) of patients using MINtS. Of the 47 patients whose specimens were cytology-negative and MINtS-positive, 42 were histologically or clinically diagnosed with NSCLC and received treatment.</div></div><div><h3>Conclusions</h3><div>Even in patients without a pathological diagnosis of lung cancer, MINtS can identify driver gene mutations, which can be useful for guiding subsequent treatment decisions.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108505"},"PeriodicalIF":4.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674335","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}
引用次数: 0
Exclusive radiologically determined myopenia does not equate to sarcopenia 经放射学确定的 "肌少症 "并不等于 "肌肉疏松症"。
IF 4.5 2区 医学
Lung Cancer Pub Date : 2025-03-18 DOI: 10.1016/j.lungcan.2025.108504
Erkan Topkan , Ugur Selek
{"title":"Exclusive radiologically determined myopenia does not equate to sarcopenia","authors":"Erkan Topkan ,&nbsp;Ugur Selek","doi":"10.1016/j.lungcan.2025.108504","DOIUrl":"10.1016/j.lungcan.2025.108504","url":null,"abstract":"","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108504"},"PeriodicalIF":4.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674255","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}
引用次数: 0
Feasibility and safety of perioperative entrectinib in a patient with ROS1-positive locally advanced NSCLC: A case report
IF 4.5 2区 医学
Lung Cancer Pub Date : 2025-03-18 DOI: 10.1016/j.lungcan.2025.108501
Mengying Fan , Wanpu Yan , Minglei Zhuo , Rong Yu , Liping Qi , Xin Yang , Yifan Fang , Ke-Neng Chen
{"title":"Feasibility and safety of perioperative entrectinib in a patient with ROS1-positive locally advanced NSCLC: A case report","authors":"Mengying Fan ,&nbsp;Wanpu Yan ,&nbsp;Minglei Zhuo ,&nbsp;Rong Yu ,&nbsp;Liping Qi ,&nbsp;Xin Yang ,&nbsp;Yifan Fang ,&nbsp;Ke-Neng Chen","doi":"10.1016/j.lungcan.2025.108501","DOIUrl":"10.1016/j.lungcan.2025.108501","url":null,"abstract":"<div><div>NSCLC with <em>ROS1</em> fusion mutations represents a rare mutation subtype, making it challenging to conduct randomized controlled studies. Here, we report the case of a patient with stage IIIA (cT2aN2M0) <em>ROS1</em> fusion lung adenocarcinoma who achieved downstaging and completed resection after a 3-month treatment with entrectinib, resulting in a postoperative pathological stage of ypT1cN0M0. The patient continued adjuvant entrectinib therapy and has remained recurrence-free during follow-up, with 21 months since diagnosis and 18 months since surgery.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108501"},"PeriodicalIF":4.5,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683200","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}
引用次数: 0
Efficacy of antiangiogenic therapy in patients with advanced SMARCA4-deficient thoracic tumor
IF 4.5 2区 医学
Lung Cancer Pub Date : 2025-03-16 DOI: 10.1016/j.lungcan.2025.108498
Mengting Shi , Xueyuan Chen , Ting Lin , Jinhui Xue , Yuanyuan Zhao , Zhixiong Lin
{"title":"Efficacy of antiangiogenic therapy in patients with advanced SMARCA4-deficient thoracic tumor","authors":"Mengting Shi ,&nbsp;Xueyuan Chen ,&nbsp;Ting Lin ,&nbsp;Jinhui Xue ,&nbsp;Yuanyuan Zhao ,&nbsp;Zhixiong Lin","doi":"10.1016/j.lungcan.2025.108498","DOIUrl":"10.1016/j.lungcan.2025.108498","url":null,"abstract":"<div><h3>Background</h3><div>SMARCA4 (BRG1)-deficient thoracic tumors (SDTTs) are frequently diagnosed at an advanced stage and had poor prognosis, underscoring the critical importance of seeking out novel therapeutic avenues, particularly in the realm of antiangiogenic treatment. However, the efficacy of antiangiogenic therapy in SDTT remains unknown.</div></div><div><h3>Method</h3><div>We conducted a retrospective cohort study at SYSUCC from August 1, 2018, to August 15, 2024, screening patients diagnosed with advanced SDTTs confirmed by immunohistochemistry.</div></div><div><h3>Results</h3><div>A total of 151 patients with advanced SDTTs were enrolled in the study, including 49 patients received anti-angiogenic therapy and 102 patients never. The ORR and DCR of first-line therapy with antiangiogenic therapy was 51.4 % and 86.5 %, respectively, compared to only 37.1 % and 78.7 % for those without antiangiogenic therapy. The median PFS of SDTTs treated with antiangiogenic therapy was significantly longer than those without (7.97vs.5.87 months, HR [95 %CI]: 0.612[0.380–0.984], <em>P</em> = 0.043). For patients who did not receive immune checkpoint inhibitors (ICIs), the median PFS of SDTTs treated with anti-angiogenic agent combined with chemotherapy (C + A) was longer than those treated with chemotherapy alone (C) (5.10 vs 2.57 months, HR [95 %CI]: 0.365[0.137–0.968], <em>P</em> = 0.043). For patients received chemotherapy and ICIs, the addition of anti-angiogenic agent (C + I + A) provided significantly longer PFS (11.90 vs 6.90 months, HR [95 %CI]:0.425, [0.221–0.818], <em>P</em> = 0.010). This C + I + A therapy outperforms C + A therapy, showing the longest PFS (11.90 vs 5.10 months, HR [95 %CI]:0.294[0.112–0.772], <em>P</em> = 0.013).</div></div><div><h3>Conclusion</h3><div>The administration of antiangiogenic therapy shows a promising effect in first-line therapies for advanced SDTT patients. The C + I + A combination therapy is the optimal solution among currently available treatment options.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108498"},"PeriodicalIF":4.5,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643504","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}
引用次数: 0
Clinical characteristics and management of long survivors in extensive stage small cell lung cancer
IF 4.5 2区 医学
Lung Cancer Pub Date : 2025-03-16 DOI: 10.1016/j.lungcan.2025.108499
Elisa Gobbini , Mamadou Hassimiou Diallo , David Pasquier , Sophie Schneider , Christos Chouaid , Didier Debieuvre , Xavier Quantin , Radj Gervais , Clarisse Audigier Valette , Grégoire Justeau , Magali Ravoire , Anne Madroszyk , Eric Pichon , Lionel Falchero , Yannick Simoneau , Olivier Bylicki , Anne Baranzelli , Lise Bosquet , Maurice Pérol , Nicolas Girard
{"title":"Clinical characteristics and management of long survivors in extensive stage small cell lung cancer","authors":"Elisa Gobbini ,&nbsp;Mamadou Hassimiou Diallo ,&nbsp;David Pasquier ,&nbsp;Sophie Schneider ,&nbsp;Christos Chouaid ,&nbsp;Didier Debieuvre ,&nbsp;Xavier Quantin ,&nbsp;Radj Gervais ,&nbsp;Clarisse Audigier Valette ,&nbsp;Grégoire Justeau ,&nbsp;Magali Ravoire ,&nbsp;Anne Madroszyk ,&nbsp;Eric Pichon ,&nbsp;Lionel Falchero ,&nbsp;Yannick Simoneau ,&nbsp;Olivier Bylicki ,&nbsp;Anne Baranzelli ,&nbsp;Lise Bosquet ,&nbsp;Maurice Pérol ,&nbsp;Nicolas Girard","doi":"10.1016/j.lungcan.2025.108499","DOIUrl":"10.1016/j.lungcan.2025.108499","url":null,"abstract":"<div><h3>Background</h3><div>Extensive disease small cell lung cancer (ED-SCLC) accounts for more than 70% of new diagnoses of SCLC with a 5-year survival of 12%. A limited percentage of ED-SCLC achieved a long term survival but their clinical and biological characteristics are largely unknown. Here we reported baseline clinical characteristics and treatment sequences of a large cohort of Long Survivors ED-SCLC compared to patients with poor outcomes.</div></div><div><h3>Methods</h3><div>The Epidemio-Strategy and Medical Economics (ESME) lung cancer data platform is a multicenter real-life database using a retrospective data collection process. We selected ED-SCLC patients diagnosed between 2014 and 2021. Long Survivors were defined as having an overall survival (OS) ≥ 24 months. Statistical comparisons were performed by Pearson’s Chi-square, and logistic regression.</div></div><div><h3>Results</h3><div>We identified 3150 ED-SCLC and 489 long survivors representing 13 % of the study population. mOS was 36 months (95 %CI 34 to 39) in Long Survivors and 9 months (95 %CI 8.9 to 9.4) in other patients. Compared to Short Survivors, Long Survivors were enriched in women, patients younger than 65 years-old, ECOG PS 0–1 at diagnosis less than 3 metastatic sites and never or former smokers. The C-statistic of the multiparametric model based on patient’s clinical characteristics was estimated at 0.70, with a 95 % CI (0.68, 0.73). Among those patients receiving a platinum-based chemotherapy with or without immunotherapy in first-line, a prolonged survival benefit from the chemo-immunotherapy strategy was found exclusively within the Long Survivors group even thus not statistically significant (p = 0.058).</div></div><div><h3>Conclusion</h3><div>Long Survivors represents a small proportion of ED-SCLC characterized by a less extensive disease and better general conditions at diagnosis. This group of patients is most likely to benefit from immunotherapy in first line setting. Biological characteristics of these patients should be investigated in order to inform clinical research for new therapeutic strategies.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108499"},"PeriodicalIF":4.5,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683765","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}
引用次数: 0
ALK-EML4 Fusion in Small Cell Lung Cancer: Clinical and Molecular Insights From a Rare Case
IF 4.5 2区 医学
Lung Cancer Pub Date : 2025-03-15 DOI: 10.1016/j.lungcan.2025.108497
Ghina Jaber , Chris Raffoul , Tasnim Diab , Sara Sinno , Zeina Barakat , Hazem I. Assi
{"title":"ALK-EML4 Fusion in Small Cell Lung Cancer: Clinical and Molecular Insights From a Rare Case","authors":"Ghina Jaber ,&nbsp;Chris Raffoul ,&nbsp;Tasnim Diab ,&nbsp;Sara Sinno ,&nbsp;Zeina Barakat ,&nbsp;Hazem I. Assi","doi":"10.1016/j.lungcan.2025.108497","DOIUrl":"10.1016/j.lungcan.2025.108497","url":null,"abstract":"<div><h3>Background</h3><div>Small cell lung cancer (SCLC) is a rare and aggressive malignancy with a poor prognosis and limited therapeutic options. While anaplastic lymphoma kinase (ALK) rearrangements are commonly observed in non-small cell lung cancer (NSCLC), their occurrence in SCLC is exceedingly rare. This report presents a unique case of SCLC harboring the ALK-EML4 fusion gene, identified through next-generation sequencing (NGS), contributing to a deeper understanding of potential targeted therapies for SCLC patients.</div></div><div><h3>Case Description</h3><div>A 35-year-old male with a 45-pack-year smoking history presented with hyponatremia, dyspnea, and weight loss. Imaging revealed a left hilar mass with mediastinal lymphadenopathy, and a CT-guided biopsy confirmed the diagnosis of SCLC. The patient underwent initial treatment with chemotherapy and radiation. Despite an initial positive response, disease progression occurred, leading to a change in treatment with dual immunotherapy and palliative reirradiation. Subsequent NGS testing identified an EML4-ALK fusion gene. The patient was readmitted later with worsening symptoms and new metastatic lesions. Due to disease progression, immunotherapy was discontinued, and chemotherapy with carboplatin and irinotecan, along with alectinib, was initiated. Follow-up imaging revealed a partial response in the primary tumor.</div></div><div><h3>Conclusions</h3><div>This case highlights the rare occurrence of ALK fusion in SCLC, which may offer insights into potential targeted treatments. The patient’s progression despite standard therapies suggests the need for further investigation into ALK inhibitors for SCLC patients with such mutations. Clinicians should consider NGS testing as a valuable diagnostic tool for identifying genetic alterations in SCLC, which could guide personalized treatment strategies and improve outcomes.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108497"},"PeriodicalIF":4.5,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643505","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}
引用次数: 0
Novel strategies for rare oncogenic drivers in non-small-cell lung cancer: An update from the 2024 Annual ESMO meeting.
IF 4.5 2区 医学
Lung Cancer Pub Date : 2025-03-14 DOI: 10.1016/j.lungcan.2025.108490
J W T van der Wel, A J de Langen
{"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, A J de Langen","doi":"10.1016/j.lungcan.2025.108490","DOIUrl":"https://doi.org/10.1016/j.lungcan.2025.108490","url":null,"abstract":"<p><p>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. 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. 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. 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.</p>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":" ","pages":"108490"},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","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}
引用次数: 0
Letter: Alectinib combined with cobimetinib in ALK-rearranged lung cancer: A phase IB study
IF 4.5 2区 医学
Lung Cancer Pub Date : 2025-03-14 DOI: 10.1016/j.lungcan.2025.108489
Fatima Naveed, Saad Khan, Ayesha Khan, Faraz Arshad, Rizwan Ahmad
{"title":"Letter: Alectinib combined with cobimetinib in ALK-rearranged lung cancer: A phase IB study","authors":"Fatima Naveed,&nbsp;Saad Khan,&nbsp;Ayesha Khan,&nbsp;Faraz Arshad,&nbsp;Rizwan Ahmad","doi":"10.1016/j.lungcan.2025.108489","DOIUrl":"10.1016/j.lungcan.2025.108489","url":null,"abstract":"","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108489"},"PeriodicalIF":4.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674262","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}
引用次数: 0
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