Lung Cancer最新文献

{"title":"From data to prediction: Digital chest drain insights into postoperative recovery after lung cancer surgery","authors":"Koen C.H.A. Verkoulen ,&nbsp;Iris E.W.G. Laven ,&nbsp;Jean H.T. Daemen ,&nbsp;Aimée J.P.M. Franssen ,&nbsp;Michiel H.M. Gronenschild ,&nbsp;Karel W.E. Hulsewé ,&nbsp;Yvonne L.J. Vissers ,&nbsp;Alessandro Brunelli ,&nbsp;Kostas Papagiannopoulos ,&nbsp;Erik R. de Loos","doi":"10.1016/j.lungcan.2025.108486","DOIUrl":"10.1016/j.lungcan.2025.108486","url":null,"abstract":"<div><h3>Objective</h3><div>Prolonged air leak is one of the major complications following lung cancer surgery and objectively measured digital drainage data have been investigated as predictive factors. With this scoping review, we aim to provide a comprehensive overview of risk factors, derived from digital drainage data, for predicting postoperative (drainage) course after pulmonary resection in patients with lung cancer.</div></div><div><h3>Methods</h3><div>MEDLINE and EMBASE were systematically searched for studies that investigated digital drainage data after lung cancer surgery. Systematic reviews, editorials, commentaries, and reports in languages other than English were excluded. Data on general study information, characteristics of the procedures, digital drainage parameters, and clinical postoperative outcomes were extracted.</div></div><div><h3>Results</h3><div>Twenty-three studies were included, comprising 3,649 patients. Four different digital drainage systems were used. Maximum air flow exceeding 100–200 ml/min (5 studies), variable air leak patterns (3 studies), and less negative intrapleural/differential pressure (7 studies) were associated with prolonged air leak. A mean air flow of &lt;50 ml/min was associated with spontaneous air leak resolution (1 study). However, chest tube management was heterogeneous, with different suction levels and chest tube removal criteria being applied.</div></div><div><h3>Conclusions</h3><div>Mean and maximum air flow, air leak patterns, and intrapleural/differential pressure derived from digital drainage data can be considered as possible predictors for postoperative prolonged air leak after lung cancer surgery. However, definitive evidence on the use of these predictive factors in a future risk prediction model could not be provided, due to a lack of homogeneity in the chest tube strategies used in the reviewed studies.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108486"},"PeriodicalIF":4.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644047","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":"National clinical practice patterns of uniportal video-assisted thoracoscopic anatomical lung resections: nationwide population-based data from a clinical audit registry","authors":"Iris E.W.G. Laven ,&nbsp;Aimée J.P.M. Franssen ,&nbsp;Michiel H.M. Gronenschild ,&nbsp;David J. Heineman ,&nbsp;Wilhelmina H. Schreurs ,&nbsp;Karel W.E. Hulsewé ,&nbsp;Yvonne L.J. Vissers ,&nbsp;Diego Gonzalez-Rivas ,&nbsp;Erik R. de Loos","doi":"10.1016/j.lungcan.2025.108481","DOIUrl":"10.1016/j.lungcan.2025.108481","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Uniportal video-assisted thoracoscopic surgery (VATS) is an accepted surgical technique for lung cancer surgery worldwide. However, data on national patterns of uniportal VATS lung cancer resections are lacking. This study assessed the implementation and clinical practice of uniportal VATS in the Netherlands compared to other surgical approaches.</div></div><div><h3>Methods</h3><div>Data on anatomical lung resections performed for suspected lung cancer from January 2017 to December 2021 were collected from the Dutch Lung Cancer Audit for Surgery registry. Eligible procedures included those performed by uniportal VATS, multiportal VATS, robotic-assisted thoracoscopic surgery, or open surgery, excluding discontinued procedures or those performed in hospital registration years less than 20 resections.</div></div><div><h3>Results</h3><div>The use of uniportal VATS increased from 13 % in 2017 to 21 % in 2021, with the number of hospitals using this technique rising from 30 % to 41 %, reaching a plateau in the last two years. In 2021, 429 resections using uniportal VATS were performed, demonstrating a superior median hospitalization of 4 days and a non-inferior complication rate of 27 % compared to other minimally invasive approaches.</div></div><div><h3>Conclusions</h3><div>Uniportal VATS in the Netherlands reached a plateau in 2020 and 2021. This technique is particularly performed for the removal of early-stage tumors and has similar surgical outcomes as the other thoracoscopic approaches.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108481"},"PeriodicalIF":4.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611748","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":"Identifying and exploring patient engagement interventions for people diagnosed with lung cancer: A rapid systematic review","authors":"S. Cooke ,&nbsp;D. Nelson ,&nbsp;A. Arslan Argin ,&nbsp;D. Laparidou ,&nbsp;R. Young ,&nbsp;J. Waller ,&nbsp;R. Kane ,&nbsp;D. McInnerney ,&nbsp;S.L. Quaife ,&nbsp;M.D. Peake ,&nbsp;L. Mitchinson","doi":"10.1016/j.lungcan.2025.108484","DOIUrl":"10.1016/j.lungcan.2025.108484","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify and synthesise evidence describing patient engagement interventions that have been used to support people diagnosed with lung cancer.</div></div><div><h3>Methods</h3><div>A rapid systematic review was conducted following guidance from the Cochrane Rapid Reviews Methods group and reported using the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) checklist. Keyword searches were performed in MEDLINE and supplemented by Google Scholar searches. Searches were restricted to peer-reviewed articles conducted in high-income countries and published in English. Data was extracted using the Template for Intervention Description and Replication (TIDieR) checklist, tabulated, and narratively synthesised. Data extraction and quality assessment were conducted by two independent reviewers.</div></div><div><h3>Results</h3><div>Thirty-four studies were included in the final analysis. Studies show a positive impact of interventions across a range of engagement outcomes including patient and caregiver knowledge, patient activation, and decision making. Interventions were also shown to reduce healthcare use, reduce symptom severity, and improve psychosocial outcomes. Barriers to implementing interventions included: the timing/delivery of interventions, poor digital literacy, system and technical barriers, and poor uptake and adherence by advanced patients. Factors supporting intervention implementation included: participatory research/co-production approaches, providing training and support for those delivering interventions, involving caregivers, and employing broad recruitment strategies. The overall risk of bias for studies ranged from moderate to high.</div></div><div><h3>Conclusion</h3><div>The identified interventions demonstrate significant potential for enhancing patient engagement and improving outcomes for lung cancer patients. Findings from this review will support the design and implementation of future interventions to help people with cancer engage with healthcare.</div><div><strong>Review registration:</strong> The protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42024521052) on 06/03/24.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108484"},"PeriodicalIF":4.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628818","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":"Establishing survival benchmarks in the era of peri-operative immunotherapy","authors":"Filippo Tommaso Gallina ,&nbsp;Daniele Marinelli ,&nbsp;Brendon Stiles ,&nbsp;Isabelle Opitz ,&nbsp;Jonathan Spicer","doi":"10.1016/j.lungcan.2025.108491","DOIUrl":"10.1016/j.lungcan.2025.108491","url":null,"abstract":"","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108491"},"PeriodicalIF":4.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600517","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":"Sex disparities in advanced non-small cell lung cancer survival: A Danish nationwide study","authors":"Matilde Grupe Frost ,&nbsp;Kristoffer Jarlov Jensen ,&nbsp;Espen Jimenez-Solem ,&nbsp;Camilla Qvortrup ,&nbsp;Jon Alexander Lykkegaard Andersen ,&nbsp;Tonny Studsgaard Petersen","doi":"10.1016/j.lungcan.2025.108485","DOIUrl":"10.1016/j.lungcan.2025.108485","url":null,"abstract":"<div><h3>Background</h3><div>Historically, cancers often exhibit sexual dimorphism. However, following the introduction of immune checkpoint inhibitors and targeted therapies into routine clinical practice, the association of sex on patient and tumour characteristics, as well as survival remains largely unexplored in advanced NSCLC.</div></div><div><h3>Patients and methods</h3><div>In this observational study, we identified adults diagnosed with advanced NSCLC from January 1, 2017, to December 31, 2023, using Danish nationwide health registries and clinical databases. We compared females to males across demographic, social, socioeconomic, patient and tumour characteristics (including PDL-1 expression and driver mutations), treatments, and overall survival (OS) from diagnosis and initiation of the first line of treatment (LOT1). Cox proportional hazards regression was employed, adjusting for key covariates in the overall cohort and stratified by stage, histological subtype, PD-L1 expression level, and treatment type. Propensity score matching was conducted as a sensitivity analysis.</div></div><div><h3>Results</h3><div>Among 14,635 included individuals, males comprised 50 % (n = 7,322). Patient and tumour characteristics differed between sexes. The crude and adjusted female-to-male mortality hazard ratio (HR) was 0·82 (95 % confidence interval [CI]: 0·79–0·85) and 0·84 (0·81–0·88) from diagnosis and 0·80 (0·76–0·84) and 0·80 (0·75–0·84) from initiation of LOT1. Median OS for females and males was 8·8 months (95 % CI 8·4–9·2) and 7·0 months (6·7–7·3) from diagnosis and 14·1 months (13·5–15·1) and 10·9 months (10·3–11·5) from initiation of LOT1. Stratified analyses revealed that across all strata, females consistently demonstrated either favourable or comparable outcomes compared to males.</div></div><div><h3>Conclusions</h3><div>This study increases our understanding of sex-based disparities in advanced NSCLC. Adjusted analyses addressing previously suggested explanations for sex disparities in survival still demonstrated a longer survival for females, indicating yet-unidentified sex differences with potential clinical implications. Our results underscore the critical role of acknowledging sex as a key variable in oncology trials, research, and clinical practice.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108485"},"PeriodicalIF":4.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578177","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":"Immunotherapy in advanced non-small cell lung cancer: What to do for the ‘Invisible’ patients after IPSOS trial results?","authors":"Cesare Gridelli ,&nbsp;Ilaria Attili ,&nbsp;Chiara Bennati ,&nbsp;Paolo Bironzo ,&nbsp;Emilio Bria ,&nbsp;Diego L. Cortinovis ,&nbsp;Hector Soto Parra ,&nbsp;Filippo de Marinis","doi":"10.1016/j.lungcan.2025.108482","DOIUrl":"10.1016/j.lungcan.2025.108482","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitors (ICIs) are currently included in the standard of care of the first-line treatment of advanced/metastatic non-small cell lung cancer (NSCLC). However, a relevant group of clinically unfit patients, including poor Performance Status, Elderly, and those with relevant comorbidities, are not represented in most pivotal clinical trials.</div></div><div><h3>Methods</h3><div>An expert panel meeting commentary was virtually held to point out the key issues in treating such ‘invisible’ patients and to review the available evidence.</div></div><div><h3>Results</h3><div>Overall, clinically unfit patients represent up to 50% of patients with diagnosis of advanced/metastatic NSCLC. Few dedicated studies with immunotherapy were conducted in this population. Among them, the IPSOS trial finally answers the issue of first line immunotherapy in platinum-unfit patients with advanced NSCLC, demonstrating atezolizumab improved OS and good tolerability compared to monochemotherapy.</div></div><div><h3>Conclusions</h3><div>Atezolizumab monotherapy can be considered a valid first-line treatment in patients with advanced NSCLC who are unfit to receive platinum-based chemotherapy, including elderly, those with poor PS and/or comorbidities.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108482"},"PeriodicalIF":4.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611746","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":"Evaluation of teleguided high-intensity exercise rehabilitation at home before lung-cancer surgery (PREPACHIR Study)","authors":"Florent Vinas ,&nbsp;Hélène Goussault ,&nbsp;Laurent Boyer ,&nbsp;Gaëlle Rousseau Bussac ,&nbsp;Laurence Jabot ,&nbsp;Quentin Gibiot ,&nbsp;Valentine Bonnefoy ,&nbsp;Marc Antoine Brochard ,&nbsp;Seydou Goro ,&nbsp;Camille Jung ,&nbsp;Isabelle Monnet ,&nbsp;Christos Chouaïd ,&nbsp;Bernard Maitre ,&nbsp;Jean-Bernard Auliac","doi":"10.1016/j.lungcan.2025.108480","DOIUrl":"10.1016/j.lungcan.2025.108480","url":null,"abstract":"<div><h3>Introduction</h3><div>Preoperative rehabilitation lowers the surgical morbidity–mortality risk of patients with non-small cell lung cancer (NSCLC). This study evaluated the feasibility of a preoperative-rehabilitation program consisting of high-intensity exercises, at home, teleguided by physical trained sports coach.</div></div><div><h3>Methods</h3><div>This monocenter study included patients diagnosed with resectable NSCLC, scheduled segmentectomy or lobectomy, and FEV1 &lt; 80 % and/or DLCO &lt; 80 %. The main exclusion criteria were neoadjuvant chemotherapy, contraindication for high-intensity physical activity, poor understanding of connected-watch use, without a smartphone and cognitive or psychiatric disorder(s).The program combines 1-hour daily high-intensity training at home, teleguided, associated with non-supervised activity advice, with tracing via an internet-connected watch. T. Program-efficacy evaluation was based on the number of patients completing the entire program, mean increase of the maximum oxygen uptake (VO₂ max) and postoperative complications assessed with the Clavien–Dindo classification.</div></div><div><h3>Results</h3><div>Among the 76 patients eligible for surgery during the inclusion period, 29 (38 %) satisfied inclusion criteria and 24 (83 %) accomplished at least 7 days of training for a mean ± standard deviation of 17.8 ± 9 sessions; 44 % also executed non-scheduled supplementary sessions; 96 % used the internet-connected watch. VO₂ max increased significantly from 19.3 ± 3.1 to 20.4 ± 3.5 ml/kg/min (p = 0.04). Postoperatively, 9/25 (36 %) experienced a grade 1–3 adverse event, without grade 4/5.</div></div><div><h3>Conclusion</h3><div>Preoperative rehabilitation with teleguided, high-intensity exercises at home is feasible and significantly increased VO₂ max. Prospective, randomized studies are needed to evaluate the benefit compared to current care practices.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108480"},"PeriodicalIF":4.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578179","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 of EGFR tyrosine kinase inhibitors in patients with non–small cell lung cancer with EGFR exon 19 insertions: clinical-genomic, preclinical analysis through LC-SCRUM-Asia (multi-institutional genomic screening registry)","authors":"Yuji Uehara ,&nbsp;Hiroki Izumi ,&nbsp;Ikei S. Kobayashi ,&nbsp;Shingo Matsumoto ,&nbsp;Yukio Hosomi ,&nbsp;Takae Okuno ,&nbsp;Jun Sugisaka ,&nbsp;Naoto Takase ,&nbsp;Kageaki Taima ,&nbsp;Shinichi Sasaki ,&nbsp;Shuhei Teranishi ,&nbsp;Shingo Miyamoto ,&nbsp;Masahide Mori ,&nbsp;Chiho Nakashima ,&nbsp;Shuichi Asano ,&nbsp;Hajime Oi ,&nbsp;Tetsuya Sakai ,&nbsp;Yuji Shibata ,&nbsp;Hibiki Udagawa ,&nbsp;Eri Sugiyama ,&nbsp;Koichi Goto","doi":"10.1016/j.lungcan.2025.108479","DOIUrl":"10.1016/j.lungcan.2025.108479","url":null,"abstract":"<div><h3>Background</h3><div><em>EGFR</em> exon 19 insertions (<em>EGFR</em>ex19ins) are rare <em>EGFR</em> mutations. Their clinical-genomic characteristics and outcomes with EGFR-tyrosine kinase inhibitors (TKIs) remain uncertain.</div></div><div><h3>Methods</h3><div>We evaluated the clinical-genomic characteristics and outcomes of EGFR-TKIs for <em>EGFR</em>ex19ins in the multi-institutional prospective lung cancer genomic screening project (LC-SCRUM-Asia). We also studied preclinical Ba/F3 models expressing <em>EGFR</em>-K745_E746insIPVAIK (Ba/F3-IPVAIK) to investigate their sensitivity to 1st-, 2nd-, 3rd-generation, and <em>EGFR</em> exon 20 insertion-active TKIs.</div></div><div><h3>Results</h3><div>In LC-SCRUM-Asia, 16,204 NSCLC patients were enrolled from March 2015 to December 2023. <em>EGFR</em>ex19ins were detected in 13 samples (0.1 % of NSCLC). The median age was 72 years (range, 38–80); most patients were female (77 %), had adenocarcinoma (92 %), and were never-smokers (62 %). Twelve patients (93 %) had <em>EGFR</em>-K745_E746insIPVAIK, while one (7 %) had <em>EGFR</em>-K745_E746insVPVAIK. The most frequent co-mutation was <em>TP53</em> (62 %); no patients had other driver alterations. Six patients (46 %) tested positive for <em>EGFR</em> exon 19 deletions with PCR-based Cobas EGFR test, likely due to cross-reactivity arising from sequence homology. Twelve patients received EGFR-TKIs; five (42 %) experienced partial response. In the preclinical study, Ba/F3-IPVAIK showed the highest sensitivity to 2nd-generation EGFR-TKIs compared to other EGFR-TKIs. Structural studies supported these consistent results. When broken down by EGFR-TKI generations, response rates for 1st-, 2nd-, and 3rd-generation TKIs were 50 % (1/2), 80 % (4/5), and 0 % (0/5), respectively. The median PFS for 1st-, 2nd-, and 3rd-generation TKIs were 8.7 (95 % CI, 7.4–NR), 14.7 (95 % CI, 8.0–NR), and 4.4 (95 % CI, 3.4–NR) months, respectively.</div></div><div><h3>Conclusion</h3><div>Our preclinical, structural, and clinical findings indicate 2nd-generation EGFR-TKIs are more effective for <em>EGFR</em>ex19ins compared to other TKIs.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108479"},"PeriodicalIF":4.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619674","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":"Advantages of a larger working channel diameter of ultrathin bronchoscope in cone-beam computed tomography-guided transbronchial biopsy for diagnosing peripheral lung lesions","authors":"Naoya Kawakita ,&nbsp;Emi Takehara ,&nbsp;Taihei Takeuchi ,&nbsp;Keisuke Fujimoto ,&nbsp;Shinichi Sakamoto ,&nbsp;Hiroyuki Sumitomo ,&nbsp;Naoki Miyamoto ,&nbsp;Atsushi Morishita ,&nbsp;Hiroaki Toba ,&nbsp;Hiromitsu Takizawa","doi":"10.1016/j.lungcan.2025.108483","DOIUrl":"10.1016/j.lungcan.2025.108483","url":null,"abstract":"<div><h3>Background and objective</h3><div>Cone-beam computed tomography (CBCT)-guided transbronchial biopsy (TBB) using an ultrathin bronchoscope (UTB) under virtual bronchoscopic navigation (VBN) is a useful method for diagnosing peripheral pulmonary lesions. A 1.2 mm working channel UTB (SC-UTB) and a 1.7 mm working channel UTB (LC-UTB) are available, with the latter allowing radial endobronchial ultrasound (R-EBUS). The aim of this study was to compare the diagnostic yield of CBCT-guided TBB under VBN using SC-UTB and LC-UTB with R-EBUS.</div></div><div><h3>Methods</h3><div>Patients with peripheral pulmonary lesions of ≤ 30 mm were included. Lesions with unidentifiable bronchi on CT scans were excluded. The UTB and biopsy forceps were advanced to the target bronchus under VBN and 2D-fluoroscopy. For cases using SC-UTB, CBCT was performed with forceps inserted. In cases using LC-UTB, CBCT was performed with forceps inserted after inserting the R-EBUS probe. The outcomes were compared between the two groups.</div></div><div><h3>Results</h3><div>SC-UTB was used in 89 patients, and LC-UTB with R-EBUS in 68 patients. The diagnostic yield was 64.0 % and 79.4 % in cases using SC-UTB and LC-UTB with R-EBUS, respectively, showing a significantly higher diagnostic yield with the latter (p = 0.036). Additionally, the proportion of type 1 images on the primary CBCT (forceps tip within the lesion) significantly increased (31.5 % vs. 50.0 %; p = 0.019), and the proportion of re-navigation after the primary CBCT decreased (47.5 % vs. 20.6 %; p = 0.001) in the LC-UTB with R-EBUS group.</div></div><div><h3>Conclusion</h3><div>In CBCT-guided TBB using UTB for peripheral pulmonary lesions, LC-UTB with R-EBUS demonstrated a higher diagnostic yield compared to SC-UTB.</div><div><strong>Conference presentation:</strong> none.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108483"},"PeriodicalIF":4.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578176","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":"Use of immune checkpoint inhibitors in patients with lung cancer and multiple sclerosis","authors":"Belén Iglesias Martinez ,&nbsp;Amelia Insa ,&nbsp;Guillermo Cervera Ygual ,&nbsp;Francisco Gascón ,&nbsp;Jose Andrés Domínguez Moran ,&nbsp;Paloma Martín-Martorell","doi":"10.1016/j.lungcan.2025.108464","DOIUrl":"10.1016/j.lungcan.2025.108464","url":null,"abstract":"<div><div>Non-small cell lung cancer (NSCLC) constitutes 80–85% of lung cancer cases and is a leading cause of cancer-related mortality. Most patients are diagnosed at metastatic stages, where curative treatment is rarely an option and the primary goal is to prolong survival while maintaining quality of life. Since NSCLC is often diagnosed in elderly individuals, comorbidities must also be considered in the treatment planning.</div><div>Immune evasion is a central hallmark of cancer. By interactions between immune checkpoint molecules, such as programmed death 1 (PD-1) and its ligand PD-L1, as well as cytotoxic T-lymphocyte antigen 4 (CTLA-4), tumors downregulate immune responses, promoting self-tolerance and evading detection. Immune checkpoint inhibitors (ICIs) enhance the autoimmune function against cancer cells by blocking these targets and have wide evidence of efficacy in NSCLC. Currently, ICIs combined with chemotherapy are the standard of care for metastatic NSCLC without actionable mutations. In tumors with high PD-L1 expression, ICI monotherapy is also an effective option.</div><div>In some cases, treatment associated toxicities and co-existing morbidities remain a challenge. In the case of patients with autoimmune disorders, they may experience exacerbation of the underlying autoimmune disease following ICI initiation and also an increased risk of immune-related adverse effects (irAE). People with underlying multiple sclerosis (MS) have mostly been excluded from clinical trials of ICIs, so data on their safety in the setting of MS is limited.</div><div>This report presents three clinical cases from our institution involving patients with NSCLC and pre-existing MS who were treated with ICIs.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"202 ","pages":"Article 108464"},"PeriodicalIF":4.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143578180","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}