Translational lung cancer research最新文献

{"title":"Integrated management of immunotherapy and radiotherapy for patients with metastatic non-small cell lung cancer: a narrative review of current landscape and future directions.","authors":"Xinquan Liang, Fengxue Li, Yingying Zhang, Pingping Hu, Tiantian Tian, Yan Zhang, Ning Liang, Guodong Deng, Fangjie Ding, Xin Liu, Lili Qiao, Jiandong Zhang","doi":"10.21037/tlcr-2026-1-0018","DOIUrl":"https://doi.org/10.21037/tlcr-2026-1-0018","url":null,"abstract":"<p><strong>Background and objective: </strong>Despite advancements in systemic therapy, metastatic non-small cell lung cancer (NSCLC) remains largely incurable. Immunotherapy, primarily immune checkpoint inhibitors (ICIs), has improved outcomes, but durable responses are confined to a subset of patients. Emerging preclinical and clinical evidence suggests that radiotherapy (RT) can potentiate antitumor immunity, transforming localized treatment into a systemic effect. This narrative review aims to synthesize current knowledge on the mechanisms and clinical applications of combining RT with immunotherapy for metastatic NSCLC, assessing its potential to improve survival.</p><p><strong>Methods: </strong>A systematic search of PubMed was conducted to identify English-language articles published between January 2010 and December 2025 on immunotherapy combined with RT for metastatic NSCLC.</p><p><strong>Key content and findings: </strong>This article comprehensively analyzes the synergistic mechanisms between RT and immunotherapy, including immunogenic cell death (ICD), enhanced antigen presentation, and modulation of the tumor microenvironment (TME). We critically review the clinical evidence for this combination across various disease settings: definitive treatment of the primary tumor, management of brain and adrenal metastases, and the novel strategy of multisite RT. Key considerations such as the optimal sequencing of therapies and the influence of RT dose/fractionation on efficacy and abscopal effects are discussed.</p><p><strong>Conclusions: </strong>The integration of RT with immunotherapy represents a promising therapeutic paradigm for metastatic NSCLC, demonstrating encouraging efficacy, particularly in managing thoracic disease and brain metastases. Preliminary data on targeting multiple metastatic sites are also compelling. However, critical questions regarding optimal patient selection, treatment sequencing, and ideal RT protocols remain areas of active investigation, necessitating further validation in randomized controlled trials.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 3","pages":"65"},"PeriodicalIF":3.5,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692229","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":"A novel maximum wall thickness (Tmax) category for cystic lung adenocarcinomas: a retrospective study focusing on pathological invasiveness and prognosis.","authors":"Beinuo Wang, Jin Pu, Jian Zhou, Zhenghao Dong, Xiang Lin, Yu Tong, Chunchao Xia, Hu Liao","doi":"10.21037/tlcr-2025-aw-1186","DOIUrl":"https://doi.org/10.21037/tlcr-2025-aw-1186","url":null,"abstract":"<p><strong>Background: </strong>Cystic lung adenocarcinoma (CLA) is a major subtype of cystic lung cancer (CLC). Clinical T staging for CLA is ambiguous due to cystic components. This issue impedes precise assessment. Previous research has confirmed the significant predictive value of cystic morphology. This study explores a new category for better CLA prognostic stratification, aiding precision treatment.</p><p><strong>Methods: </strong>Diagnosed CLAs were classified into preinvasive (adenocarcinoma in situ, or minimally invasive adenocarcinoma) and invasive adenocarcinomas. Radiologic analysis focused on cystic-airspace features. Logistic and Cox regression were used to identify independent risk factors for pathological invasiveness and prognosis. A novel category incorporating maximum wall thickness (Tmax) was proposed, and Kaplan-Meier survival analysis validated this approach.</p><p><strong>Results: </strong>A total of 219 patients were included in the study. Pleural traction [odds ratio (OR) =4.76] and Tmax (OR =62.03) were independent risk factors for pathological invasiveness of CLAs. Irregular cystic morphology [hazard ratio (HR) =3.77] and Tmax (HR =7.39) were independent prognostic factors for CLAs. Multiloculation (HR =0.38) was associated with a potential protective effect. A novel Tmax category was first proposed: Tmax① ≤0.5 cm; 0.5 cm < Tmax② ≤1.0 cm; 1.0 cm < Tmax③ ≤1.3 cm; Tmax④ >1.3 cm. Kaplan-Meier survival analysis demonstrated highly significant prognostic stratification in 5-year disease-free survival (DFS) and overall survival (OS) across Tmax subgroups.</p><p><strong>Conclusions: </strong>The Tmax variable will serve as the most critical indicator for evaluating the invasiveness and prognosis of CLAs. A novel Tmax category has been established. Its predictive model effectively reflects pathological invasiveness and prognostic outcomes in patients. This Tmax category is proven beneficial for clinical surgeons in conducting staged diagnoses and other applications.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 3","pages":"53"},"PeriodicalIF":3.5,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691453","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":"Effectiveness and safety of combination immunotherapy with or without ipilimumab according to PD-L1 expression in patients with non-small cell lung cancer: a multi-center retrospective cohort study.","authors":"Akio Nomura, Takeshi Masuda, Kiyofumi Shimoji, Shun Takao, Yusuke Izumi, Yusuke Araki, Yusuke Takayama, Ken Masuda, Kakuhiro Yamaguchi, Shinjiro Sakamoto, Yasushi Horimasu, Taku Nakashima, Hiroshi Iwamoto, Tadashi Senoo, Hiroyasu Shoda, Nobuhisa Ishikawa, Masahiro Yamasaki, Hironobu Hamada, Morihito Okada, Noboru Hattori","doi":"10.21037/tlcr-2025-aw-1281","DOIUrl":"https://doi.org/10.21037/tlcr-2025-aw-1281","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The standard first-line treatment for patients with driver mutation-negative non-small cell lung cancer (NSCLC) is chemotherapy and immunotherapy, including chemotherapy plus anti-programmed death-1 (PD-1)/programmed cell death ligand 1 (PD-L1) antibody (C + PD-1/PD-L1) or anti-PD-1 antibody (nivolumab) and anti-cytotoxic T-lymphocyte antigen-4 antibody (ipilimumab) (C + NI). Subgroup analyses of phase III trials and network meta-analyses suggest that treatment effectiveness varies according to the PD-L1 tumor proportion score (TPS), with the potential benefit of ipilimumab-containing regimens in PD-L1-negative patients. However, real-world evidence across PD-L1 subgroups, particularly in patients with PD-L1 TPS between 1-24%, remains limited. The aim of this study was to compare the real-world effectiveness of C + PD-1/PD-L1 and C + NI across PD-L1 TPS subgroups and evaluated their safety in the overall population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Consecutive patients with advanced or metastatic NSCLC who received C + PD-1/PD-L1 or C + NI from March 2019 to April 2022 at five institutions were included retrospectively. Patients with driver mutations or those who received second-line or later treatments were excluded. In the C + PD-1/PD-L1 group, platinum doublets were administered for up to four cycles, with pemetrexed maintenance permitted when the initial regimen included pemetrexed, whereas in the C + NI group, platinum doublets were limited to a maximum of two cycles with no maintenance chemotherapy. All chemotherapeutic agents were administered at standard doses according to the approved prescription information. Medical records were reviewed for baseline characteristics, treatment exposure, PD-L1 TPS, and grade ≥3 immune-related adverse events. Patients were routinely followed-up according to institutional practice, and survival outcomes were assessed through regular outpatient visits and medical record reviews.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 212 patients received C + PD-1/PD-L1 and 55 patients received C + NI. The proportion of patients with a low PD-L1 TPS was significantly higher in the C + NI group than in the C + PD-1/PD-L1 cohort. Overall survival (OS) in the overall population was not significantly different [median OS: 21.1 months &lt;i&gt;vs.&lt;/i&gt; not reached, HR: 1.06; 95% confidence interval (CI): 0.68-1.67, P=0.79], and OS in the PD-L1 TPS &lt;1% or 1-24% group did not significantly differ between the two groups (PD-L1 TPS: &lt;1%: median OS: 21.5 months &lt;i&gt;vs.&lt;/i&gt; not reached, HR: 1.14; 95% CI: 0.56-2.30, P=0.72, PD-L1 TPS: 1-24%: median OS: 22.4 &lt;i&gt;vs.&lt;/i&gt; 17.8 months, HR: 0.76; 95% CI: 0.34-1.70, P=0.50). Multivariate Cox regression analysis showed that poor performance status was an independent prognostic factor for the overall population. In the subgroups with PD-L1 TPS &lt;1% or 1-24%, no variables were identified as independent prognostic factors. The incidence of grade ≥3 immune-related advers","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 3","pages":"59"},"PeriodicalIF":3.5,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692258","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":"Development of a deep learning model based on computed tomography automatic segmentation to assist in selecting optimal time-to-surgery and dissected lymph node count for non-small cell lung cancer patients undergoing neoadjuvant immunotherapy and chemotherapy: a multicenter study.","authors":"Junfeng Zhao, Ying Li, Jiaxuan Chen, Chuankun Han, Yifei Yan, Chen Zhou, Yingrui Bai, Yali Xu, Yintao Li","doi":"10.21037/tlcr-2025-1-1495","DOIUrl":"https://doi.org/10.21037/tlcr-2025-1-1495","url":null,"abstract":"<p><strong>Background: </strong>Many studies have confirmed the efficacy of neoadjuvant immunotherapy combined with chemotherapy (NICT) in treating patients with non-small cell lung cancer (NSCLC). However, the optimal time-to-surgery (TTS) and the appropriate dissected lymph node (DLN) count remain unclear. Therefore, this study aims to determine the optimal TTS and DLN count for NSCLC following NICT by establishing a deep learning model based on computed tomography (CT) automatic segmentation to predict the efficacy of neoadjuvant therapy.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with NSCLC who underwent NICT and surgical treatment at two centers between January 2019 and June 2024. A proven high-precision and strong generalization three-dimensional (3D) segmentation architecture with a flexible interaction mode (VISTA3D) is applied in this study for CT images to achieve automatic tumor identification in NSCLC patients via automated segmentation combined with segmentation point prompts. This study employed ResNet18 (an 18-layer residual network pre-trained on ImageNet) as the feature extraction backbone. In the final configuration, the shallow stagelayers of the model were frozen, with only the two deeper stagelayers unfrozen to participate in gradient updates. This study employed BCEWithLogitsLoss to accommodate the classification requirements of the task. The primary evaluation metric in this study was the receiver operating characteristic curve. Based on the model, patients were divided into two groups: responders and non-responders. Optimal TTS and DLN counts were determined for each group.</p><p><strong>Results: </strong>A total of 330 patients were included, with 270 patients in the training set and 60 patients in the external test set. The area under the curve of the deep learning model was 0.854 (95% confidence interval: 0.745-0.976). We assigned patients to responders and non-responders groups based on the deep learning model score. In the responder group, prolonged TTS was associated with better prognosis, with no significant difference in postoperative complications. In the non-responder group, earlier surgery was associated with better prognosis, with no significant difference in postoperative complications. In the responder group, a DLN count of ≤21 was associated with better prognosis.</p><p><strong>Conclusions: </strong>In patients undergoing NICT, our model-based stratification suggests that for predicted responders, appropriately delaying surgery may be associated with better outcomes, whereas for predicted non-responders, earlier surgery is associated with better outcomes. Furthermore, among predicted responders, an observed DLN count of ≤21 was associated with improved survival, highlighting the potential importance of balancing oncologic resection with immune preservation. These findings require prospective validation.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 3","pages":"58"},"PeriodicalIF":3.5,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692273","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":"Mediastinal staging and restaging techniques in locally advanced non-small cell lung cancer in the era of neoadjuvant and perioperative chemoimmunotherapy-a narrative review.","authors":"María Izquierdo-Chamarro, Aylen Vanessa Ospina-Serrano, Mariano Provencio-Pulla","doi":"10.21037/tlcr-2025-1-1352","DOIUrl":"https://doi.org/10.21037/tlcr-2025-1-1352","url":null,"abstract":"<p><strong>Background and objective: </strong>Lung cancer (LC) is the leading cause of cancer-related death in worldwide. Approximately 70% of patients have advanced or locally advanced non-small cell lung cancer (LA-NSCLC) at diagnosis, which confers an unfavorable prognosis. Recently, neoadjuvant and perioperative chemoimmunotherapy has demonstrated survival benefit, becoming the new standard treatment. The most significant prognostic factor in LA-NSCLC is N2 mediastinal nodal involvement. In this scenario, mediastinal staging and restaging techniques play a key role by enabling lymph node evaluation and assessment of response to treatment. Nevertheless, despite current mediastinal staging methods, unsuspected pN2 disease is detected in 25% of patients. Furthermore, evidence regarding mediastinal staging and restaging techniques in the setting of neoadjuvant and/or perioperative chemoimmunotherapy remains limited, highlighting the need to clarify their utility in the era of neoadjuvant and perioperative chemoimmunotherapy. The purpose of this review is to identify the scientific evidence regarding mediastinal staging and restaging techniques in patients with LA NSCLC undergoing neoadjuvant and perioperative chemoimmunotherapy.</p><p><strong>Methods: </strong>We searched PubMed/MEDLINE, and Google Scholar for articles published since 1987. Search terms included \"NSCLC\", \"stage III\", \"neoadjuvant\", \"mediastinal lymph node\", \"staging\", \"restaging\". The selection focused on English-language research and reviews addressing LA-NSCLC mediastinal staging and restaging techniques.</p><p><strong>Key content and findings: </strong>The article reviews the role of mediastinal staging and restaging techniques in the neoadjuvant and/or perioperative treatment of LA-NSCLC. The limited accuracy of non-invasive methods supports the use of minimally invasive techniques for mediastinal staging and restaging. Conversely, the potential risks of invasive procedures restrict their use to selected situations. It should be noted that evidence for these techniques in the era of chemoimmunotherapy remains scarce, for mediastinal staging data are mainly derived from the chemotherapy treatment setting, whereas for mediastinal restaging the available evidence comes exclusively from positron emission tomography-computed tomography (PET-CT).</p><p><strong>Conclusions: </strong>N2 mediastinal nodal involvement is the most relevant prognostic factor in LA-NSCLC. Regardless of the available mediastinal staging and restaging techniques, unforeseen pN2 disease is detected in a substantial proportion of cases. There is a lack of utility data on these methods in the chemoimmunotherapy setting. Further research is needed to determine their role in current therapeutic approaches.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 3","pages":"63"},"PeriodicalIF":3.5,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692325","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":"Effect of cold ischemia time and storage temperature on anaplastic lymphoma kinase (ALK) expression in surgically resected lung cancer specimens.","authors":"Ryuichi Yoshimura, Naoki Yanagawa, Noriyuki Yamada, Makoto Tomoyasu, Wataru Shigeeda, Yuka Kaneko, Ryotaro Endo, Hironaga Kanno, Hiroyuki Deguchi, Hajime Saito","doi":"10.21037/tlcr-2025-1-1338","DOIUrl":"https://doi.org/10.21037/tlcr-2025-1-1338","url":null,"abstract":"<p><strong>Background: </strong>Driver gene mutations in lung cancer serve as essential targets for personalized therapy. Ensuring the quality of resected specimens is crucial for accurate diagnosis. This study aimed to evaluate the correlation between cold ischemia time and anaplastic lymphoma kinase (ALK) expression in non-small cell lung cancer (NSCLC) specimens.</p><p><strong>Methods: </strong>ALK-positive lung cancers resected from a 47-year-old woman and a 69-year-old woman were analyzed. The resected tumor was divided into nine sections and fixed after different cold ischemia times (0-24 h). One specimen was stored at room temperature and the other under refrigerated conditions prior to fixation. ALK expression was assessed using an ALK immunohistochemical assay and quantified with bioimage analysis software by averaging the percentage of ALK-positive cells in ten randomly selected microscopic fields. To validate the effect of storage temperature in clinical practice, specimens from 642 patients who underwent radical pulmonary resection for lung adenocarcinoma between 2021 and 2025 were retrospectively analyzed. Cases stored at room temperature until fixation (n=458) were compared with those stored under refrigeration below 4 ℃ (n=184).</p><p><strong>Results: </strong>Pathological evaluation showed ALK positivity up to 3 h after resection but negativity after 4 h in room temperature-stored specimens. In contrast, specimens stored under refrigerated conditions maintained ALK positivity even after 8 h of cold ischemia. Quantitative analysis confirmed a marked reduction in ALK-positive cells with increasing ischemia time (77.4% at 0 h <i>vs.</i> at 2.1% at 24 h) in room temperature-stored specimens. In the validation cohort, the refrigerated group demonstrated a significantly higher ALK positivity rate (3.8% <i>vs.</i> 0.2%; P<0.001).</p><p><strong>Conclusions: </strong>Prolonged cold ischemia time profoundly affects ALK status. Surgically resected tumors should be stored below 4 ℃ immediately after resection and fixed in formalin within 3 h at the latest.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 3","pages":"52"},"PeriodicalIF":3.5,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692307","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":"Proposal on incorporating consolidation-to-tumor ratio into the clinical T1 classification in patients with invasive lung adenocarcinoma.","authors":"Molin Zhang, Chaoqiang Deng, Fangqiu Fu, Ting Ye, Akif Turna, Yuan Li, Yang Zhang, Haiquan Chen","doi":"10.21037/tlcr-2025-aw-1274","DOIUrl":"https://doi.org/10.21037/tlcr-2025-aw-1274","url":null,"abstract":"<p><strong>Background: </strong>The prognostic implication of consolidation-to-tumor ratio (CTR) in patients with part-solid nodules (PSNs) remains ambiguous. The aim of this study is to explore the potential of CTR for refining prognostic stratification within the current clinical T1 classification.</p><p><strong>Methods: </strong>There were 1,340 N0M0 lung adenocarcinoma (LUAD) patients with PSNs (solid size ≤3 cm) enrolled. We constructed a novel risk stratification model based on both solid component size and CTR. The lung cancer-specific survival (LCSS) and recurrence-free survival (RFS) rates of the patients in the current and modified staging groups were evaluated.</p><p><strong>Results: </strong>At a median follow-up of 80.5 months, there were 89 recurrences and 40 lung cancer-associated deaths. The 5-year LCSS and RFS rates differed significantly in patients divided by CTR (0< CTR ≤0.5 <i>vs</i>. 0.5< CTR ≤0.8, LCSS: P<0.001, RFS: P<0.001; 0.5< CTR ≤0.8 <i>vs</i>. 0.8< CTR <1, LCSS: P=0.002, RFS: P<0.001). Subgroup analysis showed that a larger CTR was associated with worse prognosis in each clinical T1 classification (T1a: CTR ≤0.5 <i>vs</i>. CTR >0.5, P=0.03; T1b: CTR ≤0.5 <i>vs</i>. CTR >0.5, P=0.006; T1c: CTR ≤0.8 <i>vs</i>. CTR >0.8, P=0.04). The CTR-incorporated stratification scheme clearly classified the prognosis of PSNs (LCSS: T1mi: 100%, T1a: 99.1%, T1b: 89.4%, T1c: 75.3%; RFS: T1mi: 100%, T1a: 98.2%, T1b: 87.6%, T1c: 66.9%).</p><p><strong>Conclusions: </strong>CTR had a significant effect on the prognosis of PSNs, even when the solid component sizes were similar. An exploratory staging model incorporating CTR showed potential for improving risk stratification over the current T1 classification, but warrants external validation in future studies.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 3","pages":"51"},"PeriodicalIF":3.5,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692309","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":"Erratum: <i>KRAS</i> under attack: recent advances in targeted therapies involving G12C inhibitors and XPO1 inhibition.","authors":"","doi":"10.21037/tlcr-2026b-01","DOIUrl":"https://doi.org/10.21037/tlcr-2026b-01","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.21037/tlcr-2025-665.].</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 3","pages":"68"},"PeriodicalIF":3.5,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692291","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":"Prognostic implications of dominant lesion misidentification in multiple primary lung cancer.","authors":"Bowen Zhao, Xiaoyun Su, Yu Huang, Xiaoyu Han, Yan Li, Chi Zhang, Zuhan Gen, Qiuyu Len, Shiwen He, Shiwen Fan, Ming Chen, Kuo Li, Fan Yang, Guangyao Wu, Yongde Liao","doi":"10.21037/tlcr-2025-aw-1316","DOIUrl":"https://doi.org/10.21037/tlcr-2025-aw-1316","url":null,"abstract":"<p><strong>Background: </strong>Surgical resection remains the cornerstone of treatment for multiple primary lung cancer (MPLC). Given that the dominant lesion (DL) primarily determines the prognosis of patients with MPLC, accurate identification of the DL is crucial. This study aims to investigate the prognostic impact of preoperative misidentification of the DL on patients with MPLC.</p><p><strong>Methods: </strong>Patients with clinical stage I MPLC between January 2014 and December 2021 were retrospectively collected. The DL was preoperatively identified based on the mean diameter of lesions on computed tomography (CT) images, with postoperative confirmation via pathological examination results. Patients were categorized into the Inconsistent group (IG) if preoperative misidentification of the DL led to two scenarios: (I) a discrepancy between the actual surgical procedure performed and the optimal surgical approach retroactively determined based on postoperative assessment; or (II) prioritized resection of secondary lesions followed by staged resection of the DL. All remaining patients, in whom preoperative DL identification was consistent with postoperative confirmation and surgical procedures aligned with the DL-guided strategy, were assigned to the Consistent group (CG). Propensity score matching (PSM) was implemented to mitigate confounding effects from intergroup clinical characteristic variances. Overall survival (OS) and recurrence-free survival (RFS) were assessed, with prognostic factors evaluated using multivariate cox regression analysis.</p><p><strong>Results: </strong>From an initial cohort of 159 patients, 78 patients were selected through 1:2 PSM. All covariates demonstrated satisfactory balance between groups after matching, with no statistically significant differences observed. Five-year OS rates were 96.15% [95% confidence interval (CI): 91.7-98.3%] for IG and 98.08% (95% CI: 94.2-99.4%) for CG. Corresponding RFS rates were 62.86% (95% CI: 54.8-70.1%) and 91.54% (95% CI: 85.1-95.3%), respectively. Multivariable analysis identified inconsistent surgery [hazard ratio (HR) 5.341; 95% CI: 1.085-26.282; P=0.04] and receipt of postoperative adjuvant therapy (HR 5.613; 95% CI: 1.359-23.174; P=0.02) as independent risk factors of RFS.</p><p><strong>Conclusions: </strong>In patients with MPLC, preoperative misidentification of the DL may potentially affect prognosis due to the difference of surgical approach. Consequently, accurate preoperative identification of DLs is essential for optimizing surgical planning.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 3","pages":"61"},"PeriodicalIF":3.5,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692295","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":"Real-time breath metabolomics as catalyst for personalized lung cancer diagnostics: prospective matched case-control trial (LUCAbreath).","authors":"Felix Schmidt, Diego M Baur, Patrick Baumgartner, Jonas Herth, Kai Fricke, Noriane A Sievi, Kapil Dev Singh, Thomas Gaisl, Alice Huang, Daniel Franzen, Silvia Ulrich, Pablo Sinues, Malcolm Kohler","doi":"10.21037/tlcr-2025-aw-1187","DOIUrl":"https://doi.org/10.21037/tlcr-2025-aw-1187","url":null,"abstract":"<p><strong>Background: </strong>Exhaled breath analysis offers notable advantages as a non-invasive method for obtaining biological information from lung cancer patients. However, since the 1980s, its successful translation into clinical practice has remained elusive. The primary challenges include the low concentrations of metabolites in exhaled breath, complexities in breath collection methodologies, difficulties in process standardisation, limited molecular coverage across different methods, and challenges in compound identification and in understanding their molecular origin. Comprehensive reviews by Amann <i>et al.</i> [2011], Hanna <i>et al.</i> [2018], Schmidt <i>et al.</i> [2023], and Vadala <i>et al.</i> [2023] provide holistic insights into the dynamic field of lung cancer breath research. This study aimed to evaluate the efficacy of real-time secondary electrospray ionization high-resolution mass spectrometry (SESI-HRMS) in differentiating lung cancer patients from matched controls based on breath metabolomic profiles.</p><p><strong>Methods: </strong>This prospective matched case-control study analysed 178 patients. The study included treatment-naive lung cancer patients and controls matched (1:1) on age, sex, and smoking status. SESI-HRMS was used for real-time breath analysis. Data processing was conducted through a validated multistep analytical framework. Statistical evaluation incorporated multivariate techniques and machine learning algorithms. High-resolution mass spectral features were assigned following the Schymanski [2014] classification, enabling the identification of distinct metabolic alterations.</p><p><strong>Results: </strong>SESI-HRMS identified 3,750 exhaled breath features. <i>T</i>-tests revealed 608 features with significant differences in intensity (P≤0.05) between cases and controls, of which 18 features remained significant after multiple testing correction (q≤0.05). Prediction model achieved reasonable performances. Cancer <i>vs.</i> controls was predicted with an accuracy of 0.75, sensitivity and specificity of 0.80 and 0.71, respectively. Functional enrichment analysis highlighted distinct metabolic pathways for different histological cancer types, including de novo fatty acid metabolism in adenocarcinoma and glucose metabolism in squamous cell carcinoma.</p><p><strong>Conclusions: </strong>Real-time SESI-HRMS breath analysis differentiated lung cancer patients with acceptable accuracy from matched controls and provides valuable metabolic insights in lung cancer. This non-invasive approach could complement existing methods like genome profiling and low-dose computed tomography, potentially enhancing early detection and personalised treatment strategies towards a multi-omics approach. Further research is warranted to validate these preliminary findings and to refine the identification of putative breath biomarkers.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 3","pages":"57"},"PeriodicalIF":3.5,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692440","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}