Translational lung cancer research最新文献

{"title":"Clinicopathological factors <i>vs</i>. molecular model for predicting adjuvant EGFR-TKI benefit in stage I EGFR-mutant non-small cell lung cancer.","authors":"Yu Jiang, Yuechun Lin, Wenhai Fu, Si Jiang, Zhexue Hao, Hengrui Liang, Qihua He, Ran Cheng, Bingliang Li, Hongsheng Deng, Caichen Li, Jianfu Li, Shan Xiong, Ran Zhong, Songan Chen, Wei Wang, Jianxing He, Wenhua Liang","doi":"10.21037/tlcr-2025-20","DOIUrl":"10.21037/tlcr-2025-20","url":null,"abstract":"<p><strong>Background: </strong>Adjuvant epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) show promising outcomes in early-stage non-small cell lung cancer (NSCLC) with EGFR mutations, but accurately identifying patients who would derive the greatest benefit remains a clinical challenge. We compared the predictive performance of clinicopathological factors and the 14-gene assay to assess postoperative prognosis and predict the potential benefit of adjuvant EGFR-TKIs in stage I NSCLC.</p><p><strong>Methods: </strong>From March 2013 to February 2019, patients with completely resected stage I NSCLC [8th edition tumor-node-metastasis (TNM) classification staging] and EGFR mutation were included. The 14-gene assay, assessed through quantitative reverse transcription polymerase chain reaction (qPCR), was developed and subsequently validated across diverse international cohorts. Clinicopathological high-risk factors included any feature indicating a higher risk of recurrence based on the National Comprehensive Cancer Network (NCCN) guidelines. The primary endpoint of this study was the 5-year disease-free survival (DFS) rate.</p><p><strong>Results: </strong>Diagnostic values were evaluated in 180 stage I NSCLC patients. The 14-gene assay demonstrated superior performance compared to clinicopathological factors in predicting recurrence events. Patients with molecular high-risk, rather than clinicopathological high-risk factors, showed a more favorable response to adjuvant EGFR-TKIs. Specifically, adjuvant EGFR-TKIs benefited molecular high-risk patients, regardless of clinicopathological high-risk (DFS rate increased from 65.9% to 95.0%, P=0.02) or low-risk subgroups (80.0% to 100%, P=0.04). Patients with molecular low risk did not show any benefit from EGFR-TKIs, regardless of clinicopathological high-risk (DFS rate increased from 93.3% to 100%, P=0.37) or low-risk subgroups (97.0% to 100%, P=0.73).</p><p><strong>Conclusions: </strong>The 14-gene assay is proven to be superior to clinicopathological factors, offering valuable guidance for adjuvant EGFR-TKIs decisions in stage I NSCLC.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1531-1542"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326925","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":"Emotional distress: the hidden barrier to immunotherapy success in advanced non-small cell lung cancer.","authors":"Shannon Zhang, Shiyao Wang, Zhaohui Liao Arter","doi":"10.21037/tlcr-2025-31","DOIUrl":"10.21037/tlcr-2025-31","url":null,"abstract":"","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1877-1881"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326948","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":"Evaluating the tumor response assessment of modified-RECIST 1.1 in advance non-small cell lung cancer: a <i>post-hoc</i> analysis of 1,147 patients from the EAST-LC trial.","authors":"Qun Chen, Wenwen Huang, Gang Chen, Huaqiang Zhou, Jing Luo, Yuanyuan Zhao, Yan Huang, Yunpeng Yang, Wenfeng Fang, Ting Zhou, Yuxiang Ma, Li Zhang, Hongyun Zhao","doi":"10.21037/tlcr-24-809","DOIUrl":"10.21037/tlcr-24-809","url":null,"abstract":"<p><strong>Background: </strong>Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) provides conventional response evaluation in solid tumors. However, RECIST 1.1 measures up to two lesions per organ, which can be time-consuming and less-reliable in terms of reproducibility. This study sought to compare response assessment using RECIST 1.1 and modified RECIST 1.1 (mRECIST 1.1, measuring the single largest lesion per organ) in advanced non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>This study analyzed the medical files of 1,147 advanced NSCLC patients from the East Asia S-1 Trial in Lung Cancer (EAST-LC) clinical trial. The tumor responses were compared using the RECIST 1.1 and the mRECIST 1.1 by the kappa statistics. And a κ value of >0.75 indicated strong concordance. Concordance index (C-index), which ranges from 0-1, was calculated to evaluate prognostic accuracy of radiologic response according to the two criteria. The Kaplan-Meier method and log-rank test were conducted for survival. Statistical analyses were tested at a two-sided significance level of 0.05.</p><p><strong>Results: </strong>The amount of target lesions was lower by mRECIST 1.1 than RECIST 1.1. The best tumor responses revealed a great concordance between two criteria (κ=0.989). The C-index by the two criteria was similar for overall survival (OS) (0.709 versus 0.708) and responders had significantly longer progression-free survival (PFS) and OS versus non-responders (P<0.001) by the RECIST 1.1 and mRECIST 1.1. The median OS using the original RECIST 1.1 criteria was 33.6 months in the complete response (CR) and partial response (PR) arm, 18.6 months in the stable disease (SD) arm, and 7.3 months in the progressive disease (PD) arm. When the mRECIST 1.1 criteria were applied, the median OS of the above three groups was 30.9, 18.3 and 7.3 months, respectively. Patients were also stratified into four groups using quartiles of the absolute PFS value according to the two criteria. In comparison with RECIST 1.1, the median OS were 5.8 versus 6.0 months, 8.3 versus 8.4 months, 14.5 versus 14.6 months, and 25.6 versus 25.6 months in the lowest quartile, 2^nd quartile, 3^rd quartile, and 4^th quartile groups, respectively.</p><p><strong>Conclusions: </strong>mRECIST 1.1 was comparable to RECIST 1.1 and might be preferable owing to its convenience in the assessment of tumor response in advanced NSCLC.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1688-1698"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326949","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":"Impaired natural killer cell maturation in lung adenocarcinoma driven by <i>FABP4</i> and <i>SPON2</i> downregulation through disrupted lipid metabolism.","authors":"Hongxia Tian, Kezhen Li, Jing Chen, Weibang Guo, Zepeng Guo, Shuilian Zhang, Zhi Xie, Xin Huang, Sipei Wu, Wenzhao Zhong","doi":"10.21037/tlcr-24-1027","DOIUrl":"10.21037/tlcr-24-1027","url":null,"abstract":"<p><strong>Background: </strong>Although natural killer (NK) cells play a crucial role in antitumor immunity, the metabolic changes driving their dysfunction in lung adenocarcinoma remain poorly understood. This study investigates how these metabolic modifications impact NK cell function within the lung adenocarcinoma microenvironment.</p><p><strong>Methods: </strong>A total of 13 pairs of lung adenocarcinoma samples were obtained from The Cancer Genome Atlas. Differential gene expression, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment, and single-cell metabolic quantification analyses were used to characterize the transcriptomic, pathway, and metabolic signatures of NK cells. The developmental trajectory was reconstructed via pseudotime analysis. The fatty acid-binding protein 4 (<i>FABP4</i>) and spondin2 (<i>SPON2</i>) expression was examined using immunofluorescence (IF) and immunohistochemistry (IHC) in patients with lung adenocarcinoma. In NK cells with <i>FABP4</i> downregulation, <i>FABP4</i> function was analyzed using antibody-independent cell-mediated cytotoxicity assays, flow cytometry (FCM), and liquid chromatography-mass spectrometry.</p><p><strong>Results: </strong>The number of NK cells was significantly decreased in the lung adenocarcinoma microenvironment. <i>FABP4</i> and <i>SPON2</i> expression was significantly lower in NK cells within tumor tissues than in the adjacent tissues. FABP4 expression was significantly lower in tumor tissues than in the adjacent tissues, whereas no significant difference in SPON2 expression was observed. The cytotoxic function of NK cells with decreased <i>FABP4</i> levels was impaired. Non-targeted lipid metabolism analysis indicated that differentially expressed lipids in NK cells with low <i>FABP4</i> levels were functionally enriched in the glycerophospholipid metabolism pathway compared to those in normal NK cells.</p><p><strong>Conclusions: </strong>The study findings present new evidence showing that low <i>FABP4</i> and <i>SPON2</i> gene expression may impair NK cell maturity by affecting lipid metabolism in lung adenocarcinoma. These results provide a new perspective on restoring immune function in patients with lung cancer.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1660-1676"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326953","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":"Pneumonectomy-a necessary evil?","authors":"Koen C H A Verkoulen, Lars Geenen, Aimée J P M Franssen, Lori M van Roozendaal, Jean H T Daemen, Karel W E Hulsewé, Yvonne L J Vissers, Michel Gonzalez, Francesco Guerrera, Erik R de Loos","doi":"10.21037/tlcr-2025-233","DOIUrl":"10.21037/tlcr-2025-233","url":null,"abstract":"","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1496-1499"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326962","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":"Impact of omitting clinical target volume in radiotherapy for locally advanced non-small cell lung cancer: a propensity score matching analysis.","authors":"Liang Liu, Wen Bao, Xiaoshuai Yuan, Yaoyao Zhu, Ying Zhang, Petros Christopoulos, Baptiste Abbar, Cheng Qian, Shuangyan Yang, Yaping Xu","doi":"10.21037/tlcr-2025-409","DOIUrl":"10.21037/tlcr-2025-409","url":null,"abstract":"<p><strong>Background: </strong>Determining the planned target volume (PTV) for locally advanced (LA) non-small cell lung cancer (NSCLC) is often a challenging task for radiation oncologists. Due to advances in effective multidisciplinary treatments, the necessity to reconcile the clinical target volume (CTV) with the gross tumor volume (GTV) and the PTV presents an ongoing controversy. This study sought to analyze the effects of omitting the CTV on the clinical outcomes of patients with LA-NSCLC.</p><p><strong>Methods: </strong>Data were retrospectively collected from all consecutive patients with histologically confirmed LA-NSCLC treated with intensity-modulated radiotherapy (IMRT) at Shanghai Pulmonary Hospital from January 2019 to December 2020. The patients were divided into two groups based on different radiotherapy planning techniques: (I) the planning target volume-gross target (PTV-G) group; and (II) the planning target volume-clinical target (PTV-C) group. The PTV-G was directly based on the GTV, while the PTV-C was based on the simulated CTV. A propensity score matching (PSM) analysis was conducted to enhance the comparability of the clinical data between the two groups. The primary endpoint of the study was the occurrence of radiotherapy-associated adverse events. Secondary endpoints included progression-free survival (PFS), overall survival (OS), post-treatment tumor recurrence patterns, and variations in peripheral blood cell characteristics pre- and post-radiotherapy.</p><p><strong>Results: </strong>A total of 255 patients were identified from our local database. After matching on propensity score with a 1:2 ratio, 156 patients were included in the final analysis, with 52 in the PTV-G group and 104 in the PTV-C group. The incidence of ≥ grade 3 radiation pneumonitis (RP) was significantly higher in the PTV-C group than in the PTV-G group (12.5% <i>vs.</i> 5.7%, P=0.03). Similarly, the incidence of ≥ grade 3 radiation esophagitis was higher in the PTV-C group than the PTV-G group (15.4% <i>vs.</i> 3.8%, P=0.02). However, no statistically significant differences were found between the PTV-G and PTV-C groups in terms of the objective response rate (ORR) and the disease control rate (DCR) (1-year ORR: 57.7% <i>vs.</i> 55.8%, P=0.37; 1-year DCR: 78.8% <i>vs.</i> 84.6%, P=0.16). No differences were found in median PFS (15.4 months for PTV-G <i>vs.</i> 14.8 months for PTV-C, P=0.28) or median OS (26.8 months for PTV-G <i>vs.</i> 25.4 months for PTV-C, P=0.06).</p><p><strong>Conclusions: </strong>Omitting the CTV was associated with a decrease of grade ≥3 radiation-induced toxicities without pejorative impact on PFS or OS in LA-NSCLC patients treated with IMRT. Furthermore, no increase in regional or metastatic recurrence rates were observed. This radiotherapy strategy may be a viable option for selected LA-NSCLC patients, reducing toxicities without compromising outcomes.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1770-1785"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326951","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":"Oral microbiome and risk of lung cancer: results from a two-sample mendelian randomization analysis.","authors":"Chudong Wang, Biao Hu, Qiuyi Liang, Han Jiang, Lu Yuan, Shuben Li","doi":"10.21037/tlcr-2024-1163","DOIUrl":"10.21037/tlcr-2024-1163","url":null,"abstract":"<p><strong>Background: </strong>Numerous studies have suggested that the oral microbiome may function as a biomarker for lung cancer screening. However, the relationship between oral microbiome and lung cancer has not been thoroughly investigated. Consequently, investigating the causal relationship between oral microbiome and lung cancer was the primary goal of this study.</p><p><strong>Methods: </strong>We conducted a two-sample Mendelian randomization (MR) analysis to investigate the causal relationship between the oral microbiome and lung cancer. Summary statistics for the oral microbiomes were obtained from large-scale metagenome-genome-wide association studies (mgGWAS), while genome-wide association study (GWAS) summary statistics for lung cancer were sourced from the IEU-OpenGWAS online platform. We employed inverse variance weighted (IVW) analysis and Wald ratio methods to evaluate the causal associations between the oral microbiome and lung cancer. Finally, we performed MR Steiger's test to strengthen the validity of the causal associations.</p><p><strong>Results: </strong>Three oral microbiomes were causally associated with lung cancer. <i>Gemella haemolysans</i> (pheno.388) from saliva and an unclassified species (pheno.844) of Clostridia from saliva were protective factors for lung cancer, and an unclassified species (pheno.1354) of <i>Prevotella</i> from tongue was a risk factor for lung cancer. And there is no bidirectional association of causality between oral microbiomes and lung cancer.</p><p><strong>Conclusions: </strong>The oral microbiomes, <i>Gemella haemolysans</i> (pheno.388) from saliva, an unclassified species (pheno.844) of Clostridia from saliva and an unclassified species (pheno.1354) of <i>Prevotella</i> from tongue, were causally associated with lung cancer. Oral microbiology holds significant potential for clinical applications in etiologic exploration, early screening, prevention, and enhancing survival in lung cancer. Regarding treatment, personalized therapy based on oral flora may provide novel therapeutic strategies for lung cancer.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1715-1723"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326958","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":"Pattern-based volumetric CT quantification to predict radiation pneumonitis in patients with non-small-cell lung cancer who have diffuse parenchymal lung disease.","authors":"Jonghoon Kim, Min Hwan Kwak, Jae Myoung Noh, You Jin Oh, Hongseok Yoo, Hye Jeon Hwang, Joon Beom Seo, Sung Goo Park, Hong Ryull Pyo, Ho Yun Lee","doi":"10.21037/tlcr-2025-7","DOIUrl":"10.21037/tlcr-2025-7","url":null,"abstract":"<p><strong>Background: </strong>Diffuse parenchymal lung disease (DPLD) is a well-known risk factor for radiation pneumonitis (RP) after radiation therapy (RT) for lung cancer. However, it is hard to evaluate the exact extent of DPLD and to predict RP. This study sought to quantify the extent of DPLD and to determine which pattern(s) of DPLD lead to RP using texture analysis of pre-treatment computed tomography (CT) scans.</p><p><strong>Methods: </strong>Lung cancer patients with impaired lung function or fibrosis scheduled for proton therapy were prospectively included. Pre-treatment chest CT was assessed, and patterns were classified semi-automatically by quantitative analysis software. Texture patterns included emphysema, ground-glass opacities (GGOs), reticulation, and honeycombing. Univariable and multivariable logistic regression analyses were used to analyze independent risk factors for RP.</p><p><strong>Results: </strong>A total of 54 patients [median age, 71.5 years (range, 57-87 years); 50 men] were enrolled from August 2018 to January 2020. RP of grade ≥3 occurred in seven patients (12.9%). The median extent of emphysematous tissue was 4.8% (range, 0-34.1%), and the median interstitial lung disease (ILD) extent was 5.5% (range, 0-27.3%). During the multivariable analysis, the \"sex + total ILD extent\" and \"sex + total fibrosis extent\" models showed the best performance. In the first model, RP of grade ≥3 was associated with female sex and a high total ILD percentage [odds ratios (ORs), 18.0 and 1.2, respectively].</p><p><strong>Conclusions: </strong>High percentage of lung volume occupied by ILD, especially fibrosis correlates with severe RP.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1635-1649"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326960","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":"Re-irradiation for local recurrence after definitive stereotactic body radiotherapy for early-stage non-small cell lung cancer.","authors":"Taiki Takaoka, Natsuo Tomita, Chisa Hashizume, Takahiko Tsugawa, Akira Torii, Dai Okazaki, Masanari Niwa, Nozomi Kita, Masanosuke Oguri, Seiya Takano, Masahiro Sasaguchi, Machiko Ukai, Yasutaka Ogawa, Akio Niimi, Akio Hiwatashi","doi":"10.21037/tlcr-2025-89","DOIUrl":"10.21037/tlcr-2025-89","url":null,"abstract":"<p><strong>Background: </strong>Salvage treatment for local recurrence of non-small cell lung cancer (NSCLC) after stereotactic body radiotherapy (SBRT) remains unestablished. We investigated the safety and efficacy of a second SBRT course for in-field local recurrence of NSCLC after definitive SBRT.</p><p><strong>Methods: </strong>This study included 35 patients with NSCLC who received a second SBRT course between July 2004 and August 2021. The median interval between the first and second SBRT was 24 months (range, 6-81 months). The median prescription dose was 60 Gy in eight fractions (range, 48-66 Gy) for the second SBRT. Overall survival (OS), local control (LC), progression-free survival (PFS), and toxicity after a second SBRT were assessed.</p><p><strong>Results: </strong>The median follow-up period was 29 months (range, 3-124 months). The three-year OS, LC, and PFS rates were 50%, 47%, and 34% for all 35 patients and 72% <i>vs.</i> 21%, 85% <i>vs.</i> 34%, and 62% <i>vs.</i> 9% in the adenocarcinoma and squamous cell carcinoma groups, respectively (P=0.04, 0.01, and 0.003, respectively). Four patients demonstrated no further recurrence for more than five years after the second SBRT. Radiation pneumonitis after the second SBRT was grade 2 in three (8.5%) patients, rib fractures occurred in nine (25.7%) patients, and no patient developed grade 3 or higher toxicity.</p><p><strong>Conclusions: </strong>Re-irradiation with SBRT was safe and can be a salvage treatment option for in-field local recurrence of NSCLC, especially adenocarcinoma, after definitive SBRT.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1650-1659"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326965","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":"Absent preoperative non-small cell lung cancer confirmation and relevant stage migration in the era before neoadjuvant chemoimmunotherapy: implications for treatment decisions in resectable non-small cell lung cancer.","authors":"Guus R M van den Heuvel, Bas L R Mandos, Olga C J Schuurbiers, Francesco Ciompi, Erik Aarntzen, Kaamar Azijli, Iris Walraven, Hans J M Smit, Michel M van den Heuvel","doi":"10.21037/tlcr-2024-1120","DOIUrl":"10.21037/tlcr-2024-1120","url":null,"abstract":"<p><strong>Background: </strong>Achieving preoperative pathological confirmation and accurate clinical staging are crucial for neoadjuvant treatment decisions in resectable non-small cell lung cancer (NSCLC), though often challenging. This study examines the prevalence of missing preoperative pathological confirmation with focus on patients with clinical stage II or III NSCLC. In addition, pre- and postoperative staging discrepancies are studied in the presence of preoperative NSCLC confirmation. These two impeding factors were studied in an era before the introduction of neoadjuvant chemoimmunotherapy in resectable NSCLC.</p><p><strong>Methods: </strong>In this retrospective observational study, patients with resectable NSCLC diagnosed between 2015 and 2019 were selected. The prevalence of absent preoperative confirmation of NSCLC was evaluated. Stage migration was analyzed in the overall population and across two patient cohorts with either a present or absent upfront pathological NSCLC diagnosis. Relevant stage migration was assessed in the cohort with preoperative NSCLC confirmation. Relevant upstaging was defined as migration from clinical stage I to pathological stage IIA-IIIB and relevant downstaging from clinical stage IIA-IIIB to pathological stage I.</p><p><strong>Results: </strong>In 277 of 809 patients (34.2%), no preoperative pathological NSCLC diagnosis was obtained, including 83 patients with clinical stage II or III disease (30.0% and 10.3% of the total cohort). In 532 of 809 patients (65.8%), preoperative pathological NSCLC confirmation was achieved. In this cohort, relevant stage migration was noticed in 105 patients (19.7% and 13.0% of the total cohort).</p><p><strong>Conclusions: </strong>In the era before the introduction of neoadjuvant chemoimmunotherapy as standard of care, absent preoperative NSCLC confirmation or inaccurate staging occurred in nearly a quarter of potential candidates for neoadjuvant treatment. These two limiting factors will need to be addressed in order to adequately administer neoadjuvant therapy in patients with resectable NSCLC conform current guidelines.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1543-1557"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326921","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}