Translational lung cancer research最新文献

{"title":"Change of bone mineral density as a prognostic marker in small cell lung cancer treated with immune checkpoint inhibitors: a multicenter retrospective study.","authors":"Weiwei Liu, Yusheng Guo, Peng Mo, Jie Lou, Bingxin Gong, Xiaona Fu, Yi Li, Kailu Zhang, Yi Ren, Shanshan Jiang, Peng Sun, Junping Li, Yong Wang, Lian Yang","doi":"10.21037/tlcr-2024-1125","DOIUrl":"10.21037/tlcr-2024-1125","url":null,"abstract":"<p><strong>Background: </strong>Changes in bone mineral density (BMD) are recognized as an independent predictor of survival in a variety of diseases. However, the prognostic value of BMD in small cell lung cancer (SCLC) patients treated with immune checkpoint inhibitors (ICIs) is not well understood. This study aimed to explore the prognostic ability of change in bone mineral density (ΔBMD) on the survival of SCLC patients receiving ICIs.</p><p><strong>Methods: </strong>A total of 300 SCLC patients receiving ICIs from three hospitals were enrolled and underwent non-enhanced thoracic computed tomography (CT) before and after treatment. Overall survival (OS) and progression-free survival (PFS) were analyzed using Cox regression models and Kaplan-Meier survival curves. A nomogram model based on independent prognostic factors was developed using multivariate Cox proportional hazards analysis. The predictive efficacy and clinical benefit of the nomogram were evaluated using the time-dependent area under the receiver operating characteristic (ROC) curve and calibration curves.</p><p><strong>Results: </strong>Lower ΔBMD was associated with shorter PFS and OS. ΔBMD was identified as an independent prognostic factor affecting OS (risk ratios =0.461; P<0.001). The established nomogram resulted in the area under the ROC curve for OS at 9, 12, and 18 months of 0.743, 0.782, and 0.781, respectively. The C-index was 0.701 [95% confidence interval (CI): 0.663-0.739], and the calibration curves confirmed that predictions aligned well with actual observations.</p><p><strong>Conclusions: </strong>Lower ΔBMD is correlated with poorer clinical outcomes in SCLC patients undergoing treatment with ICIs.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1582-1595"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326923","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 coronavirus disease 2019 on surgery in patients with early-stage lung cancer: the COVIDLungSurg prospective cohort study.","authors":"Zhenyi Niu, Feng Zhu, Yuqin Cao, Congcong Luo, Dan Liu, Chunping Wang, Zhenbin Qiu, Lishan Peng, Mingyuan Du, Runsen Jin, Yan Yan, Dong Dong, Hui Jing, Xiaofeng Wang, Wei Guo, Zengya Guo, Chengqiang Li, Dingpei Han, Yajie Zhang, Jie Xiang, Hailei Du, Kai Chen, Zhengxin Yin, Jie Yang, Wenzhao Zhong, Yongxin Zhou, Mingsong Wang, Dongchun Ma, Hecheng Li","doi":"10.21037/tlcr-2024-1276","DOIUrl":"10.21037/tlcr-2024-1276","url":null,"abstract":"<p><strong>Background: </strong>Previous studies found that preoperative coronavirus disease 2019 (COVID-19) was associated with higher risk of postoperative complications. A seven-to-eight week delay of surgery was recommended for patients with newly diagnosed COVID-19. However, given the widespread vaccination and less virulent variant, the timing of surgery after COVID-19 requires further evaluation. This study was conducted to investigate the impact of COVID-19 on early-stage lung cancer patients undergoing surgery.</p><p><strong>Methods: </strong>We conducted this prospective cohort study of COVID-19 lung surgery (COVIDLungSurg) in five hospitals in China between January 2023 and April 2024. Early-stage lung cancer patients who underwent surgery were included in this study. The primary outcome was the rate of postoperative complication within the first postoperative 30 days. The secondary outcomes included total length of hospital stay, postoperative stay, and 30-day mortality. Adjusted analyses were performed using propensity score matching and logistic regression models. This study was registered at ClinicalTrials.gov (NCT05684549).</p><p><strong>Results: </strong>Of the 1,734 patients included in our study, 1,496 had preoperative COVID-19. A total of 1,538 patients were fully vaccinated against COVID-19. The rate of postoperative complication was 9.5% (165/1,734) in all the included patients, with no significant difference in patients with and without history of COVID-19 [9.2% (137/1,496) <i>vs.</i> 11.8% (28/238), P=0.20]. Among patients with preoperative COVID-19, time since COVID-19 to surgery did not show any association with postoperative complications in the multivariable logistic regression model [odds ratio, 1.00; 95% confidence interval (CI): 0.99-1.01; P=0.41].</p><p><strong>Conclusions: </strong>In the Omicron predominant era, preoperative COVID-19 was not associated with higher risk of postoperative complications in early-stage lung cancer patients. The time between COVID-19 infection and surgery was not associated with postoperative complications.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1677-1687"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326950","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 factors of liver metastases in extensive-stage small cell lung cancer receiving chemo-immunotherapy.","authors":"Kyoichi Kaira, Yuhei Kurata, Hisao Imai, Ayako Shiono, Yu Miura, Kosuke Hashimoto, Ou Yamaguchi, Atusto Mouri, Hiroshi Kagamu","doi":"10.21037/tlcr-2024-1091","DOIUrl":"10.21037/tlcr-2024-1091","url":null,"abstract":"<p><strong>Background: </strong>Chemoimmunotherapy combining platinum-based chemotherapy and etoposide with an anti-programmed death-ligand 1 (PD-L1) antibody is the standard treatment for patients with extensive-stage small cell lung cancer (ES-SCLC). However, the biomarkers that can predict outcomes after chemo-immunotherapy remain unclear. This study retrospectively investigated the prognostic factors after first-line chemoimmunotherapy in patients with ES-SCLC.</p><p><strong>Methods: </strong>This study included 110 patients with ES-SCLC who received chemoimmunotherapy as a first-line treatment. Clinical data were extracted from medical records, and inflammatory and nutritional factors such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), prognostic nutrition index (PNI), and advanced lung cancer inflammation index (ALI) were analyzed to determine the prognostic predictors. Survival data were analyzed using the log-rank test. Univariate and multivariate analyses of variables were performed using Cox regression.</p><p><strong>Results: </strong>The median patient age was 72 years (range, 50-88 years). At diagnosis, metastases were present in the brain, liver, and bones in 32.7%, 25.5%, and 39.1% of cases, respectively. The platinum-based chemotherapy regimens included atezolizumab in 67.3% of cases and durvalumab in 32.8%, respectively. Univariate analysis identified sex, ALI, pro-gastrin-releasing peptide (ProGRP), liver metastasis, and bone metastasis as significant predictors of progression-free survival (PFS), meanwhile, age, sex, performance status (PS), NLR, ALI, ProGRP, liver metastasis, and bone metastasis as significant predictors of overall survival (OS). Multivariate analysis identified liver metastasis as an independent predictor of PFS and OS. High ProGRP levels, bone metastasis, occurrence of immune-related adverse events (irAEs) of any grade, and partial response (PR) were significantly associated with the presence of liver metastasis. Multivariate analysis identified a combination of maximal tumor diameter >30 mm and the presence of >10 metastatic lesions as independent predictors of OS in 28 patients with liver metastasis.</p><p><strong>Conclusions: </strong>Liver metastasis is a significant predictor of outcomes after chemoimmunotherapy in patients with ES-SCLC. The maximal diameter and number of liver metastases may affect the immune response in patients with liver metastasis.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1569-1581"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326963","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":"Visceral crisis in a patient with non-small cell lung cancer and <i>ROS1::SDC4</i> fusion: intrinsic resistance to entrectinib via L2026M mutation-a case report.","authors":"Vaneza Avila Rodriguez, Nicolle Wagner-Gutiérrez, Jairo Andrés Zuluaga León, Leonardo Rojas, Lucia Viola, Stella Isabel Martínez Jaramillo, Carlos Andrés Carvajal Fierro, Alejandro Ruiz-Patiño, Oscar Arrieta, Luis Corrales, Claudio Martin, Andrés F Cardona","doi":"10.21037/tlcr-2024-1149","DOIUrl":"10.21037/tlcr-2024-1149","url":null,"abstract":"<p><strong>Background: </strong><i>ROS1</i> rearrangements are identified in approximately 1-2% of non-small cell lung cancer (NSCLC) cases, predominantly in younger, non-smoking patients. Targeted therapies such as entrectinib, a second-generation <i>ROS1</i> tyrosine kinase inhibitor (TKI), have demonstrated efficacy, particularly in managing brain metastases. However, intrinsic and acquired resistance mechanisms remain poorly understood, limiting long-term treatment success.</p><p><strong>Case description: </strong>We report a unique case of early entrectinib resistance due to a gatekeeper mutation in the ROS1 kinase domain, underscoring the importance of molecular profiling in optimizing therapeutic strategies. We report a case of a 50-year-old male, a non-smoker, who was diagnosed with ROS1-rearranged NSCLC harboring an <i>ROS1::SDC4</i> fusion. First-line treatment with entrectinib was initiated, resulting in an initial partial response. However, rapid disease progression was observed within a few months. Retrospective molecular analysis identified the L2026M mutation in the <i>ROS1</i> kinase domain, a known gatekeeper mutation that reduces TKI binding affinity and enhances tumor cell survival. This case highlights the clinical impact of resistance mutations in ROS1-positive NSCLC and underscores the critical role of comprehensive molecular profiling in guiding treatment decisions.</p><p><strong>Conclusions: </strong>The emergence of the L2026M mutation suggests a need for next-generation TKIs and combination strategies to overcome resistance. Future studies should explore novel inhibitors targeting ROS1 resistance pathways to improve outcomes in this subset of NSCLC patients.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1862-1869"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326968","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":"Combination of immune checkpoint inhibitors with multi-targeted tyrosine kinase inhibitors for second- or later-line therapy of non-small cell lung cancer: a systematic review and meta-analysis.","authors":"Wujian Xu, Ximing Liao, Kun Wang, Ting Shi","doi":"10.21037/tlcr-2024-1204","DOIUrl":"10.21037/tlcr-2024-1204","url":null,"abstract":"<p><strong>Background: </strong>Second- or later-line therapy for patients with advanced non-small cell lung cancer (NSCLC) is highly individualized. Combining immune checkpoint inhibitors (ICIs) with multi-targeted tyrosine kinase inhibitors (multi-TKIs) has emerged as a chemotherapy-free option for these patients. We aim to provide a comprehensive overview of the efficacy and safety of the treatment.</p><p><strong>Methods: </strong>We systematically searched four databases for studies evaluating ICIs combined with multi-TKIs in second- or later-line therapy for NSCLC. Data were extracted and study quality was assessed using the Canadian Institute of Health Economics tool for case series. A systematic review and meta-analysis were conducted for efficacy outcomes.</p><p><strong>Results: </strong>Twenty studies (10 prospective and 10 retrospective) were included from 155 retrieved articles. Nineteen studies were conducted in China, with programmed death receptor 1 (PD-1) antibodies and anlotinib as the most frequently used combination. The single-arm meta-analysis showed that the pooled median progression-free survival (mPFS) was 5.74 months [95% confidence interval (CI): 4.65-6.84], and the median overall survival was 15.41 months (95% CI: 13.40-17.41). The objective response rate was 26.35% (95% CI: 19.52-33.18%), and the disease control rate was about 80.73% (95% CI: 75.59-85.86%). For patients with EGFR/ALK/ROS1 mutations, the mPFS was 3.17 months (95% CI: 2.54-3.79). The most commonly reported severe adverse events across the included studies were hypertension, fatigue, hepatic dysfunction, urinary abnormalities, and hand-foot syndrome.</p><p><strong>Conclusions: </strong>The combination of ICIs and multi-TKIs offers an alternative chemotherapy-free treatment option for patients with advanced NSCLC in the second- or later-line setting.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1724-1739"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326926","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":"Impacts of co-mutations in oligometastatic and oligoprogressive non-small cell lung cancer with <i>EGFR/ALK</i> mutations-a narrative review of the current literature.","authors":"Jeong Uk Lim, Ae Lee Jang, Jayoung Lee, Sonya Youngju Park, Tai Joon An, Young Jo Sa, Hyo Rim Kim, Tae-Jung Kim, Byoung Hyuck Kim, Chan Kwon Park","doi":"10.21037/tlcr-2024-1121","DOIUrl":"10.21037/tlcr-2024-1121","url":null,"abstract":"<p><strong>Background and objective: </strong>Non-small cell lung cancer (NSCLC) remains one of the primary causes of cancer mortality globally, with an increasing focus on advanced targeted therapies. Despite these advancements, oligometastatic NSCLC, particularly cases with actionable mutations such as those in epidermal growth factor receptor (<i>EGFR</i>) and anaplastic lymphoma kinase (<i>ALK</i>), presents unique therapeutic challenges and opportunities for improved outcomes. Recent studies indicate that consolidative local ablative therapies (LAT) such as stereotactic body radiation therapy (SBRT) combined with tyrosine kinase inhibitors (TKIs) may enhance progression-free and overall survival for patients with oligometastatic NSCLC harboring these mutations. This narrative review aims to summarize current evidence on the clinical impact of co-mutations in EGFR/ALK-positive oligometastatic NSCLC.</p><p><strong>Methods: </strong>The relevant literature was identified by using PubMed and ClinicalTrials.gov (last search phase November 2024) and was restricted to English language. Peer-reviewed manuscripts but also conference abstracts that did not undergo peer-review were included.</p><p><strong>Key content and findings: </strong>Co-mutations complicate treatment by potentially influencing radiosensitivity and resistance to systemic therapies. This review discusses current findings on co-mutations in <i>EGFR</i>/<i>ALK</i>-positive oligometastatic NSCLC, examining their impact on LAT and systemic treatment outcomes, with a particular focus on synchronous and oligoprogressive disease states. Moreover, emerging biomarkers such as circulating tumor DNA may guide therapeutic strategies and optimize personalized treatment plans.</p><p><strong>Conclusions: </strong>As clinical trials continue to investigate combinative and sequential LAT-TKI strategies, understanding the genomic landscape of co-mutations in oligometastatic NSCLC is important for refining treatment approaches and enhancing long-term survival.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1848-1861"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326952","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":"Attention mechanism-based habitat analysis for predicting pleural invasion and prognosis of pulmonary nodules.","authors":"Wei Zhang, Xiangfeng Gan, Wenzeng Chen, Xiaohui Duan, Zhuojian Shen, Haohua Xu, Honglue Dai, Ju Chen, Baishen Chen","doi":"10.21037/tlcr-2024-1122","DOIUrl":"10.21037/tlcr-2024-1122","url":null,"abstract":"<p><strong>Background: </strong>The use of segmental resection in pulmonary adenocarcinoma is increasing, yet visceral pleural invasion (VPI) remains a critical risk factor impacting overall survival (OS). The benefits of segmental resection for these patients are unclear, and non-invasive methods to predict VPI need further development. This study aims to develop a predictive model for VPI and OS, aiding surgeons in preoperative and intraoperative decision-making.</p><p><strong>Methods: </strong>A retrospective study was conducted using data from the Sun Yat-sen Memorial Hospital, the Fifth Affiliated Hospital of Sun Yat-sen University and an external dataset (named NSCLC Radiogenomics from The Cancer Imaging Archive) of cT1 stage pulmonary nodules. Original computed tomography images were enhanced using generative adversarial networks. Habitat analysis identified tumor subregions, which were clustered. Radiomics and vision transformer features were extracted and integrated using attention-equipped transformers to develop prediction models. Performance was evaluated using receiver operating characteristic (ROC) curves, net reclassification improvement, and integrated discrimination improvement.</p><p><strong>Results: </strong>The study included 742 patients, comprising 338 males and 404 females, with a mean age of 61±10.2 years. Data from the Fifth Affiliated Hospital of Sun Yat-sen University were divided into training and validation cohorts, while data from the Sun Yat-sen Memorial Hospital and the NSCLC Radiogenomics dataset formed the test cohort. The Rad-adjacent model had an area under the curve (AUC) of 0.822 for predicting VPI, while the combined model achieved an AUC of 0.819. For predicting 5-year OS, the combined model's AUC was 0.821, compared to 0.775 for the Rad-adjacent model.</p><p><strong>Conclusions: </strong>The developed models show strong predictive capabilities for VPI and OS in cT1 stage lung adenocarcinoma, providing valuable non-invasive support for surgical decision-making.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1596-1610"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326922","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":"Deep learning in histopathology images for prediction of oncogenic driver molecular alterations in lung cancer: a systematic review and meta-analysis.","authors":"Rafael Parra-Medina, Gabriela Guerron-Gomez, Daniel Mendivelso-González, Javier Hernan Gil-Gómez, Juan Pablo Alzate, Marcela Gomez-Suarez, Jose Fernando Polo, John Jaime Sprockel, Andres Mosquera-Zamudio","doi":"10.21037/tlcr-2024-1196","DOIUrl":"10.21037/tlcr-2024-1196","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer (LC) is the second most diagnosed cancer and the leading cause of cancer mortality worldwide. Non-small cell lung cancer (NSCLC) accounts for 85% of cases, with oncogenic alterations like <i>EGFR, ALK, ROS1</i>, and <i>KRAS</i> guiding targeted therapies. Their prevalence varies by ethnicity, smoking status, and gender. Advances in artificial intelligence (AI) enable molecular biomarker prediction from hematoxylin and eosin-stained whole-slide images (H&E WSIs), offering a non-invasive approach to precision oncology. This review assesses deep learning (DL) models predicting oncogenic drivers in NSCLC from H&E WSIs and their diagnostic accuracy.</p><p><strong>Methods: </strong>A systematic review registered in PROSPERO (CRD42024573602) was conducted in Embase, LILACS, Medline, Web of Science, and Cochrane to identify studies on DL models using H&E slides for LC gene alterations. Only English and Spanish studies were included. Key metrics were extracted for meta-analysis. Studies without LC-specific data, missing essential metrics, or with inconsistent results were excluded.</p><p><strong>Results: </strong>We found evidence that convolutional neural networks (CNNs) were the most common architectures in studies. Also, in the meta-analysis, <i>ALK</i> {sensitivity of 84% [95% confidence interval (CI): 62-95%] and specificity of 85% (95% CI: 55-96%)}, <i>EGFR</i> [80% (95% CI: 72-86%) and specificity of 77% (95% CI: 69-83%)] and <i>TP53</i> [sensitivity and specificity of 70% (95% CI: 65-83%)] were the oncogenic driver molecular alterations that demonstrated the best predictive capability performance.</p><p><strong>Conclusions: </strong>Our results emphasize the potential of these models as screening tools despite H&E WSI.It is necessary to validate these predictive models among diverse populations and clinical outcomes. This approach is crucial and leaves an open door for advances in precision medicine, offering promising avenues for personalized treatment strategies.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1756-1769"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326946","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":"Different prognosis of multiple lung cancer identified by 116-gene panel by next-generation sequencing based on an Asian population.","authors":"Chen-Hui Ni, Mu-Ting Wang, Ping-Hua Lin, Yan-Qi Lu, Yi-Peng Chen, Wei Zheng, Yuan-Zhong Chen, Chang-Ping Yang, Chun Chen, Bin Zheng","doi":"10.21037/tlcr-2024-1160","DOIUrl":"10.21037/tlcr-2024-1160","url":null,"abstract":"<p><strong>Background: </strong>Patients with multiple lung cancer are becoming more common. The optimal criterion to distinguish multiple primary lung cancer (MPLC) from intrapulmonary metastases (IPM) is still unclear. In this study, we try to distinguish between MPLC and IPM and investigate their prognosis and risk factors.</p><p><strong>Methods: </strong>This study was a retrospective analysis of patients with at least two malignant resected nodules in three medical centers from January 2019 to December 2019. Fifty-three patients with 130 lesions were enrolled and tested with 10-gene and 116-gene panels using next-generation sequencing (NGS). Disease-free survival (DFS) was defined as the time from surgery to either the date of the first recurrence (local or distant) or the last follow-up. The follow-up period was up to October 31, 2024. Tumor mutations were identified for each gene using the 116-gene and 10-gene panels, and clonal relatedness was identified by mutational profiling. Univariate and multivariate Cox regression analyses were conducted to identify independent risk factors for DFS.</p><p><strong>Results: </strong>Fifty-three cases with 130 lesions met the inclusion criteria. A total of 16 recurrences were identified during follow-up. The 3- and 5-year DFS was 77.4% and 69.8%, respectively. According to the 116-gene panel, 35 (66.1%) cases favored MPLC, and 18 cases (33.9%) favored IPM on the basis of shared mutations. There was no difference in the 3-year DFS (82.9% <i>vs.</i> 66.7%, log-rank P=0.22), while there was an obvious difference in the 5-year DFS (80% <i>vs.</i> 60%, log-rank P=0.02). Univariate analysis showed alkaline phosphatase and forced expiratory volume in the first second percentage (FEV1%) as risk factors for metastasis (P=0.03 and P=0.003). Multivariate analysis showed that FEV1% was an independent factor (P=0.001). Cox regression analysis showed that the positive covariates were as follows: early stage [hazard ratio (HR) =4.192; 95% confidence interval (CI): 1.378 to 12.749; P=0.01] and MPLC (HR =0.187; 95% CI: 0.057 to 0.613; P=0.006).</p><p><strong>Conclusions: </strong>NGS-based 116-gene panel classification can improve the accuracy of diagnosing MPLC and IPM. The diagnosis of IPM was associated with poor prognosis in Asian population.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1699-1714"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326947","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":"Neoadjuvant tepotinib in stage IIB N0 non-small cell lung carcinoma with <i>MET</i> exon 14 skipping mutation: a case report and review of the literature.","authors":"Amanda Reyes, Rebecca Pharaon, Atish Mohanty, Jae Kim, Erminia Massarelli","doi":"10.21037/tlcr-2024-1197","DOIUrl":"10.21037/tlcr-2024-1197","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer has the highest mortality rate world-wide, but treatments for non-small cell lung cancer (NSCLC) including immune check point inhibitors and targeted tyrosine kinase inhibitors have greatly improved survival. Many of the targeted tyrosine kinase inhibitors have already been approved in the first line in metastatic disease. The use of combination chemotherapy and immunotherapy treatment in the perioperative setting has been highly successful, but patients with driver alterations were largely left out including patients with mesenchymal epithelial transition exon 14 (<i>MET</i> Ex14) mutations. There are on-going randomized controlled clinical trials evaluating targeted kinase inhibitors in the perioperative setting. We also provide an in-depth overview of the MET pathway as well as the current state of <i>MET</i>-targeted peri-operative treatment in lung cancer and highlight the relevant trials.</p><p><strong>Case description: </strong>We discuss the rationale and clinical course of the use of neoadjuvant and adjuvant tepotinib in a case study of an elderly patient with a <i>MET</i> Ex14 mutation in surgically resectable stage IIB N0 NSCLC, who was not an optimal candidate for traditional chemotherapy for several reasons.</p><p><strong>Conclusions: </strong>From the single case report, we found that tepotinib was both safe and effective when used in the neoadjuvant setting with no evidence of recurrence after greater than one year of post-operative follow up. Adjuvant treatment was not as well tolerated and therefore stopped. We conclude with a discussion on the advantages and potential downfalls of <i>MET</i>-targeted tyrosine kinase inhibitors in the perioperative setting as well as some potential new areas of investigation.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1870-1876"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326955","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}