Translational lung cancer research最新文献

{"title":"Current evidence and ongoing trials for surgery versus stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer: a narrative review.","authors":"Lauren Drake, Robert Timmerman, Hiran C Fernando","doi":"10.21037/tlcr-2025-387","DOIUrl":"10.21037/tlcr-2025-387","url":null,"abstract":"<p><strong>Background and objective: </strong>Pulmonary resection with mediastinal lymph node dissection is the standard of care for standard-risk operable patients with early-stage non-small cell lung cancer (NSCLC), while stereotactic body radiation therapy (SBRT) is the mainstay treatment for inoperable patients. Within the last decade, SBRT has become increasingly used to treat high-risk operable patients who may otherwise be offered a compromise operation such as wedge resection, as well as standard-risk operable patients who would be able to tolerate lobectomy. The aim of this review is to discuss the current available data comparing SBRT and surgery with an emphasis on the ongoing randomized JoLT-Ca Sublobar Resection (SR) Versus Stereotactic Ablative Radiotherapy (SABR) for Lung Cancer (Stablemates) and veterans affairs lung cancer surgery or stereotactic radiotherapy (VALOR) studies.</p><p><strong>Methods: </strong>A search for studies comparing SBRT to surgery in early-stage NSCLC was conducted on PubMed. An emphasis was made on selecting publications between 2020 to 2024 to include the most recent studies on the topic. Meta-analyses, systematic reviews, propensity matched studies, retrospective reviews and national database analyses were included. ClinicalTrials.gov was searched for information pertaining to current randomized trials.</p><p><strong>Key content and findings: </strong>The majority of current data supports surgery over SBRT based on overall survival (OS), however, a direct comparison between the two has been challenging. Definitions for locoregional control, requirements of biopsy proven malignancy, the extent of surgical resection and mediastinal lymphadenectomy, and primary end points vary by study. Previous randomized controlled trials have failed to accrue, though two ongoing randomized studies, Stablemates (NCT02468024) and VALOR (NCT02984761), are nearing accrual which will better inform clinicians which treatment may be preferable to which patients.</p><p><strong>Conclusions: </strong>The current evidence favors surgery over SBRT for early-stage NSCLC in terms of OS, especially for standard-risk operable patients. For high-risk operable patients, surgery should still be considered standard of care, however the evidence is less clear, since many studies show similar recurrence rates. Based on the current evidence, we recommend surgical resection with mediastinal lymph node dissection for all patients with early-stage NSCLC who are operable. For patients medically unfit to undergo surgery, SBRT should be considered the standard of care.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 8","pages":"3153-3160"},"PeriodicalIF":3.5,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065628","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":"International cost-effectiveness analysis of durvalumab consolidation treatment after chemoradiotherapy for patients with limited-stage small-cell lung cancer.","authors":"Kun Liu, Youwen Zhu, Hong Zhu","doi":"10.21037/tlcr-2025-354","DOIUrl":"10.21037/tlcr-2025-354","url":null,"abstract":"<p><strong>Background: </strong>The recently conducted ADRIATIC trial demonstrated that adding durvalumab led to significant improvements in the survival of non-advanced limited-stage small cell lung cancer (LS-SCLC) following concurrent chemoradiotherapy (CCRT). While efficacious, immunotherapeutic drugs are associated with high costs. Therefore, the purpose of this study is to conduct pharmacoeconomic analyses of the cost-effectiveness of durvalumab consolidation treatment after CCRT for LS-SCLC from the perspective of payers in specific countries.</p><p><strong>Methods: </strong>The costs and efficacy of consolidation durvalumab versus placebo treatment following CCRT for LS-SCLC patients were analyzed using a three-state Markov model. The lifetime direct medical costs, incremental cost-effectiveness ratios (ICERs), incremental cost-utility ratios (ICURs), and incremental net-health benefit (INHB) associated with these treatment strategies were evaluated from the perspective of payers in China and the USA (the primary source countries for patients in the ADRIATIC trial) at respective willingness-to-pay (WTP) thresholds of $37,023 and $150,000 per quality-adjusted life-year (QALY). Sensitivity and subgroup analyses were used to assess model stability.</p><p><strong>Results: </strong>Durvalumab consolidation was associated with 2.24 and 2.80 incremental QALYs relative to placebo for patients in China and the USA, but it was also associated with significant increases in lifetime medical costs ($48,511 <i>vs.</i> $18,769 and $403,946 <i>vs.</i> $154,579), for corresponding ICURs of $13,257/QALY and $89,079/QALY in China and the USA. Sensitivity analyses supported the stability of the established model, while subgroup analyses indicated that durvalumab consolidation was recommended within 2 weeks of CCRT.</p><p><strong>Conclusions: </strong>Durvalumab consolidation following CCRT represents a cost-effective option for the treatment of LS-SCLC patients in China and the USA.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 8","pages":"2942-2953"},"PeriodicalIF":3.5,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065591","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":"Preoperative diagnostic accuracy of dominant lesion in multifocal pulmonary nodules.","authors":"Bowen Zhao, Xiaoyun Su, Yu Huang, Chi Zhang, Guanchao Ye, Junhua Wu, Shiwen Fan, Ming Chen, Kuo Li, Fan Yang, Guangyao Wu, Yongde Liao","doi":"10.21037/tlcr-2025-419","DOIUrl":"10.21037/tlcr-2025-419","url":null,"abstract":"<p><strong>Background: </strong>Due to the widespread implementation of computed tomography (CT) in lung cancer screening, multifocal pulmonary nodules (MPNs) are increasingly detected. Given the importance of selecting preoperative dominant lesions (DLs) in the management of MPNs, this study evaluates the diagnostic accuracy of commonly used approaches for assessment of preoperative DLs.</p><p><strong>Methods: </strong>Patients who underwent surgical resection and CT for MPNs from May 2019 to September 2023 were retrospectively collected from a single center. The postoperative DLs were determined based on the pathology results. Four methods were employed to identify preoperative DLs including diameter, Mayo model, Brock model, and Peking University multiple pulmonary nodules malignancy prediction model (PKU-M model) and the predictive results of these methods were compared with postoperative DLs. Subgroup analysis was conducted based on the type of nodules.</p><p><strong>Results: </strong>A total of 999 patients with 2,285 nodules were included in this study. The accuracy of the proposed methods including diameter, Mayo model, Brock model, and PKU-M model for the assessment of preoperative DLs were 81.09%, 78.69%, 81.73%, and 78.77%, respectively. Compared to the pathology results, the Kappa values for the four methods were 0.62, 0.51, 0.59, and 0.51, respectively. Among the three subgroups, four methods applied in subsolid nodule group demonstrated the best performance with accuracy of 83.07%, 77.88%, 81.90% and 72.59%, respectively.</p><p><strong>Conclusions: </strong>Current assessment approaches for identifying preoperative DLs still have room for improvement and further studies are warranted to develop a more effective approach for the assessment of preoperative DLs.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 8","pages":"3042-3053"},"PeriodicalIF":3.5,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065597","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":"Beyond the tumor: towards a cachexia-based host phenotype through body composition analysis in patients with resectable lung cancer.","authors":"Koen C H A Verkoulen, Lars Geenen, Aimée J P M Franssen, Anne M A Verzijl, Yvonne L J Vissers, Karel W E Hulsewé, Juliette H R J Degens, David P J van Dijk, Erik R de Loos","doi":"10.21037/tlcr-2025-511","DOIUrl":"10.21037/tlcr-2025-511","url":null,"abstract":"<p><p>Cancer cachexia, characterized by involuntary weight loss and extensive muscle and adipose tissue wasting, is a major contributor to morbidity and mortality in cancer patients. To date, no effective medical intervention can completely reverse this multifactorial syndrome, which is driven by different metabolic changes. Identification of cachectic patients is primarily based on alterations in body composition and the assessment of systemic metabolic and inflammatory changes. While these changes have been thoroughly described in patients with more advanced stages of lung cancer, their role in resectable lung cancer remains less explored. In this review, we summarize the different methods to assess body composition metrics such as skeletal muscle (SM) mass, fat distribution and overall body composition. As the dominant driver of cancer cachexia, we also describe the two most widely accepted acute phase proteins. Furthermore, we discuss the short and long-term clinical implications of cancer cachexia and the corresponding body composition and inflammatory changes in resectable lung cancer patients. Finally, we explore the possibility of identifying a specific host phenotype of cachectic lung cancer patients that predisposes to adverse outcomes of lung cancer surgery, which might enhance the predictive value for overall survival and aid in treatment decision-making in lung cancer patients in the future.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 8","pages":"3183-3195"},"PeriodicalIF":3.5,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065598","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":"Comparative investigation of neoadjuvant chemoimmunotherapy versus perioperative (chemo)immunotherapy in resectable non-small cell lung cancer: a real-world retrospective cohort study.","authors":"Yehao Yang, Sini Li, Qian Zhang, Wanchen Zhai, Haicheng Wu, Hui Li, Yun Fan","doi":"10.21037/tlcr-2025-301","DOIUrl":"10.21037/tlcr-2025-301","url":null,"abstract":"<p><strong>Background: </strong>In patients with resectable non-small cell lung cancer (NSCLC), recent clinical trials have highlighted the survival advantages conferred by chemoimmunotherapy in both the neoadjuvant and perioperative treatment settings. Despite these findings, a direct comparative analysis to discern the superior protocol between neoadjuvant and perioperative approaches remains an uncharted territory. Therefore, this study aimed to compare the efficacy of neoadjuvant chemoimmunotherapy (NT) and perioperative (chemo)immunotherapy (PT) in resectable NSCLC.</p><p><strong>Methods: </strong>We performed a single-center retrospective study at Zhejiang Cancer Hospital, identifying 318 patients who underwent surgical intervention for stages IB-IIIB NSCLC between 2019 and 2021, with participants stratified into two groups based on distinct treatment strategies: NT or PT. We employed propensity score matching (PSM) to adjust for confounding variables, and subsequently utilized Kaplan-Meier survival curves and Cox proportional hazards regression models to investigate the correlation between treatment regimens and survival at the postoperative mark.</p><p><strong>Results: </strong>Following PSM, 248 patients were included (NT, 124; PT, 124). Comparative analyses underscored the efficacy disparities between NT and PT. In the overall population analysis, the PT group demonstrated superior event-free survival (EFS) [hazard ratio (HR), 0.48; 95% confidence interval (CI), 0.29-0.78; P=0.003] and improved overall survival (OS) (HR, 0.43; 95% CI, 0.23-0.79; P=0.006) compared with the NT group. Notably, subgroup analyses revealed in patients without a pathological complete response (pCR), the PT group experienced significantly enhanced EFS with a 3-year EFS rate of 76.5% compared to 57.5% in the NT group (HR, 0.48; 95% CI, 0.28-0.83; P=0.008), as well as improved OS with a rate of 84.4% versus 71.7% (HR, 0.48; 95% CI, 0.24-0.94; P=0.03). However, no statistically significant differences in EFS and OS were observed between the two treatment groups among patients who achieved pCR. Additionally, PT significantly improved EFS and OS in stage IIIA-IIIB patient populations. Multivariate analyses further revealed pCR as an independent prognostic factor for longer EFS in stage IB-IIIB NSCLC patients (HR, 0.42; 95% CI, 0.22-0.80; P=0.009).</p><p><strong>Conclusions: </strong>Our study demonstrated that in comparison with NT, the PT approach can significantly enhance the survival prognosis for patients with resectable stage IB-IIIB NSCLC. Notably, patients without a pCR after surgery may stand to benefit more from the perioperative treatment approach.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 8","pages":"2954-2968"},"PeriodicalIF":3.5,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065664","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 systematic review and network meta-analysis of immune checkpoint inhibitors in operable NSCLC: neoadjuvant, adjuvant, or perioperative?","authors":"Fausto Petrelli, Lorenzo Dottorini, Mauro Rossitto, Fausto Meriggi, Sara Cherri, Alberto Zaniboni, Antonio Ghidini","doi":"10.21037/tlcr-2025-185","DOIUrl":"10.21037/tlcr-2025-185","url":null,"abstract":"<p><strong>Background: </strong>The optimal timing for immune checkpoint inhibitor (ICI) therapy in patients with operable non-small cell lung cancer (NSCLC) remains a subject of clinical uncertainty. This Bayesian network meta-analysis (NMA) aimed to compare the efficacy of ICIs administered in neoadjuvant, adjuvant, and perioperative settings.</p><p><strong>Methods: </strong>A systematic review of randomized controlled trials (RCTs) published up to September 1, 2024, identified eight eligible studies comprising a total of 3,659 patients. Primary outcomes included disease-free survival (DFS) and event-free survival (EFS). A Bayesian framework was used to estimate hazard ratios (HRs) and 95% credible intervals (CrIs), with treatment efficacy ranked using the surface under the cumulative ranking curve (SUCRA). Risk of bias was assessed using the Cochrane Risk of Bias tool, and sensitivity analyses confirmed the robustness of the findings after exclusion of studies at higher risk.</p><p><strong>Results: </strong>Perioperative ICIs demonstrated superior efficacy compared with neoadjuvant or adjuvant strategies. Specifically, perioperative toripalimab plus chemotherapy ranked first (SUCRA =0.99; rank 1 probability =87%), followed by perioperative nivolumab (SUCRA =0.94). Both regimens significantly reduced the risk of disease recurrence or progression compared to surgery alone or standard chemotherapy. While neoadjuvant and adjuvant ICIs provided moderate benefit, they ranked lower in overall efficacy. Sensitivity analyses excluding higher-risk studies did not substantially alter the results, confirming their robustness. No direct comparisons were available between all strategies, and heterogeneity in control arms, ICI agents, programmed death ligand-1 (PD-L1) inclusion thresholds, and follow-up duration limit cross-trial comparability. Additionally, long-term overall survival data were largely immature across studies.</p><p><strong>Conclusions: </strong>These findings suggest that perioperative administration of ICIs, particularly toripalimab and nivolumab in combination with chemotherapy, may offer the most effective approach to improving DFS/EFS in resectable NSCLC. However, further head-to-head trials, longer follow-up, and biomarker-stratified analyses are needed to confirm these results and guide personalized treatment decisions.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 8","pages":"3067-3075"},"PeriodicalIF":3.5,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065513","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 type 2 diabetes mellitus on systemic treatment for advanced non-small cell lung cancer.","authors":"Yasuhiro Kato, Eri Kuramochi, Rei Yamaguchi, Erika Mikami, Kaoruko Shinbu, Jyunichi Aoyama, Shunsuke Kobayashi, Fumitaka Okajima, Masahiro Seike, Tetsuya Okano","doi":"10.21037/tlcr-2025-302","DOIUrl":"10.21037/tlcr-2025-302","url":null,"abstract":"<p><strong>Background: </strong>The effect of type 2 diabetes mellitus (T2DM) on treatments for advanced non-small cell lung cancer (NSCLC) remains unelucidated. We aimed to assess the effect of T2DM on the treatment for advanced NSCLC.</p><p><strong>Methods: </strong>We retrospectively investigated clinicopathological character, treatment effect, and adverse events (AEs) in advanced NSCLC patients started on systemic treatment at Nippon Medical School Chiba-Hokusoh Hospital from 2018 to 2024.</p><p><strong>Results: </strong>The numbers of T2DM and non-T2DM patients among those undergoing immune checkpoint inhibitor (ICI) therapy, molecular targeted therapy (MTT), and cytotoxic chemotherapy (CTT) were 37 and 78, 30 and 86, 9 and 17, respectively. The overall survival (OS) of patients complicated T2DM was significantly worse in total (19.3 <i>vs</i>. 34.5 months, P=0.001), the ICI (11.5 <i>vs</i>. 34.2 months, P=0.005) and the MTT cohort (27.4 <i>vs</i>. 43.4 months, P=0.03). Median progression-free survival (PFS) was significantly poor for T2DM patients in the ICI cohort (5.7 <i>vs</i>. 12.5 months, P=0.04). However, a significant difference was not found for the MTT cohort (13.3 <i>vs</i>. 12.7 months, P=0.91). There were no significant differences in AEs in either cohort. Hemoglobin A1c (HbA1c) was significantly higher in patients with derived neutrophil lymphocyte ratio (dNLR) ≥3. The PFS in T2DM patients in the ICI cohort was investigated with regard to clinicopathological factors and T2DM treatments. Specialist consultation was identified as a factor that improved PFS of ICI.</p><p><strong>Conclusions: </strong>Our research suggests that T2DM is an independent poor prognostic factor in advanced NSCLC and affects ICI treatment.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 8","pages":"2928-2941"},"PeriodicalIF":3.5,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065656","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":"The evolution of chest tube management following lung cancer surgery: many options, scarce evidence.","authors":"Lars Geenen, Koen C H A Verkoulen, Aimée J P M Franssen, Juliette H R J Degens, Karel W E Hulsewé, Yvonne L J Vissers, Erik R de Loos","doi":"10.21037/tlcr-2025-507","DOIUrl":"10.21037/tlcr-2025-507","url":null,"abstract":"<p><p>After lung cancer surgery, a chest tube is routinely placed to prevent complications such as a pneumothorax or pleural effusion. However, chest tube placement often comes with patient discomfort, impaired mobilization, and prolonged hospitalization, necessitating improved chest drain policies to reduce drainage time or even omit chest drains. In recent years, extensive research has been conducted on chest tube removal criteria and the optimization of thoracic drainage strategies, particularly on the use of suction versus water seal and digital drainage systems versus analogue drainage systems. To date, no clear consensus has been reached on either removal criteria or optimal drainage technique, mostly due to conflicting study outcomes and a lack of high-quality evidence. This review aims to provide a comprehensive overview of the current understanding of thoracic drainage in the context of lung cancer surgery and to identify potential gaps in current knowledge. It outlines the historical development of thoracic drainage and describes key aspects of current drainage strategies, incorporating both evidence-based and expert-opinion-based findings. Furthermore, we propose several strategies how chest drainage techniques can continue to evolve and become less invasive with the introduction of the enhanced recovery after surgery (ERAS) protocol, and thereby explore the possibilities of omitting chest tubes after anatomical resection, as well as patient-specific drainage strategies. In conclusion, standardized definitions and removal criteria for chest drainage are crucial to unify and optimize postoperative care in thoracic surgery. Developing personalized, evidence-based strategies will improve patient outcomes and advance minimally invasive approaches within the ERAS pathways.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 8","pages":"3161-3169"},"PeriodicalIF":3.5,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065710","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":"The role of immunogenic cell death in the prognosis and development of treatment strategies for non-small cell lung cancer: a multiomics and machine learning approach for predictive and personalized treatment.","authors":"Yichen Sun, Hao Chen, Zhaoyang Wang, Rui Jiao, Franz Zehentmayr, Fabrizio Tabbò, Chengyang Wu, Tao Zhang, Hanyu Yan, Jian Wang, Xiaolong Yan","doi":"10.21037/tlcr-2025-769","DOIUrl":"10.21037/tlcr-2025-769","url":null,"abstract":"<p><strong>Background: </strong>Non-small cell lung cancer (NSCLC) is the predominant histological subtype of lung cancer, whose diverse genomic landscape complicates prognosis and outcome prediction. In this context, immunogenic cell death (ICD), a distinct mechanism of cell death, may exert important antitumor effects. However, the specific role of ICD in NSCLC has not been clarified, and there is no suitable method for using ICD to achieve the treatment and prognosis assessment of NSCLC. The purpose of the current research is to develop a new approach to predict the survival prognosis and response to chemotherapy and targeted therapy in patients with NSCLC.</p><p><strong>Methods: </strong>We used 101 combinations of 10 machine learning algorithms to construct an ICD-related signature (ICDRS). The predictive potential of this specific ICDRS for immune cell infiltration and therapeutic response was evaluated. We also examined the molecular mechanisms underlying the various responses of different ICDRS subpopulations, characterized the mutational landscape and tumor mutational burden (TMB), and assessed the applicability of the ICDRS in single-cell transcriptomic datasets. Gene expression patterns were subsequently validated with quantitative real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC).</p><p><strong>Results: </strong>We screened out five key ICDRS genes (<i>MMP14, ALDH2, FBP1, HLA-DRA, KCTD12</i>). Patients were classified into high-risk and low-risk groups according to the ICDRS score determined by the expression levels of these five genes. The high-risk group exhibited less favorable prognoses compared with the low-risk group, which demonstrated more positive outcomes. The low-risk group had more anticancer immune-cell infiltration and showed better response to chemotherapy and targeted therapy than the high-risk group (P<0.05).</p><p><strong>Conclusions: </strong>The ICDRS exhibited excellent predictive performance and broad applicability, suggesting it as a powerful tool for prognosis and therapy response. The current study may contribute to more adequate patient selection in the context of tailored therapies.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 8","pages":"3107-3125"},"PeriodicalIF":3.5,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065190","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 narrative review of immunotherapy for non-small cell lung cancer: current progress, sensitization approaches, and synergistic strategies.","authors":"Lu Zhou, Takehiro Uemura, Baptiste Abbar, Senyi Deng","doi":"10.21037/tlcr-2025-754","DOIUrl":"10.21037/tlcr-2025-754","url":null,"abstract":"<p><strong>Background and objective: </strong>With increasing understanding of tumor immune tolerance mechanisms, a series of immune checkpoint molecules have been identified. Immune checkpoint blockade (ICB) therapy, which was developed based on these discoveries, has emerged as a promising strategy for the clinical treatment of non-small cell lung cancer (NSCLC), and has shown notable therapeutic benefits. However, the limited response rate remains a major barrier to further improving ICB efficacy and poses a significant challenge to the clinical management of NSCLC. This review summarizes recent advances in clinical immunotherapy for NSCLC and discusses future prospects in the field.</p><p><strong>Methods: </strong>A systematic literature search was performed using the official websites of organizations and databases, including PubMed, the United States (US) Food and Drug Administration (FDA), China's National Medical Products Administration (NMPA), the National Cancer Institute (NCI), the National Comprehensive Cancer Network (NCCN), the Chinese Society of Clinical Oncology (CSCO), the American Society of Clinical Oncology (ASCO), and the European Society for Medical Oncology (ESMO) The inclusion criteria were: (I) English-language articles published between 2004 and 2025; and (II) clinical studies specifically addressing immune checkpoint inhibitor (ICI) therapy in NSCLC populations.</p><p><strong>Key content and findings: </strong>Researchers have explored various approaches from drug development and treatment response evaluation to combination strategies, and have made substantial progress in enhancing the effectiveness of ICB therapy.</p><p><strong>Conclusions: </strong>ICB therapy for NSCLC has evolved from monotherapy to multimodal combination approaches, and significant breakthroughs have been achieved; however, three major challenges persist; that is, acquired drug resistance, a lack of reliable biomarkers, and the suboptimal management of special patient populations. To address these issues, future research should focus on: (I) elucidating resistance mechanisms through multi-omics approaches; (II) developing novel biomarkers and next-generation targeted agents; and (III) refining combination therapy regimens. These coordinated efforts will ultimately enable personalized precision immunotherapy tailored to individual patients' molecular profiles and clinical characteristics.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 8","pages":"3249-3269"},"PeriodicalIF":3.5,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065493","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}