Translational lung cancer research最新文献

{"title":"One-year mortality risk prediction model for patients with interstitial lung disease and lung cancer.","authors":"Xiaorui Ding, Wanqing Zhou, Guanning Zhong, Ranxun Chen, Qingqing Xu, Lulu Chen, Yingwei Zhang, Yi Zhuang, Liyun Miao, Jinghong Dai","doi":"10.21037/tlcr-2025-235","DOIUrl":"10.21037/tlcr-2025-235","url":null,"abstract":"<p><strong>Background: </strong>The association of interstitial lung disease (ILD) with lung cancer (LC) has generated increased research interest in recent years. We aimed to characterize the clinical features and prognostic factors of patients with ILD and LC and to develop a 1-year mortality risk prediction model for these patients.</p><p><strong>Methods: </strong>The retrospective study enrolled patients with ILD and LC admitted to Nanjing Drum Tower Hospital from 2017 to 2022. The demographic data, histological type and staging of LC, high-resolution computed tomography (HRCT) patterns of ILD, laboratory examinations, and therapeutic and follow-up information were collected. The primary endpoint for the prediction model was all-cause 1-year mortality. Logistic regression analysis was used to identify risk predictors and further establish a nomogram to predict 1-year mortality. Area under the curve (AUC), calibration curves, and decision curves were used to assess the utility of the nomogram.</p><p><strong>Results: </strong>A total of 206 patients with concurrent ILD and LC were included. Adenocarcinoma was the most common pathological subtype (94/206, 45.6%), followed by squamous cell carcinoma (55/206, 26.7%) and small-cell lung cancer (SCLC) (42/206, 20.4%). Moreover, 43.7% (90/206) of tumors were located inside ILD lesions. Among the patients with non-small cell lung cancer (NSCLC), 90 were diagnosed with advanced-stage disease (> stage IIIA) while 28 patients with SCLC were at the extensive phase. The most common HRCT pattern of ILD was usual interstitial pneumonia (UIP) (102/206, 49.5%). The all-cause 1-year mortality rate was 41.3%. The prediction model incorporated age, sex, neutrophil count, and lactate dehydrogenase (LDH) and albumin (Alb) levels. The AUC values in training and internal validation sets were 0.775 and 0.716 respectively. Calibration curves indicated strong consistency, and decision curves confirmed the clinical net benefit achievable at different risk thresholds.</p><p><strong>Conclusions: </strong>We developed a 1-year mortality risk prediction model for patients with concurrent ILD and LC to identify those with high risk of death and facilitate precise management. Future multicenter studies are needed for further external validation.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1786-1803"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326956","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":"Sacituzumab govitecan: a new hope for patients with pretreated extensive small-cell lung cancer (SCLC)-insights from the TROPiCS-03 trial.","authors":"Baptiste Abbar, Frank Aboubakar Nana, Jean Philippe Spano, Jacques Cadranel, Paul Gougis","doi":"10.21037/tlcr-2025-216","DOIUrl":"10.21037/tlcr-2025-216","url":null,"abstract":"","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1887-1891"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326966","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":"Ivonescimab plus chemotherapy in advanced or metastatic non‑squamous non‑small cell lung cancer with EGFR variant in China: a cost-effectiveness analysis.","authors":"Rong Long, Weilu Kuang, Qin Zhou","doi":"10.21037/tlcr-2024-1053","DOIUrl":"10.21037/tlcr-2024-1053","url":null,"abstract":"<p><strong>Background: </strong>A highly anticipated multicenter phase 3 HARMONi-A study (NCT05184712) showed that ivonescimab plus chemotherapy greatly enhanced progression-free survival (PFS) in individuals with non‑squamous non-small cell lung cancer (nsq-NSCLC) after treatment with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) with an acceptable safety profile. This investigation systematically analyzed the cost-effectiveness of treating advanced/metastatic nsq-NSCLC with EGFR mutations with a combination of ivonescimab and chemotherapy from the standpoint of the Chinese healthcare system.</p><p><strong>Methods: </strong>A decision-embedded Markov model with three specific health states was established for predicting the economic and health outcomes associated with ivonescimab plus chemotherapy or chemotherapy alone over a 10-year time frame. The key health outcomes in the study included life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), and incremental net health benefits (INHBs). Extensive sensitivity analyses were performed to assess the stability and uncertainty of the model with parameter adjustments. Additionally, cohort analyses for relevant subgroups were performed.</p><p><strong>Results: </strong>The base-case overall cost (efficacy) of ivonescimab plus chemotherapy was $41,354 (0.90 QALYs), which was more than $35,166 and 0.13 QALYs of chemotherapy alone. This yielded an ICER of $277,594 per additional QALY with a corresponding INHB of -0.82 QALYs, which was significantly higher than the willingness-to-pay (WTP) threshold of $36,997/QALY in China. The sensitivity analyses indicated that the ivonescimab cost was the dominant driver for ICER, while the model results remained stable irrespective of variations in the model parameters within given ranges.</p><p><strong>Conclusions: </strong>The findings indicate that for Chinese patients with nsq-NSCLC with EGFR who did not respond to EGFR-TKI therapy, the ivonescimab-chemotherapy combination is not cost-effective in the absence of price adjustment or any current charitable aid program.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1622-1634"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326954","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":"Outcomes of chemotherapy with or without immunotherapy in older patients with non-small cell lung cancer and low PD-L1 expression.","authors":"Hayato Kawachi, Tae Hata, Tadaaki Yamada, Yasuhiro Goto, Akihiko Amano, Yoshiki Negi, Satoshi Watanabe, Naoki Furuya, Tomohiro Oba, Tatsuki Ikoma, Akira Nakao, Keiko Tanimura, Hirokazu Taniguchi, Akihiro Yoshimura, Tomoya Fukui, Daiki Murata, Kyoichi Kaira, Shinsuke Shiotsu, Makoto Hibino, Asuka Okada, Yusuke Chihara, Takashi Kijima, Koichi Takayama","doi":"10.21037/tlcr-2024-1236","DOIUrl":"10.21037/tlcr-2024-1236","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) in combination with chemotherapy have demonstrated efficacy in the treatment of non-small cell lung cancer (NSCLC) with a programmed death ligand 1 (PD-L1) tumor proportion score (TPS) of 1-49%. However, older patients remain underrepresented in clinical trials, and optimal treatment strategies for this population remain unclear. This study sought to evaluate the efficacy and safety of first-line treatment with either platinum-based chemotherapy alone (Chemo) or in combination with ICIs (ICI/Chemo) in older patients with NSCLC who have low PD-L1 expression.</p><p><strong>Methods: </strong>This retrospective multicenter study included patients diagnosed with advanced NSCLC (stage IIIB-IV) with a PD-L1 TPS of 1-49% from 19 Japanese institutions. We examined the relationship between baseline patient characteristics and treatment outcomes within each group. Propensity score matching (PSM) was used to balance patient characteristics between the ICI/Chemo and Chemo groups.</p><p><strong>Results: </strong>We evaluated data from 613 patients, finding that the ICI/Chemo group (n=370) exhibited significantly longer median progression-free survival (PFS) and overall survival (OS) compared to the Chemo group (n=243). Among the 613 patients, 152 were aged ≥75 years. Of these, 63 received Chemo, while 89 underwent ICI/Chemo as first-line treatment. In this older cohort, ICI/Chemo significantly improved median PFS; however, no significant difference was observed in OS. Nonetheless, the incidence of grade ≥3 adverse events and pneumonitis of any grade was higher in the ICI/Chemo group compared to the Chemo group among older patients. Multivariate analysis using Cox proportional hazards models indicated that Eastern Cooperative Oncology Group performance status (ECOG PS) was significantly associated with PFS and OS. In older patients with ECOG PS 0, ICI/Chemo showed significant PFS benefits; in those with ECOG PS 1, both the PFS and OS were similar between the two groups.</p><p><strong>Conclusions: </strong>ICI combined with chemotherapy may be a potentially effective treatment strategy for older patients with NSCLC and low PD-L1 expression. However, compared with the overall population, the benefits of adding ICI to chemotherapy were decreased, while the risk of toxicity may increase, making appropriate patient selection crucial for this population. Particularly, in patients with ECOG PS 1, the additional benefit of ICI over chemotherapy was minimal in terms of efficacy, suggesting that the introduction of ICI combined with chemotherapy should be carefully considered for this patient population.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1558-1568"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326959","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":"Perioperative immunochemotherapy in stage IIIA non-small cell lung cancer: insights on the path forward.","authors":"Junichi Soh","doi":"10.21037/tlcr-2025-202","DOIUrl":"10.21037/tlcr-2025-202","url":null,"abstract":"","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1882-1886"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326961","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":"Surgery without distance: will 5G-based robot-assisted telesurgery redefine modern surgery?","authors":"Xin Xie, Yu Tian, Jia Huang, Qingquan Luo, Tianxiang Chen","doi":"10.21037/tlcr-2025-16","DOIUrl":"10.21037/tlcr-2025-16","url":null,"abstract":"<p><p>The rapid advancement of the 5G technology is catalyzing a paradigm shift in the realm of remote surgery, offering the potential to overcome geographical constraints and to realize optimized allocation of global healthcare resources. We review the evolution of telesurgery, from early pioneering efforts to recent advancements made possible by 5G networks, which offer low latency and high data transfer speeds crucial for real-time surgical operations. Thus, 5G facilitates seamless transmission of control signals, images, and audio, allowing surgeons to perform complex procedures remotely with unprecedented precision. Notable achievements in telemedicine demonstrate the feasibility and safety of this cutting-edge approach. Despite these milestones, challenges such as network reliability, cybersecurity concerns, and the need for standardized global protocols remain critical barriers that impede the broad implementation worldwide. Moreover, ethical considerations surrounding patient autonomy, informed consent, liability assignment, regulatory approval, and data privacy framework in cross-border telesurgery require careful attention. The development of regional robotic surgery centers powered by 5G, alongside advancements in artificial intelligence, holds promise for bridging healthcare disparities and enhancing the precision of remote surgical procedures. As these technologies mature, they have great potential to redefine the landscape of surgery, ushering in an era of more accessible, collaborative, and efficient healthcare delivery worldwide.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1821-1829"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326967","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":"Chinese expert consensus on shape-sensing robotic-assisted bronchoscopy (ssRAB) in the management of peripheral pulmonary lesions.","authors":"Fangfang Xie, Chunxi Zhang, Chun Li, Dan Liu, Quncheng Zhang, Chuanyong Mu, Gang Hou, Manxiang Li, Chunli Tang, Fei Xu, Hong Chen, Zhongbo Chen, Ye Gu, Zhenbiao Guan, Cheng Ji, Haitao Li, Wei Li, Xuan Li, Yishi Li, Hairong Lian, Jiangrong Liao, Zhuang Luo, Haifeng Ouyang, Yongchun Shen, Yiwei Shi, Nansheng Wan, Tao Wang, Hong Wang, Huaqi Wang, Juan Wang, Jingxiang Wu, Xuemei Wu, Yang Xia, Kui Xiao, Wujian Xu, Huizhen Yang, Junyong Yang, Taosheng Ye, Xianwei Ye, Pengfei Yu, Nan Zhang, Peng Zhang, Qi Zhao, Xiaoxuan Zheng, Jun Zou, Enguo Chen, Hao Zhang, Jiayuan Sun","doi":"10.21037/tlcr-2025-400","DOIUrl":"10.21037/tlcr-2025-400","url":null,"abstract":"<p><strong>Background: </strong>Shape-sensing robotic-assisted bronchoscopy (ssRAB) is a new bronchoscopy technology that utilizes optic fibers to provide accurate position information and robotic-control to deliver improved maneuverability. This technology has been used in the United States since 2019 and investigated in China since 2021. In order to provide a standard practice and make the best use of this technology for managing peripheral pulmonary lesions (PPLs), experts developed the consensus.</p><p><strong>Methods: </strong>This consensus was developed using Delphi method. A panel comprising nine experts formulated eight consensus statements after a thorough review of clinical evidence and practical experience. During the second phase, a questionnaire was distributed to collect feedback on these statements from an external panel of 39 physicians. The percentage of responses and the percentage of agreement on each statement were calculated. The consensus was defined as achieved with an agreement percentage threshold of 80% or above.</p><p><strong>Results: </strong>The eight consensus statements formulated in phase 1 included recommendations for path planning, anesthesia, the use of radial endobronchial ultrasound (EBUS), the use of fluoroscopy and/or cone-beam computed tomography (CBCT) with ssRAB, solving computed tomography (CT)-to-body divergence, the use of sampling tools with ssRAB, cloud biopsy, and the use of rapid on-site evaluation (ROSE) with ssRAB. All panel physicians completed the questionnaire in phase 2. All the statements achieved positive consensus, with six receiving 100% agreement and two reaching 97.4% agreement.</p><p><strong>Conclusions: </strong>The document establishes a consensus on recommended practices for optimal utilization of ssRAB technology in the management of PPLs. The guidelines will be updated as new evidence emerges or additional ssRAB platforms are introduced into practice.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1500-1515"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326924","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":"Radial endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) enhances diagnostic yield in pulmonary nodule biopsy.","authors":"Rong Lih Ho, Joong Hyun Ahn, Jung Ho Han, Junsu Choe, Sun Hye Shin, Byeong-Ho Jeong, Sang-Won Eom, Hojoong Kim, Kyungjong Lee","doi":"10.21037/tlcr-2025-68","DOIUrl":"10.21037/tlcr-2025-68","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing pulmonary lesions remains challenging despite various modalities. The PeriView Flex aspiration needle offers a promising solution to forceps biopsy limitations. This study aims to assess whether combining radial endobronchial ultrasound (rEBUS)-guided transbronchial needle aspiration (TBNA) and transbronchial lung biopsy (TBLB) may enhance tissue acquisition for inaccessible lesions using forceps.</p><p><strong>Methods: </strong>This retrospective study included 33 patients with pulmonary lesions who underwent a combination of rEBUS-guided TBNA and TBLB between September 2023 and August 2024. Diagnostic yields were calculated using a strict definition and were compared with those of propensity score-matched controls who underwent rEBUS-guided TBLB alone.</p><p><strong>Results: </strong>The median age of the cohort was 68 years, with a male-to-female ratio of 1.2:1.0. About 65% of lesions were in the outer two-thirds of the thorax, with a median size of 16.75 mm (interquartile range: 13.00-23.88 mm). Most lesions were solid (81.8%), followed by consolidation (9.1%), part-solid (6.1%) and cavitary lesions (3%). In our cohort, 21.2% had type Ia and 15.2% had type Ib, classified as favorable bronchial patterns on computed tomography (CT). However, approximately two-thirds had unfavorable bronchial patterns, including type Ic (12.1%), IIa (45.5%), and IIb (6.1%). An adjacent rEBUS view was present in 52% of the cases. The combined TBNA-TBLB approach achieved a diagnostic yield of 66.7%, which was highest in CT bronchus types Ia and Ib (83.3%) and lowest in types Ic, IIa, and IIb (57.1%). Propensity score matching (1:3) showed a higher diagnostic yield with TBNA-TBLB (66.7%) than with TBLB alone (48.5%), P=0.10. Post-procedural pneumothorax occurred in one patient (3.0%) in TBNA-TBLB group compare to 2.3% in TBLB group.</p><p><strong>Conclusions: </strong>Adding TBNA to TBLB improved the diagnostic yield for pulmonary nodules with adjacent or tunnel-type bronchi. This combined approach offers a practical strategy for enhancing diagnostic accuracy.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1611-1621"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326964","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 Bayesian deep learning model with consolidation-to-tumor ratio (CTR) prior revolutionizes the prediction of spread through air spaces (STAS) in stage IA lung adenocarcinoma: a large-scale diagnostic study.","authors":"Jie Cao, Nan Chen, Lingyu Zhou, Le Yi, Zhiyu Peng, Lin Qiu, Haokun Wu, Xiyue Tan, Kunhao Wu, Huahang Lin, Zhaokang Huang, Zetao Liu, Chenglin Guo, Xiuyuan Xu, Zhang Yi, Jiandong Mei","doi":"10.21037/tlcr-24-890","DOIUrl":"10.21037/tlcr-24-890","url":null,"abstract":"<p><strong>Background: </strong>The preoperative prediction of spread through air spaces (STAS) in patients with early-stage lung adenocarcinoma (LUAD) is crucial for selecting the appropriate surgical approach and improving patient outcomes. Previous research has confirmed that there is a significant correlation between consolidation-to-tumor ratio (CTR) and STAS. This study aimed to develop a Bayesian deep learning (DL) model based on the CTR prior to predict STAS in patients with stage IA LUAD.</p><p><strong>Methods: </strong>This large-scale diagnostic study included patients with solitary primary invasive LUAD who underwent complete resection between November 2017 and October 2023. Enrolled patients were randomly assigned to training, validation, and test cohorts in a 7:2:1 ratio. Using a variational Bayesian inference framework, we developed a DL model based on the CTR prior (STAS-DL_{Prior CTR}). The performance of STAS-DL_{Prior CTR} was compared with another DL model without the CTR prior (STAS-DL_{Non-prior CTR}) using the receiver operating characteristic (ROC) curve, calibration curve, decision curve analysis (DCA), and clinical impact curve (CIC).</p><p><strong>Results: </strong>A total of 1,374 patients were included, with 961 in the training cohort, 275 in the validation cohort, and 138 in the test cohort. The results showed that CTR in the STAS-positive group was significantly higher than that in the STAS-negative group [0.63 (interquartile range, 0.36, 0.98) <i>vs</i>. 0.35 (interquartile range, 0.19, 0.60), P<0.001]. Compared to STAS-DL_{Non-prior CTR}, the area under the ROC curve (AUC) tends to be higher for STAS-DL_{Prior CTR} (0.831 <i>vs</i>. 0.731, P=0.06) in the validation cohort, and STAS-DL_{Prior CTR} demonstrated a significantly higher AUC (0.858 <i>vs</i>. 0.637, P=0.008) in the test cohort. Additionally, the calibration curve suggested better calibration for STAS-DL_{Prior CTR}. DCA and CIC also indicated that STAS-DL_{Prior CTR} conferred higher clinical net benefit.</p><p><strong>Conclusions: </strong>The proposed model based on the CTR prior offers significant advantages in predicting STAS in patients with stage IA LUAD, and incorporating doctors' knowledge as priors can effectively guide the development of DL models.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1516-1530"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326920","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 effectiveness of pembrolizumab-chemotherapy versus chemotherapy with/without bevacizumab in unresectable, locally advanced or metastatic non-small cell lung cancer: a Chinese multicenter real-world analysis emphasizing PD-L1-negative populations.","authors":"Xiaobei Guo, Hui Zhang, Yuequan Shi, Qi He, Anwen Liu, Zhimin Zeng, Jinghui Wang, Song Wei, Tong Zhang, Cuimin Ding, Jian Fang, Xiaoling Chen, Paul Van Schil, Haoran Zhang, Junyi Pang, Minjiang Chen, Jing Zhao, Wei Zhong, Zhen Huo, Yan Xu, Mengzhao Wang","doi":"10.21037/tlcr-2025-271","DOIUrl":"10.21037/tlcr-2025-271","url":null,"abstract":"<p><strong>Background: </strong>Current limited evidence suggests that the use of pembrolizumab combined with chemotherapy may be effective for treatment-naïve patients with metastatic non-small cell lung cancer (NSCLC) and negative programmed cell death ligand 1 (PD-L1) expression, but real-world data are relatively scarce. This retrospective cohort study analyzed the efficacy, adverse events, and prognostic factors in these patients treated with chemotherapy with or without pembrolizumab.</p><p><strong>Methods: </strong>This retrospective study analyzed the data of patients with unresectable, locally advanced or metastatic NSCLC without sensitive epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) or proto-oncogene receptor tyrosine kinase (ROS1) alterations who had negative PD-L1 expression and received first-line pembrolizumab plus chemotherapy (the Pembro group) or platinum-based dual chemotherapy with or without bevacizumab (the Chemo group). The efficacy outcomes and safety profiles of the two groups were compared.</p><p><strong>Results: </strong>The study included 246 patients (Pembro group, n=114; Chemo group, n=132). The median follow-up period was 28.3 months. The Pembro group significantly prolonged progression-free survival (PFS) compared with the Chemo group [9.5 months, 95% confidence interval (CI): 7.5-11.5 <i>vs</i>. 7.2 months, 95% CI: 5.7-8.7; hazard ratio (HR) =0.64, 95% CI: 0.46-0.87; P=0.004]. Squamous cell lung cancer (SCC) patients demonstrated substantial PFS benefit (13.8 months, 95% CI: 3.2-24.1 <i>vs</i>. 4.8 months, 95% CI: 3.4-6.2; P<0.001), while non-SCC patients showed comparable PFS (9.3 months, 95% CI: 7.6-11.0 <i>vs</i>. 8.0 months, 95% CI: 6.0-10.0; P=0.56). Overall survival (OS) favored the Pembro group (21.2 months, 95% CI: 16.0-26.4 <i>vs</i>. 20.1 months, 95% CI: 15.5-24.7; HR =0.71, 95% CI: 0.50-1.00; P=0.052). The SCC patients in the Pembro group demonstrated a significant survival benefit with a median OS that was not reached, compared to 14.2 months (95% CI: 6.3-22.1) in the chemo group (HR =0.42, 95% CI: 0.22-0.78; P=0.007). Grade ≥3 non-immune-related adverse events (non-irAEs) occurred more often in the Pembro group (46.8%) than the Chemo group (33.1%, P=0.03). Moreover, 45 (39.5%) patients experienced 63 irAEs, and no grade 5 or new irAEs were observed.</p><p><strong>Conclusions: </strong>Pembrolizumab combined with chemotherapy may prolong survival in patients with PD-L1-negative advanced NSCLC, particularly those with squamous histology.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1804-1820"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326927","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}