Translational lung cancer research最新文献

{"title":"A structural dose-response relationship between lymph node yield and survival after anatomical segmentectomy for early-stage NSCLC: a SEER-based retrospective cohort study.","authors":"Ye Tian, Edoardo Zanfrini, Etienne Abdelnour-Berchtold, Jean Yannis Perentes, Thorsten Krueger, Michel Gonzalez","doi":"10.21037/tlcr-2026-0850","DOIUrl":"https://doi.org/10.21037/tlcr-2026-0850","url":null,"abstract":"<p><strong>Background: </strong>Adequate lymph node evaluation is central to oncologic segmentectomy for early-stage non-small cell lung cancer (NSCLC), yet the quantitative relationship between lymph node yield and survival remains unclear. This study aimed to evaluate the association between regional lymph node yield and overall survival after segmentectomy for early-stage NSCLC.</p><p><strong>Methods: </strong>Using Surveillance, Epidemiology, and End Results (SEER) (2000-2022), we identified patients with NSCLC undergoing anatomical segmentectomy and clinical N0M0 disease with tumors ≤30 mm. Regional lymph node yield (\"regional nodes examined\") was analyzed as 0, 1-5, 6-10, and >10 nodes, and continuously using restricted cubic splines. Overall survival (OS) was evaluated with Kaplan-Meier and multivariable Cox regression. Lung cancer-specific death was assessed using Fine-Gray competing-risk models.</p><p><strong>Results: </strong>A total of 2,217 patients met inclusion criteria (median follow-up 58 months), with 783 deaths during follow-up. OS differed significantly across lymph node yield groups (log-rank P<0.001). Five-year OS increased stepwise with higher yield, from 52.5% for 0 nodes to 65.9% for 1-5 nodes, 77.4% for 6-10 nodes, and 83.9% for >10 nodes. In multivariable Cox models, higher yields were independently associated with lower all-cause mortality: 1-5 nodes, hazard ratio (HR) =0.79 [95% confidence interval (CI): 0.67-0.94]; 6-10 nodes, HR =0.55 (95% CI: 0.44-0.70), and >10 nodes, HR =0.40 (95% CI: 0.30-0.52) (all P≤0.006; P for trend <0.001). Restricted cubic spline analysis supported a continuous association between yield and mortality risk without strong evidence of non-linearity (P overall <0.001; P non-linearity =0.27). The association was consistent across age (<70 <i>vs.</i> ≥70 years) and tumor size strata (T1a-c), without significant interaction.</p><p><strong>Conclusions: </strong>In SEER patients undergoing anatomical segmentectomy for clinical N0M0 NSCLC ≤30 mm, higher regional lymph node yield demonstrated a dose-response association with higher OS and lower lung cancer-specific mortality. These findings support lymph node yield as a pragmatic marker of nodal evaluation during segmentectomy.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 9","pages":"277"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184240","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 T-cell exhaustion-related signature for predicting response to immunotherapy among patients with lung adenocarcinoma.","authors":"Chengcheng Yang, Zefeng Wang, Jintao Xie, Huanhuan Zhao, Tianqi Song, Shiqi Luo, Xinyan Wang","doi":"10.21037/tlcr-2026-1101","DOIUrl":"https://doi.org/10.21037/tlcr-2026-1101","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Lung adenocarcinoma (LUAD) remains a leading cause of cancer-related mortality, and although immunotherapy has improved outcomes for a proportion of patients, reliable predictive biomarkers of response are lacking. T-cell exhaustion-associated transcriptional states are increasingly recognized as relevant to antitumor immunity, yet their prognostic and predictive associations in LUAD remain incompletely defined. The aim of this study was to evaluate transcription factors previously linked to T-cell exhaustion and to construct a prognostic gene signature for stratifying patients with LUAD and estimating potential benefit from immunotherapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Ten transcription factors previously linked to T-cell exhaustion were identified from the literature. Using LUAD transcriptomic data, we evaluated their prognostic relevance and identified four factors associated with overall survival (OS). Based on these, patients were divided into high- and low-risk exhaustion groups, and differentially expressed genes (DEGs) were derived. Univariate Cox regression and least absolute shrinkage and selection operator (LASSO) Cox analysis were applied to screen prognosis-related DEGs, through which a six-gene T-cell exhaustion-related prognostic score (TEXRGPS) was constructed. The expression of these six genes was validated via reverse-transcription quantitative polymerase chain reaction (RT-qPCR) in 20 pairs of LUAD and adjacent normal tissues from our hospital. Associations of TEXRGPS with clinical characteristics, immune cell infiltration, and predicted response to immune checkpoint inhibitors (ICIs) were also assessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Four of the ten transcription factors were associated with prognosis and were used to stratify patients. Six key DEGs-&lt;i&gt;CCL19&lt;/i&gt;, &lt;i&gt;CD79A&lt;/i&gt;, &lt;i&gt;CHRDL1&lt;/i&gt;, &lt;i&gt;MS4A1&lt;/i&gt;, &lt;i&gt;S100P&lt;/i&gt;, and &lt;i&gt;SFTPC&lt;/i&gt;-were selected to construct the TEXRGPS. RT-qPCR confirmed differential expression between tumor and adjacent non-tumor tissues. A high TEXRGPS was associated with adverse clinical features and poor prognosis, whereas a low TEXRGPS was associated with prolonged survival. The TEXRGPS was negatively correlated with the estimated infiltration of multiple immune cell types, including CD8&lt;sup&gt;+&lt;/sup&gt; T cells and dendritic cells. Low-risk patients had higher computationally predicted sensitivity to anti-PD-1/PD-L1 and anti-CTLA-4 therapies than high-risk patients. These retrospective associations require prospective validation before clinical application.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The TEXRGPS was associated with prognosis, computational estimates of immune infiltration, and predicted immunotherapy response in retrospective LUAD cohorts. The signature may support future risk-stratification research, but it does not establish a direct functional relationship between the selected genes and exhausted T cells. Prospective multicenter validation, together with sing","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 9","pages":"288"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184264","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 different <i>TP53</i> mutation subtypes on response and outcome in advanced lung adenocarcinoma receiving first-line immunotherapy or chemo-immunotherapy.","authors":"Xiru Quan, Wendi Xuzhang, Shengping Shen, Ying Yang, Yongfeng Yu, Shun Lu","doi":"10.21037/tlcr-2026-0824","DOIUrl":"https://doi.org/10.21037/tlcr-2026-0824","url":null,"abstract":"<p><strong>Background: </strong>Immunotherapy, either as a monotherapy or in combination with chemotherapy, has become the standard first-line treatment for advanced lung adenocarcinoma (LUAD) without driver mutations. Although <i>TP53</i> is frequently mutated in LUAD, the clinical significance of different <i>TP53</i> mutation subtypes in the setting of first-line immunotherapy remains poorly defined. This study aimed to evaluate the association between <i>TP53</i> mutation subtypes and treatment outcomes in patients with locally advanced or metastatic LUAD receiving first-line immunotherapy or chemo-immunotherapy.</p><p><strong>Methods: </strong>A total of 129 locally advanced or metastatic LUAD patients with <i>TP53</i> mutations receiving first-line immunotherapy or chemo-immunotherapy between January 2018 and November 2022 at Shanghai Chest Hospital were retrospectively analyzed. <i>TP53</i> mutation status was confirmed by next-generation sequencing (NGS). Kaplan-Meier analysis and Cox proportional hazards model were employed to analyze the effect of <i>TP53</i> mutation subtypes on treatment outcomes.</p><p><strong>Results: </strong><i>TP53</i> mutations were categorized into four groups: missense, nonsense, frameshift, and others. Missense mutations were the most frequent subtype (78/129, 60.5%), followed by frameshift (23/129, 17.8%), nonsense (18/129, 14.0%), and others (10/129, 7.8%). Patients with <i>TP53</i> frameshift mutations exhibited worse progression-free survival (PFS) (median PFS, 6.0 <i>vs.</i> 13.5 months; P=0.002) and overall survival (OS) (median OS, 13.3 <i>vs.</i> 39.9 months; P<0.001) than those with non-frameshift mutations. A significantly higher proportion of patients in the frameshift group experienced progressive disease (PD) as their best overall response than in the non-frameshift group (30.4% <i>vs.</i> 7.6%, P=0.006). In multivariate analysis, <i>TP53</i> frameshift mutations remained independently associated with inferior PFS [hazard ratio (HR) =2.229, 95% confidence interval (CI): 1.337-3.715, P=0.002] and OS (HR =3.278, 95% CI: 1.730-6.210, P<0.001).</p><p><strong>Conclusions: </strong>In this retrospective cohort, <i>TP53</i> frameshift mutations were associated with poorer survival in patients with advanced LUAD receiving first-line immunotherapy or chemo-immunotherapy, suggesting distinct prognostic implications across <i>TP53</i> mutation subtypes.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 9","pages":"271"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184542","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":"Regional disparities in lung cancer surgery and survival in South Korea: a nationwide population-based retrospective cohort study using linked cancer registry and national health insurance data.","authors":"Hee Sung Kim, Kyoung Eun Yeob, So Young Kim, Hye Sook Han, Jong Hyock Park","doi":"10.21037/tlcr-2026-0533","DOIUrl":"https://doi.org/10.21037/tlcr-2026-0533","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer incidence is rising in South Korea, where cancer care is increasingly concentrated in capital-region hospitals. Whether this centralization improves surgical outcomes for patients residing outside the capital region-or mainly imposes travel and access burdens without a universal survival benefit-remains unresolved. We examined regional patterns of surgical hospital utilization and stage-specific survival among non-capital residents undergoing lung cancer surgery.</p><p><strong>Methods: </strong>In this nationwide population-based retrospective cohort study, we linked the Korea Central Cancer Registry and the Korean National Health Insurance Service databases to identify adults newly diagnosed with lung cancer (2012-2019). Among 52,521 patients who underwent lung cancer surgery, 27,482 resided in non-capital regions, of whom 13,893 (50.6%) underwent index surgery at capital-region hospitals and 13,589 (49.4%) at non-capital hospitals. Multivariable logistic regression (2017-2019) identified factors associated with capital-region surgery, and Cox proportional hazards models estimated adjusted hazard ratios (aHRs) for 1-, 3-, and 5-year all-cause mortality by stage, hospital type, and histology. Follow-up extended from diagnosis to death or December 31, 2022.</p><p><strong>Results: </strong>Among non-capital residents, surgery at capital-region hospitals was more frequent among women, younger patients, higher-income groups, and those with fewer comorbidities. The likelihood of capital-region surgery increased with income [highest <i>vs.</i> lowest quintile, adjusted odds ratio (aOR) 4.357; 95% confidence interval (CI), 3.560-5.333] and was higher among urban residents (aOR 2.124; 95% CI, 1.948-2.316) and medical insurance holders versus Medical Aid recipients (aOR 3.064; 95% CI, 2.522-3.772). Survival did not differ by hospital region for localized-stage disease, whereas non-capital hospitals showed higher mortality for regional (3-year aHR 1.219; 95% CI, 1.076-1.382; 5-year aHR 1.188; 95% CI, 1.067-1.322) and distant stages (5-year aHR 1.239; 95% CI, 1.011-1.519).</p><p><strong>Conclusions: </strong>The survival advantage of capital-region hospitals was not universal but confined to advanced-stage disease, likely reflecting unequal access to systemic therapy, clinical trials, and multidisciplinary care rather than differences in surgical quality. Early-stage lung cancer can be safely managed in regional hospitals with adequate surgical capacity. A stage-specific delivery strategy-strengthening regional early-stage surgery while improving non-capital access to advanced treatment-is needed to ensure equitable cancer care nationwide.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 9","pages":"283"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184563","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 impact of immune-related adverse events in non-completers of durvalumab consolidation therapy for non-small cell lung cancer: a single-center retrospective cohort study.","authors":"Noriyuki Ebi, Ryoma Kawabata, Makoto Fujimoto, Ami Hirata, Yuuka Sakaki, Yusuke Otsuka, Eriko Kinoshita, Yuki Shundo, Toyoshi Yanagihara, Hiroyuki Inoue, Masaki Fujita","doi":"10.21037/tlcr-2026-0603","DOIUrl":"https://doi.org/10.21037/tlcr-2026-0603","url":null,"abstract":"<p><strong>Background: </strong>Durvalumab consolidation therapy after chemoradiotherapy (CRT) is standard for unresectable, locally advanced non-small cell lung cancer (NSCLC). However, long-term outcomes, treatment discontinuation impact, and the prognostic significance of immune-related adverse events (irAEs)-controlling for immortal time bias-remain unclear. We evaluated overall survival (OS) and progression-free survival (PFS) by completion status and irAE occurrence in an exploratory single-center cohort.</p><p><strong>Methods: </strong>We retrospectively analyzed 59 consecutive NSCLC patients receiving durvalumab post-CRT (median follow-up: 53.6 months). Completion was defined as 12 months of therapy (completers, n=25; non-completers, n=34). Survival was estimated using Kaplan-Meier analysis. Time-dependent Cox regression evaluated irAE onset to adjust for immortal time bias, with sensitivity analyses stratified by discontinuation reason. Event-free patients were censored at last follow-up.</p><p><strong>Results: </strong>Of 59 patients (median age: 70 years), 25 (42%) completed therapy, while 34 (58%) discontinued early (disease progression: n=16, adverse events: n=15, preference: n=3). During follow-up, 28 deaths [completers: 8/25 (32%); non-completers: 20/34 (59%)] and 36 progression events [completers: 9/25 (36%); non-completers: 27/34 (79%)] occurred. Completers achieved superior median OS (70.9 <i>vs.</i> 39.2 months; 5-year OS: 61% <i>vs.</i> 22%; P<0.01) and PFS (not reached <i>vs.</i> 7.9 months; 5-year PFS: 52% <i>vs.</i> 11%; P<0.001). Among non-completers (n=34, 20 deaths), time-dependent Cox analysis showed irAE onset reduced mortality risk [hazard ratio (HR) =0.384; 95% confidence interval (CI): 0.147-0.999; P=0.0498], yielding a higher 5-year OS rate (43% <i>vs.</i> 0%, P=0.03). Stratified sensitivity analysis indicated a consistent directional trend, though limited by event counts (HR =0.44; 95% CI: 0.11-1.72; P=0.24).</p><p><strong>Conclusions: </strong>One-year durvalumab completion remains the primary clinical objective. In patients discontinuing early, irAE onset was associated with a potential prognostic signal after controlling for time-varying bias; however, these findings represent cautious, hypothesis-generating observations requiring prospective multi-center validation.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 9","pages":"276"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184565","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":"Deferring or delivering stereotactic radiosurgery in EGFR-mutated non-small cell lung cancer: lessons from the STARLET randomized analysis.","authors":"Jason P Sheehan, Jared H Chung, Georgios Mantziaris, David R Penberthy, Camilo E Fadul","doi":"10.21037/tlcr-2026-0940","DOIUrl":"https://doi.org/10.21037/tlcr-2026-0940","url":null,"abstract":"","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 9","pages":"293"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184511","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":"Exploratory study to evaluate the combined effect of CBM588: <i>Clostridium butyricum</i> in platinum plus pemetrexed with pembrolizumab for non-small cell lung cancer-protocol of MIYABRO study.","authors":"Ryuta Tagawa, Hirokazu Taniguchi, Norihito Kaku, Kazumasa Akagi, Hiromi Tomono, Noritaka Honda, Yosuke Dotsu, Midori Matsuo, Shinnosuke Takemoto, Akisato Itagaki, Koki Yamashita, Yasuhiro Umeyama, Hiroshi Gyotoku, Takaya Ikeda, Nanae Sugasaki, Kazutoshi Yoshiyama, Takeshi Kitazaki, Katsumi Nakatomi, Daisuke Takao, Minoru Fukuda, Katsunori Yanagihara, Hiroshi Mukae","doi":"10.21037/tlcr-2026-0742","DOIUrl":"https://doi.org/10.21037/tlcr-2026-0742","url":null,"abstract":"<p><strong>Background: </strong>Platinum plus pemetrexed and pembrolizumab is a standard first-line treatment for advanced or recurrent non-squamous non-small cell lung cancer (NSCLC) without actionable driver alterations, including tumors with a programmed death-ligand 1 (PD-L1) tumor proportion score (TPS) <50%. However, the clinical benefits vary, and biomarkers for this chemoimmunotherapy regimen remain limited. CBM588, a live biotherapeutic preparation containing <i>Clostridium butyricum</i> MIYAIRI, may modulate antitumor immunity by affecting the gut microbiota. The MIYABRO study aims to evaluate the additive efficacy and safety of CBM588 with platinum plus pemetrexed and pembrolizumab and to explore longitudinal gut microbiota dynamics.</p><p><strong>Methods: </strong>This is a multi-institutional, single-arm, phase II exploratory study enrolling 20 treatment-naïve patients with advanced or recurrent non-squamous NSCLC and a PD-L1 TPS <50%. Patients will receive continuous CBM588 from the start of the protocol treatment in combination with platinum, pemetrexed, and pembrolizumab. After four induction cycles, maintenance pemetrexed plus pembrolizumab will be continued until disease progression or unacceptable toxicity. The primary endpoints are response rate and progression-free survival (PFS). Tumor response will be assessed according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Stool samples will be collected before treatment, cycle 3, and cycle 5 for 16S rRNA sequencing to evaluate microbial diversity and responder-associated taxa.</p><p><strong>Discussion: </strong>This trial will prospectively assess CBM588 added to platinum plus pemetrexed and pembrolizumab in NSCLC with PD-L1 TPS <50% while monitoring the gut microbiota. These findings may inform microbiota-targeted strategies for optimizing chemoimmunotherapy.</p><p><strong>Trial registration: </strong>This study was registered in the Japan Registry of Clinical Trials (No. jRCT1071260004) on 6 April 2026.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 9","pages":"292"},"PeriodicalIF":3.4,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149184518","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":"Clinical, radiological, and histopathological features of checkpoint inhibitor-related pneumonitis: a retrospective cross-sectional analysis of 44 patients who underwent lung biopsy.","authors":"Junyi Mo, Haiyi Deng, Yilin Yang, You Wei, Kangjing Ma, Jie Xiao, Juhong Jiang, Xinfei He, Meizhen Que, Chengzhi Zhou, Xinqing Lin","doi":"10.21037/tlcr-2026-0536","DOIUrl":"10.21037/tlcr-2026-0536","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Checkpoint inhibitor-related pneumonitis (CIP) is a serious immune-related adverse event associated with relatively high mortality. Its clinical and radiological manifestations are non-specific and may overlap with infection, tumour progression, and other pulmonary diseases. Currently, the histopathological spectrum of CIP and its relationship with radiological patterns and clinical outcomes remain insufficiently defined. This study aimed to analyse the clinical, radiological, and histopathological features, as well as exploratory prognostic outcomes, of biopsy-evaluated patients with clinically diagnosed or highly suspected CIP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We retrospectively reviewed patients who were clinically diagnosed with or highly suspected of having CIP and underwent lung biopsy at The First Affiliated Hospital of Guangzhou Medical University between June 2018 and June 2022. Medical records were reviewed to collect clinical characteristics, radiological findings, laboratory parameters, pathological results, treatment information, and follow-up data. Chest images were independently assessed by two thoracic radiologists, and pathological slides were interpreted by pulmonary pathologists. Survival and prognostic data were obtained from medical records and follow-up information.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 217 patients clinically diagnosed with or highly suspected of having CIP were identified, of whom 45 (20.7%) underwent lung biopsy. One patient was excluded because adequate lung tissue was not obtained, leaving 44 patients for the final analysis. Seven patients underwent ultrasonography-guided percutaneous transthoracic needle biopsy (USG-TTNB), and 37 underwent transbronchial lung biopsy (TBLB); biopsy-related complications included two cases of pneumothorax and one case of haemorrhage. The main radiological patterns were organising pneumonia (OP) and nonspecific interstitial pneumonia (NSIP). Histopathological patterns included isolated NSIP, NSIP with OP (NSIP + OP), OP, usual interstitial pneumonia (UIP), and mild interstitial pneumonitis (mild IP). The concordance rate between radiological patterns and histopathological classifications was only 29.5%, with an exploratory Cohen's kappa value of 0.04. Exploratory survival analysis showed no significant difference in overall survival among patients with OP, NSIP, and NSIP + OP histopathology (P=0.71).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;For patients with clinically suspected but diagnostically challenging CIP, TBLB or USG-TTNB selected after multidisciplinary assessment may provide histopathological information and help exclude alternative diagnoses such as infection, tumour progression, and other lung injuries. The marked heterogeneity of histopathological findings and the low radiology-pathology concordance suggest that CIP assessment should not rely solely on either radiological or pathological findings. Multidisciplinary assessment m","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"231"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931192","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":"Surgical and pathologic efficacy of neoadjuvant immunochemotherapy in EGFR-mutant non-small cell lung cancer.","authors":"Sangtian Liu, Qilin Deng, Shicui Quan, Wenhua Liang, Jianxing He","doi":"10.21037/tlcr-2026-0784","DOIUrl":"10.21037/tlcr-2026-0784","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant immunochemotherapy (neo-ICT) has demonstrated promising pathological response for resectable non-small cell lung cancer (NSCLC), while its role in epidermal growth factor receptor (EGFR)-mutated NSCLC remains unclear. Here, we aim to explore whether patients with EGFR-sensitive mutation and positive programmed cell death ligand 1 (PD-L1) expression may benefit from it.</p><p><strong>Methods: </strong>We retrospectively reviewed 15 patients with stage IIB-IIIC EGFR-mutant NSCLC and a PD-L1 tumor proportion score (TPS) of ≥10%, who received neo-ICT (with or without bevacizumab) followed by surgery at The First Affiliated Hospital of Guangzhou Medical University between 2020 and 2026. The primary endpoints were pathological complete response (pCR) and major pathological response (MPR), and the secondary endpoints included R0 resection rate, tumor and nodal downstaging rates, event-free survival (EFS), and safety.</p><p><strong>Results: </strong>All patients underwent minimally invasive thoracoscopic surgery with 100% R0 resection. The MPR rate (including pCR) was 33% (5/15), of which 13% (2/15) achieved pCR and 20% (3/15) achieved non-pCR MPR. Pathologic downstaging was achieved in 67% of patients, and nodal downstaging in 73%. With a median follow-up of 29.8 months, the median EFS was 30.1 months [95% confidence interval (CI): 22.5-not reached], the 12-month EFS rate was 93.3% (95% CI: 81.5-100.0%), and the 24-month EFS rate was 66.7%. Neoadjuvant therapy was well tolerated, with no grade 3 or higher treatment-related adverse events, no surgical delays, and no treatment-related deaths reported.</p><p><strong>Conclusions: </strong>Among patients with PD-L1-positive EGFR-mutant NSCLC, neo-ICT yielded pathological and surgical responses with acceptable safety in this small retrospective cohort. Observed pathological benefits remain exploratory, and prospective studies are required to validate its clinical utility before defining its role as a neoadjuvant regimen for this patient subgroup.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"219"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931249","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 neuronal network of small cell lung cancer: a narrative review of the role of the nervous system in the pathogenesis and progression.","authors":"Mateusz Gap, Filip Gajewski, Weronika Pająk, Joanna Pec, Jakub Kleinrok, Grzegorz Kurec, Paweł Krawczyk","doi":"10.21037/tlcr-2026-0523","DOIUrl":"10.21037/tlcr-2026-0523","url":null,"abstract":"<p><strong>Background and objective: </strong>Small cell lung cancer (SCLC) is a highly aggressive cancer with a poor prognosis, in which increasing attention is focused on the role of the nervous system as an active regulator of cancer initiation, progression and metastasis. The aim of this study is to provide an integrated focus on SCLC review of the mechanisms of neuronal regulation of this cancer, as well as a critical analysis of their therapeutic potential.</p><p><strong>Methods: </strong>A literature review was conducted in the PubMed database, covering publications from 1st January 2020 to 1st December 2025, using defined keywords relating to SCLC and the nervous system. The analysis included publications that met the criteria relating to the role of the nervous system in the pathogenesis, progression or treatment of SCLC.</p><p><strong>Key content and findings: </strong>The review identifies the multi-level influence of the nervous system on SCLC, including: the formation of functional synapses between cancer cells and neurons, the relevance of vagotomy in the early stages of carcinogenesis, the role of neurotransmitters and their receptors, neuropeptides and neurotrophins in tumour development and their influence on the tumour microenvironment, as well as the interaction of SCLC with astrocytes in brain metastases (including Reelin and SERPINE1). Therapeutic perspectives were also discussed, including the use of ADRB2 blockade, the inhibition of synaptic neurotransmission, and the blockade of the neurotrophin axis.</p><p><strong>Conclusions: </strong>The findings presented in this study provide a basis for further research into the interactions between SCLC and the nervous system, with a view to developing new targeted treatments in the future.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"259"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931264","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}