Translational lung cancer research最新文献

{"title":"Robotic subxiphoid-optical thymectomy for Good's syndrome in a severely immunocompromised patient: a case report.","authors":"Rintaro Kawanishi, Masanori Shimomura, Satoru Okada, Tatsuo Furuya, Atsuki Uchibori, Machiko Nishii, Taiyo Kawamura, Takumi Nakagawa, Tsunehiro Ii, Masayoshi Inoue","doi":"10.21037/tlcr-2026-0640","DOIUrl":"10.21037/tlcr-2026-0640","url":null,"abstract":"<p><strong>Background: </strong>Good's syndrome is a rare adult-onset immunodeficiency characterized by thymoma and hypogammaglobulinemia. The optimal surgical approach for thymoma in patients with severe immunodeficiency remains undefined. In this report, we describe a case of Good's syndrome in an elderly male patient with severe hypogammaglobulinemia, who underwent robotic subxiphoid-optical thymectomy as part of a perioperative strategy aimed at reducing surgical invasiveness.</p><p><strong>Case description: </strong>An 80-year-old man with Good's syndrome presented with hypogammaglobulinemia (serum IgG, 60 mg/dL), complete absence of B cells, and a 5.5-cm anterior mediastinal tumor. Given this pronounced immunodeficiency, robotic subxiphoid-optical thymectomy was indicated to minimize surgical trauma while avoiding median sternotomy. The perioperative management strategy included preoperative intravenous immunoglobulin (IVIG) replacement therapy, extended antibiotic prophylaxis, careful patient selection, and close perioperative monitoring. Complete (R0) resection was achieved, and pathologic examination demonstrated type AB thymoma, Masaoka-Koga stage II. No perioperative infectious complications occurred, allowing timely initiation of cyclosporine when pure red cell aplasia developed eight weeks postoperatively, followed by partial hematologic recovery. Monthly IVIG replacement was continued, and no further infectious complications or thymoma recurrence were observed during 24 months of follow-up.</p><p><strong>Conclusions: </strong>This case suggests that robotic subxiphoid-optical thymectomy could be an option in selected patients with Good's syndrome and severe immunodeficiency.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"264"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931281","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":"Is there a room for radical salvage resection in initially-unresectable non-small cell lung cancer patients after EGFR-TKI based therapy?","authors":"Feng Su, Hanzhang Chen, Guilin Peng, Jianxing He, Jingpei Li","doi":"10.21037/tlcr-2026-0504","DOIUrl":"10.21037/tlcr-2026-0504","url":null,"abstract":"<p><strong>Background: </strong>Tyrosine kinase inhibitors (TKIs) constitute the standard first-line systemic therapy for patients with unresectable epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC). Despite their initial efficacy, the majority of patients inevitably develop acquired resistance or experience local recurrence. This study aimed to evaluate the safety and feasibility of minimally invasive radical salvage surgery following TKI-based therapy in a cohort of patients with initially unresectable NSCLC.</p><p><strong>Methods: </strong>This retrospective single-center study evaluated patients who underwent radical salvage lung resection following TKI-based therapy. Surgical safety and short-term efficacy were assessed, and findings were compared with results from previously published studies.</p><p><strong>Results: </strong>Twenty-six patients underwent salvage surgery following first-line treatment with third-generation TKIs; 19 received TKI monotherapy, while seven received a combination of TKIs and chemotherapy. All patients underwent anatomical lung resection, with two cases requiring conversion to open thoracotomy. R0 resection was achieved in 96.2%. An R0 resection was achieved in 96.2% of cases. The median operative time was 145 minutes (range, 105-240 minutes), and the median intraoperative blood loss was 20 mL (range, 10-700 mL). Postoperative complications occurred in four patients (15.4%), including two major events in individuals who had received preoperative TKI therapy for more than 6 months. Compared to those with shorter treatment durations, patients with prolonged preoperative TKI exposure exhibited a longer postoperative hospital stay, although operative time, blood loss, and chest tube duration were comparable. Our perioperative outcomes were consistent with those reported in six prior retrospective studies.</p><p><strong>Conclusions: </strong>Radical salvage lung resection following TKI therapy is a feasible and safe option for carefully selected patients with initially unresectable EGFR-mutant NSCLC. This approach yields high rates of complete (R0) resection with acceptable morbidity. However, patients who have undergone extended preoperative TKI treatment may present with increased technical challenges and warrant meticulous perioperative planning.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"237"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotional distress and clinical response to neoadjuvant chemoimmunotherapy in resectable non-small-cell lung cancer: a protocol for the prospective observational NeoFUSE-Lung cohort study.","authors":"Yuanpu Wei, Hancheng Yin, Deliang Hou, Hao Chen, Guobing Xu, Bin Zheng, Chun Chen, Zhang Yang","doi":"10.21037/tlcr-2026-0586","DOIUrl":"10.21037/tlcr-2026-0586","url":null,"abstract":"<p><strong>Background: </strong>Neoadjuvant chemoimmunotherapy (NACI) has improved pathological and survival outcomes in patients with resectable non-small-cell lung cancer (NSCLC), yet marked heterogeneity in treatment response persists. Emotional distress (ED) may modulate antitumor immunity through neuroendocrine and immune-related mechanisms, but its association with response to NACI in patients with resectable NSCLC remains insufficiently explored. This study aims to prospectively evaluate the relationship between ED and clinical outcomes in patients with resectable NSCLC receiving NACI, with exploratory analyses of stress-related biomarkers and gut microbiome profiles.</p><p><strong>Methods: </strong>This single-center, prospective observational cohort study will enroll patients with treatment-naïve, resectable stage II-IIIB NSCLC scheduled to receive first-line NACI at Fujian Medical University Union Hospital. All participants will receive NACI as part of routine clinical care, and no experimental intervention will be assigned. ED will be assessed using the Hospital Anxiety and Depression Scale (HADS) at baseline and after two cycles of NACI, and participants will be classified according to baseline ED status and longitudinal ED trajectories. Clinical, psychological, quality-of-life, biochemical, and fecal microbiome data will be collected at prespecified time points. The primary outcomes are overall survival (OS) and progression-free survival (PFS). Secondary outcomes include objective response rate (ORR), pathological complete response (pCR), major pathological response (MPR), and quality of life (QoL). Associations between ED and clinical outcomes will be analyzed using appropriate regression and survival models, with exploratory analyses of stress-related biomarkers and gut microbiome profiles.</p><p><strong>Discussion: </strong>This trial aims to provide prospective data on the association between ED and response to NACI in patients with resectable NSCLC, while exploring potential neuroimmune-microbiome pathways underlying this association.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry (ChiCTR) identifier: ChiCTR2600119872.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"255"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931115","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":"NRG1 fusions in non-small cell lung cancer: biology, diagnostics, and emerging HER2/HER3 therapies-a narrative review.","authors":"Andrea Marini, Irene Stasi, Antonio Pellino, Enrico Sammarco, Azzurra Farnesi, Cecilia Barbara, Ermelinda De Maio, Samanta Cupini, Gianna Musettini, Giulia Acconci, Linda Bartalini, Luna Chiara Masini, Giulia Soria, Elena Sartori, Ylenia Nodari, Carmelo Spinella, Luigi Coltelli, Adele Servadio, Andrea Giusti, Giacomo Allegrini","doi":"10.21037/tlcr-2026-0227","DOIUrl":"10.21037/tlcr-2026-0227","url":null,"abstract":"<p><strong>Background and objective: </strong><i>NRG1</i> gene fusions are rare but clinically relevant oncogenic drivers in non-small cell lung cancer (NSCLC) and drive tumorigenesis through ligand-dependent activation of HER2/HER3 signaling. In contrast to kinase-driven oncogenic fusions, <i>NRG1</i> alterations preserve the EGF-like domain that can drive HER3 dimerization and activation of downstream PI3K/AKT and MAPK signaling pathways. <i>NRG1</i> fusions were first detected in invasive mucinous adenocarcinoma but have since been identified across multiple cancers and are increasingly recognized as actionable alterations in NSCLC. Herein, we provide a narrative review summarizing current evidence on the biological basis of <i>NRG1</i> fusion-positive NSCLC, diagnostic considerations, and emerging therapeutic strategies.</p><p><strong>Methods: </strong>A structured literature search was conducted in PubMed and major oncology conference databases. The primary search was performed in February 2026 and subsequently updated through May 15, 2026, during manuscript revision. English-language studies focusing on biological mechanisms, clinicopathological features, diagnostic strategies, and therapeutic approaches in <i>NRG1</i> fusion-positive NSCLC were considered eligible.</p><p><strong>Key content and findings: </strong><i>NRG1</i> fusion-positive NSCLC represents a distinct molecular subtype characterized by mucinous histology, low tumor mutational burden (TMB), and dependence on HER2/HER3 signaling. Detection remains technically challenging due to limitations of DNA-based sequencing approaches, underscoring the importance of RNA-based assays and integrated molecular profiling. Early clinical experience with pan-ErbB tyrosine kinase inhibitors demonstrated heterogeneous and often limited activity. Other HER2/HER3-targeted strategies, including the bispecific antibody zenocutuzumab and HER3-directed monoclonal antibodies, have shown clinically meaningful antitumor activity. The accelerated approval of zenocutuzumab in 2024 represented a pivotal milestone in the clinical management of this rare molecular subgroup.</p><p><strong>Conclusions: </strong><i>NRG1</i> fusion-positive NSCLC represents an emerging actionable lung cancer subtype with distinct biological and clinical features. The therapeutic landscape has evolved substantially with the introduction of molecular diagnostics and HER2/HER3-targeted therapies. Continued investigation of resistance mechanisms and optimal treatment sequencing will be crucial to improve outcomes for patients with this rare but clinically impactful disease.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"261"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931162","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 smoking in non-small cell lung cancer: histology-specific findings from a retrospective cohort study.","authors":"Hyo Kyen Park, Geun Dong Lee, Sehoon Choi, Hyeong Ryul Kim, Yong-Hee Kim, Dong Kwan Kim, Seung-Il Park, Jae Kwang Yun","doi":"10.21037/tlcr-2026-0598","DOIUrl":"10.21037/tlcr-2026-0598","url":null,"abstract":"<p><strong>Background: </strong>Smoking negatively influences postoperative outcomes in non-small cell lung cancer (NSCLC), but its prognostic effect may differ by histologic subtype. However, whether this impact varies between adenocarcinoma (ADC) and squamous cell carcinoma (SqCC) remains poorly understood. We aimed to quantify this difference using a pre-specified interaction analysis.</p><p><strong>Methods: </strong>We retrospectively analyzed 8,103 patients who underwent curative-intent resection for pathologic stage I-III NSCLC between 2011 and 2022. Smoking status was categorized as never versus ever (smoking history). Overall survival (OS) and recurrence-free survival (RFS) were evaluated using multivariable Cox models with a smoking × histology interaction term and additional stage-stratified analyses.</p><p><strong>Results: </strong>In the primary multivariable interaction model, smoking history was associated with worse OS in the reference ADC subgroup [hazard ratio (HR): 1.33; 95% confidence interval (CI): 1.10-1.60; P=0.003]. Histology-specific analysis showed that smoking history was associated with worse OS in ADC subgroup (HR: 1.24; 95% CI: 1.02-1.50; P=0.03), whereas in SqCC subgroup, the estimate was imprecise and binary smoking history did not clearly discriminate prognosis (HR: 1.01; 95% CI: 0.67-1.50; P=0.98). The smoking × histology interaction for OS was not significant (interaction HR: 0.74; 95% CI: 0.50-1.09; P=0.12).</p><p><strong>Conclusions: </strong>Smoking history was associated with worse postoperative OS, with the most consistent prognostic signal observed in ADC subgroup. In SqCC cohort, binary smoking history showed limited prognostic discrimination, likely reflecting near-universal smoking exposure rather than absence of biological relevance. Smoking status should be interpreted within histologic context during postoperative risk assessment.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"221"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931203","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":"Highest mediastinal lymph node metastasis was not an independent prognostic factor in pathological stage N2 non-small cell lung cancer.","authors":"Mu-Zi Yang, Jing-Sheng Cai, Zeng-Hao Chang, Xue Hou, Hao-Xian Yang","doi":"10.21037/tlcr-2026-0547","DOIUrl":"10.21037/tlcr-2026-0547","url":null,"abstract":"<p><strong>Background: </strong>Based on the definition of R stage proposed by the International Association for the Study of Lung Cancer (IASLC), non-small cell lung cancer (NSCLC) patients with highest mediastinal lymph node (HMLN) metastasis should be classified as uncertain resection. However, previous studies about HMLN metastasis had different voices, and the prognostic significance of HMLN metastasis is still controversial. This study aimed to investigate the impact of HMLN metastasis on overall survival (OS) and disease-free survival (DFS) in patients with pathological stage N2 (pN2) NSCLC.</p><p><strong>Methods: </strong>Patients with pN2 NSCLC treated between 2001 and 2014 were retrospectively included, while those with R1/R2 resection or insufficient lymph node dissection were excluded. Patients were categorized into two groups: those with HMLN metastasis (HMLN⁺ group) and those without (HMLN^- group). The Kaplan-Meier method and Cox proportional hazards models were used to assess prognostic factors for OS and DFS. Propensity score matching (PSM) was employed to minimize selection bias.</p><p><strong>Results: </strong>The study included 332 patients, of whom 142 (42.8%) had HMLN metastasis. After PSM, 90 matched pairs were generated. Patients in the HMLN⁺ group were more likely to have adenocarcinoma (P=0.002) and pN2b disease (P<0.001). Initially, the HMLN^- group demonstrated significantly better OS and DFS than the HMLN⁺ group (OS: P=0.02; DFS: P=0.005). However, after PSM, no significant difference was observed between the groups (OS: P=0.49; DFS: P=0.36). Multivariable analysis confirmed that HMLN metastasis was not an independent prognostic factor for OS (before PSM: P=0.23; after PSM: P=0.64) or DFS (before PSM: P=0.11; after PSM: P=0.55).</p><p><strong>Conclusions: </strong>HMLN metastasis was not an independent prognostic factor for OS or DFS in patients with stage N2 NSCLC. Patients with HMLN metastasis were more likely to have pN2b disease, which may account for the poorer survival observed in this group.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"232"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930378","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":"Heterogeneous efficacy and predictors of response to immunotherapy in driver-mutant advanced NSCLC: a focus on EGFR and KRAS subtypes.","authors":"Yan Zhu, Shuxue Wang, Chan Wang, Dantong Sun, Danhe Wang, Feiyan Ma, Shikai Wu","doi":"10.21037/tlcr-2026-0889","DOIUrl":"10.21037/tlcr-2026-0889","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Programmed death 1/programmed death-ligand 1 (PD-1/PD-L1) inhibitors improve survival in driver-negative advanced non-small cell lung cancer (NSCLC); however, their efficacy in oncogene-driven NSCLC has not yet been established. This study evaluated the clinical and molecular predictors of immunotherapy outcomes in this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective, two-center cohort study of 129 patients with advanced NSCLC harboring driver mutations who received PD-1/PD-L1 inhibitors (either as monotherapy or in combination with other antineoplastic drugs). Treatment efficacy and predictors were analyzed in the overall cohort and key mutational subgroups, including epidermal growth factor receptor (&lt;i&gt;EGFR&lt;/i&gt;)- and Kirsten rat sarcoma (&lt;i&gt;KRAS&lt;/i&gt;)-mutant NSCLC. We examined the efficacy of immunotherapy and assessed the correlation between treatment responses in 77 patients who received both immunotherapy and targeted therapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The efficacy of immunotherapy varied significantly by genotype. Patients with &lt;i&gt;KRAS&lt;/i&gt; mutations, a subgroup characterized by a higher prevalence of smoking history and elevated PD-L1 expression, demonstrated superior outcomes compared to those with &lt;i&gt;EGFR&lt;/i&gt;, human epidermal growth factor receptor 2 (&lt;i&gt;HER2&lt;/i&gt;), or other rare mutations. Multivariate analysis identified smoking history, high PD-L1 expression, and receipt of first-line immunotherapy as independent predictors of progression-free survival (PFS) in the overall cohort. Among the patients with &lt;i&gt;EGFR&lt;/i&gt; mutations, receipt of first- or second-generation (1G/2G) tyrosine kinase inhibitors (TKIs) alone prior to immunotherapy, Threonine 790 Methionine (T790M) mutation-negative status, and the Leucine 858 Arginine (L858R) subtype were associated with improved outcomes. However, multivariate analysis showed that a history of treatment with 1G/2G TKIs only was the sole independent predictor of PFS. In &lt;i&gt;KRAS&lt;/i&gt;-mutant patients, smoking history and high PD-L1 expression were positive predictors of PFS in the multivariate analysis. Smokers with a tumor proportion score (TPS) ≥1% achieved a median PFS of 19.0 months, compared with 8.5 months for non-smokers with a TPS ≥1% and 1.5 months for non-smokers with a TPS &lt;1% (P&lt;0.001). Targeted therapy was associated with a significantly longer median PFS than immunotherapy in both the overall cohort and the &lt;i&gt;EGFR&lt;/i&gt;- and rare-mutation subgroups. No correlation was observed between responses to targeted therapy and subsequent immunotherapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;&lt;i&gt;KRAS&lt;/i&gt;-mutant NSCLC is characterized by a high proportion of patients with a smoking history and elevated PD-L1 expression, which may contribute to its superior response to immunotherapy compared with other mutation subtypes. In the overall driver-positive population, smoking history, high PD-L1 expression, and receipt of first-line treatment were ","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"251"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148930387","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 predictive model for fusion gene positivity in treatment-naive advanced non-small cell lung cancer.","authors":"Yike Wang, Yingbo Xie, Xuan Yao, Kelan Ke, Pei Ma, Fengnan Wang, Qin Liu, Xiaohong Xie, Ming Liu, Xinqing Lin, Chengzhi Zhou, Zhanhong Xie","doi":"10.21037/tlcr-2026-0597","DOIUrl":"10.21037/tlcr-2026-0597","url":null,"abstract":"<p><strong>Background: </strong>Fusion gene-positive non-small cell lung cancer (NSCLC) represents a distinct molecular subtype with unique clinical and biological features. Although next-generation sequencing (NGS) is the gold standard for detecting ALK, ROS1, and RET fusions, it is costly, time-consuming, and occasionally limited by insufficient tissue samples. Therefore, a simple bedside predictive tool is urgently needed to identify patients likely to harbor fusion genes and prioritize testing. This study aims to establish a predictive model for fusion gene positivity and scoring system for fusion genes, assisting clinicians in early identification of patients likely to harbor fusion genes before rapid disease progression occurs, thereby preventing patients from missing optimal treatment opportunities due to rapid disease deterioration. The scoring system can also help prioritize fusion gene testing when tissue samples are insufficient.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 448 NSCLC patients admitted to The First Affiliated Hospital of Guangzhou Medical University between June 2015 and October 2024, meeting the study's inclusion criteria. These patients were categorized into the fusion gene-positive group (130 cases) and the driver-negative group (318 cases). Baseline data between the two groups were compared to identify factors potentially associated with fusion gene-positive. Univariate logistic regression analysis was utilized for screening these factors, which were then included in a multivariate analysis to construct a predictive model for fusion gene-positive. The model's discrimination and calibration were subsequently assessed. Each factor was assigned scores based on the regression coefficient β value in the model, leading to the transformation of the model into a scoring system.</p><p><strong>Results: </strong>Analysis shows that specific factors independently associated with fusion gene positivity include age, history of thrombosis, carbohydrate antigen 153 (CA153) levels, and vertebral body metastasis. Utilizing these four indicators, we developed a predictive scoring system that effectively evaluates the likelihood of patients testing positive for fusion genes [area under the curve (AUC) =0.797].</p><p><strong>Conclusions: </strong>The novel scoring model can assess the positivity of the fusion gene. Our research indicates that this score incorporates age, the presence or absence of thrombosis, CA153 levels, and the presence or absence of vertebral metastasis.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"226"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931136","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":"First-line pembrolizumab plus chemotherapy versus bevacizumab plus chemotherapy in response and survival outcomes in PD-L1-negative advanced non-squamous NSCLC: a retrospective comparative cohort study.","authors":"Kuofang Huang, Shifei Pan, Huishu Dong, Haijiao Lu, Bo Yan, Jialin Qian, Tianqing Chu","doi":"10.21037/tlcr-2026-0917","DOIUrl":"10.21037/tlcr-2026-0917","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Direct real-world comparisons of pembrolizumab plus chemotherapy and bevacizumab plus chemotherapy in programmed cell death ligand 1 (PD-L1)-negative advanced non-squamous non-small cell lung cancer (NSCLC) are limited. We compared response, survival, safety, and blood biomarkers between these regimens.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This single-center retrospective cohort included 160 patients treated at Shanghai Chest Hospital from May 2017 to October 2023: 76 received pembrolizumab plus platinum-pemetrexed chemotherapy and 84 received bevacizumab plus the same chemotherapy backbone. Eligibility required advanced non-squamous NSCLC, PD-L1 tumor proportion score &lt;1%, no actionable driver alteration, Eastern Cooperative Oncology Group performance status 0-1, at least two treatment cycles, and complete data. Laboratory time points were defined as T0 (within 1 week before treatment) and T2 (after two treatment cycles); objective response rate (ORR) and disease control rate (DCR) were assessed after two treatment cycles. Cutoffs were selected using X-tile. Treatment-group Cox models adjusted for age, sex, smoking, stage, metastatic sites, baseline lactate dehydrogenase (LDH), and prognostic nutritional index (PNI); regimen-specific models included variables with univariable P&lt;0.10.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The pembrolizumab cohort was older and included more men and patients with lung metastases. At the two-cycle response assessment, ORR (35.5% &lt;i&gt;vs.&lt;/i&gt; 33.3%, P=0.77) and DCR (92.1% &lt;i&gt;vs.&lt;/i&gt; 90.5%, P=0.72) did not differ significantly; median progression-free survival was also not significantly different [PFS; 8.8 &lt;i&gt;vs.&lt;/i&gt; 9.9 months; adjusted hazard ratio (HR) 1.15, 95% confidence interval (CI): 0.80-1.68; P=0.45]. Median overall survival (OS) was 23.2 versus 20.8 months, in the pembrolizumab group and the bevacizumab group, respectively (P=0.04); adjusted mortality was lower with pembrolizumab plus chemotherapy (HR 0.58, 95% CI: 0.39-0.88; P=0.01). Documented grade ≥3 treatment-related adverse events occurred in 34.2% versus 44.0% in the pembrolizumab group and the bevacizumab group, respectively (P=0.20). In the pembrolizumab cohort, higher baseline LDH (&gt;155 U/L) and ΔLDH (&gt;501 U/L) were independently associated with shorter PFS, whereas higher PNI at T2 (&gt;41.5) was associated with longer PFS; higher PNI at T0 (&gt;47) and T2 (&gt;39.5) were independently associated with longer OS. In the bevacizumab cohort, higher baseline LDH (&gt;255 U/L for PFS; &gt;250 U/L for OS) was independently associated with worse outcomes, whereas higher PNI at T2 (&gt;47) was associated with longer PFS and higher PNI at T0 (&gt;48) and T2 (&gt;44) were associated with longer OS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this retrospective non-randomized cohort, pembrolizumab plus chemotherapy and bevacizumab plus chemotherapy showed no statistically significant differences in response or PFS, whereas pembrolizumab plus chemotherapy was associat","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"249"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931208","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 effectiveness of concurrent training in lung cancer survivors: a systematic review.","authors":"Leonor Anjos, Mário Cardoso Marques, Dulce Esteves, Henrique Pereira Neiva, Ricardo Madeira, Adriana Maia, Diogo Luís Marques","doi":"10.21037/tlcr-2026-0424","DOIUrl":"10.21037/tlcr-2026-0424","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer is associated with marked functional decline, symptom burden, and reduced quality of life across the cancer care continuum. Although exercise is increasingly supported in oncology, evidence specific to concurrent training in people with lung cancer remains limited and heterogeneous. This review synthesized the effects of concurrent training in adults with a confirmed lung cancer diagnosis who were undergoing or had completed oncological treatment, with pulmonary function as the prespecified primary outcome and physical fitness, functional capacity, and patient-reported outcomes as secondary outcomes. This review also describes exercise prescription characteristics according to the FITT-VP (frequency, intensity, time, type, weekly volume, and progression) framework.</p><p><strong>Methods: </strong>Eligible studies were clinical trials that implemented concurrent training combining aerobic and resistance exercise within the same session. Searches were conducted in PubMed, Scopus, and Web of Science from inception to October 2025, completed by a supplementary CENTRAL research. Risk of bias was assessed using the Cochrane Risk of Bias tool for randomized trials and ROBINS-I V2 for non-randomized studies. Results were synthesized using a structured narrative approach, with relative differences calculated when pre-post data were available, but were interpreted only as descriptive indicators of within-group change and not as causal estimates of intervention effectiveness.</p><p><strong>Results: </strong>Ten studies met the inclusion criteria. Pulmonary outcomes showed limited and inconsistent responsiveness, with favorable changes in spirometric indices reported in only a minority of studies (6.3-10.5%), whereas most trials reported stability or small descriptive changes (-1.7% to 11.4%). More consistent favorable descriptive changes were observed in cardiorespiratory fitness (6.1-19%), functional capacity (6.4-9.1%), and muscular strength (5.5-42.8%). Favorable changes were also reported in selected patient-reported outcomes, including emotional well-being (9.2-12.6%), anxiety (12.5-24.6%), and sleep quality (28.6%). However, comparative effects were inconsistent across outcomes, and the evidence is limited by small sample sizes, methodological heterogeneity, inconsistent reporting, and risk of bias.</p><p><strong>Conclusions: </strong>Concurrent training may be associated with favorable changes in exercise capacity, functional performance, and muscular strength in people with lung cancer, whereas pulmonary function appears less responsive. Evidence remains limited by within-group findings, inconsistent between-group effects, heterogeneity, and risk of bias. Larger randomized trials with standardized FITT-VP reporting, adherence and safety monitoring, and longer follow-up are needed.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"256"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931270","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}