Translational lung cancer research最新文献

{"title":"Impacts of co-mutations in oligometastatic and oligoprogressive non-small cell lung cancer with <i>EGFR/ALK</i> mutations-a narrative review of the current literature.","authors":"Jeong Uk Lim, Ae Lee Jang, Jayoung Lee, Sonya Youngju Park, Tai Joon An, Young Jo Sa, Hyo Rim Kim, Tae-Jung Kim, Byoung Hyuck Kim, Chan Kwon Park","doi":"10.21037/tlcr-2024-1121","DOIUrl":"10.21037/tlcr-2024-1121","url":null,"abstract":"<p><strong>Background and objective: </strong>Non-small cell lung cancer (NSCLC) remains one of the primary causes of cancer mortality globally, with an increasing focus on advanced targeted therapies. Despite these advancements, oligometastatic NSCLC, particularly cases with actionable mutations such as those in epidermal growth factor receptor (<i>EGFR</i>) and anaplastic lymphoma kinase (<i>ALK</i>), presents unique therapeutic challenges and opportunities for improved outcomes. Recent studies indicate that consolidative local ablative therapies (LAT) such as stereotactic body radiation therapy (SBRT) combined with tyrosine kinase inhibitors (TKIs) may enhance progression-free and overall survival for patients with oligometastatic NSCLC harboring these mutations. This narrative review aims to summarize current evidence on the clinical impact of co-mutations in EGFR/ALK-positive oligometastatic NSCLC.</p><p><strong>Methods: </strong>The relevant literature was identified by using PubMed and ClinicalTrials.gov (last search phase November 2024) and was restricted to English language. Peer-reviewed manuscripts but also conference abstracts that did not undergo peer-review were included.</p><p><strong>Key content and findings: </strong>Co-mutations complicate treatment by potentially influencing radiosensitivity and resistance to systemic therapies. This review discusses current findings on co-mutations in <i>EGFR</i>/<i>ALK</i>-positive oligometastatic NSCLC, examining their impact on LAT and systemic treatment outcomes, with a particular focus on synchronous and oligoprogressive disease states. Moreover, emerging biomarkers such as circulating tumor DNA may guide therapeutic strategies and optimize personalized treatment plans.</p><p><strong>Conclusions: </strong>As clinical trials continue to investigate combinative and sequential LAT-TKI strategies, understanding the genomic landscape of co-mutations in oligometastatic NSCLC is important for refining treatment approaches and enhancing long-term survival.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1848-1861"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attention mechanism-based habitat analysis for predicting pleural invasion and prognosis of pulmonary nodules.","authors":"Wei Zhang, Xiangfeng Gan, Wenzeng Chen, Xiaohui Duan, Zhuojian Shen, Haohua Xu, Honglue Dai, Ju Chen, Baishen Chen","doi":"10.21037/tlcr-2024-1122","DOIUrl":"10.21037/tlcr-2024-1122","url":null,"abstract":"<p><strong>Background: </strong>The use of segmental resection in pulmonary adenocarcinoma is increasing, yet visceral pleural invasion (VPI) remains a critical risk factor impacting overall survival (OS). The benefits of segmental resection for these patients are unclear, and non-invasive methods to predict VPI need further development. This study aims to develop a predictive model for VPI and OS, aiding surgeons in preoperative and intraoperative decision-making.</p><p><strong>Methods: </strong>A retrospective study was conducted using data from the Sun Yat-sen Memorial Hospital, the Fifth Affiliated Hospital of Sun Yat-sen University and an external dataset (named NSCLC Radiogenomics from The Cancer Imaging Archive) of cT1 stage pulmonary nodules. Original computed tomography images were enhanced using generative adversarial networks. Habitat analysis identified tumor subregions, which were clustered. Radiomics and vision transformer features were extracted and integrated using attention-equipped transformers to develop prediction models. Performance was evaluated using receiver operating characteristic (ROC) curves, net reclassification improvement, and integrated discrimination improvement.</p><p><strong>Results: </strong>The study included 742 patients, comprising 338 males and 404 females, with a mean age of 61±10.2 years. Data from the Fifth Affiliated Hospital of Sun Yat-sen University were divided into training and validation cohorts, while data from the Sun Yat-sen Memorial Hospital and the NSCLC Radiogenomics dataset formed the test cohort. The Rad-adjacent model had an area under the curve (AUC) of 0.822 for predicting VPI, while the combined model achieved an AUC of 0.819. For predicting 5-year OS, the combined model's AUC was 0.821, compared to 0.775 for the Rad-adjacent model.</p><p><strong>Conclusions: </strong>The developed models show strong predictive capabilities for VPI and OS in cT1 stage lung adenocarcinoma, providing valuable non-invasive support for surgical decision-making.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1596-1610"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning in histopathology images for prediction of oncogenic driver molecular alterations in lung cancer: a systematic review and meta-analysis.","authors":"Rafael Parra-Medina, Gabriela Guerron-Gomez, Daniel Mendivelso-González, Javier Hernan Gil-Gómez, Juan Pablo Alzate, Marcela Gomez-Suarez, Jose Fernando Polo, John Jaime Sprockel, Andres Mosquera-Zamudio","doi":"10.21037/tlcr-2024-1196","DOIUrl":"10.21037/tlcr-2024-1196","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer (LC) is the second most diagnosed cancer and the leading cause of cancer mortality worldwide. Non-small cell lung cancer (NSCLC) accounts for 85% of cases, with oncogenic alterations like <i>EGFR, ALK, ROS1</i>, and <i>KRAS</i> guiding targeted therapies. Their prevalence varies by ethnicity, smoking status, and gender. Advances in artificial intelligence (AI) enable molecular biomarker prediction from hematoxylin and eosin-stained whole-slide images (H&E WSIs), offering a non-invasive approach to precision oncology. This review assesses deep learning (DL) models predicting oncogenic drivers in NSCLC from H&E WSIs and their diagnostic accuracy.</p><p><strong>Methods: </strong>A systematic review registered in PROSPERO (CRD42024573602) was conducted in Embase, LILACS, Medline, Web of Science, and Cochrane to identify studies on DL models using H&E slides for LC gene alterations. Only English and Spanish studies were included. Key metrics were extracted for meta-analysis. Studies without LC-specific data, missing essential metrics, or with inconsistent results were excluded.</p><p><strong>Results: </strong>We found evidence that convolutional neural networks (CNNs) were the most common architectures in studies. Also, in the meta-analysis, <i>ALK</i> {sensitivity of 84% [95% confidence interval (CI): 62-95%] and specificity of 85% (95% CI: 55-96%)}, <i>EGFR</i> [80% (95% CI: 72-86%) and specificity of 77% (95% CI: 69-83%)] and <i>TP53</i> [sensitivity and specificity of 70% (95% CI: 65-83%)] were the oncogenic driver molecular alterations that demonstrated the best predictive capability performance.</p><p><strong>Conclusions: </strong>Our results emphasize the potential of these models as screening tools despite H&E WSI.It is necessary to validate these predictive models among diverse populations and clinical outcomes. This approach is crucial and leaves an open door for advances in precision medicine, offering promising avenues for personalized treatment strategies.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1756-1769"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Different prognosis of multiple lung cancer identified by 116-gene panel by next-generation sequencing based on an Asian population.","authors":"Chen-Hui Ni, Mu-Ting Wang, Ping-Hua Lin, Yan-Qi Lu, Yi-Peng Chen, Wei Zheng, Yuan-Zhong Chen, Chang-Ping Yang, Chun Chen, Bin Zheng","doi":"10.21037/tlcr-2024-1160","DOIUrl":"10.21037/tlcr-2024-1160","url":null,"abstract":"<p><strong>Background: </strong>Patients with multiple lung cancer are becoming more common. The optimal criterion to distinguish multiple primary lung cancer (MPLC) from intrapulmonary metastases (IPM) is still unclear. In this study, we try to distinguish between MPLC and IPM and investigate their prognosis and risk factors.</p><p><strong>Methods: </strong>This study was a retrospective analysis of patients with at least two malignant resected nodules in three medical centers from January 2019 to December 2019. Fifty-three patients with 130 lesions were enrolled and tested with 10-gene and 116-gene panels using next-generation sequencing (NGS). Disease-free survival (DFS) was defined as the time from surgery to either the date of the first recurrence (local or distant) or the last follow-up. The follow-up period was up to October 31, 2024. Tumor mutations were identified for each gene using the 116-gene and 10-gene panels, and clonal relatedness was identified by mutational profiling. Univariate and multivariate Cox regression analyses were conducted to identify independent risk factors for DFS.</p><p><strong>Results: </strong>Fifty-three cases with 130 lesions met the inclusion criteria. A total of 16 recurrences were identified during follow-up. The 3- and 5-year DFS was 77.4% and 69.8%, respectively. According to the 116-gene panel, 35 (66.1%) cases favored MPLC, and 18 cases (33.9%) favored IPM on the basis of shared mutations. There was no difference in the 3-year DFS (82.9% <i>vs.</i> 66.7%, log-rank P=0.22), while there was an obvious difference in the 5-year DFS (80% <i>vs.</i> 60%, log-rank P=0.02). Univariate analysis showed alkaline phosphatase and forced expiratory volume in the first second percentage (FEV1%) as risk factors for metastasis (P=0.03 and P=0.003). Multivariate analysis showed that FEV1% was an independent factor (P=0.001). Cox regression analysis showed that the positive covariates were as follows: early stage [hazard ratio (HR) =4.192; 95% confidence interval (CI): 1.378 to 12.749; P=0.01] and MPLC (HR =0.187; 95% CI: 0.057 to 0.613; P=0.006).</p><p><strong>Conclusions: </strong>NGS-based 116-gene panel classification can improve the accuracy of diagnosing MPLC and IPM. The diagnosis of IPM was associated with poor prognosis in Asian population.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1699-1714"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant tepotinib in stage IIB N0 non-small cell lung carcinoma with <i>MET</i> exon 14 skipping mutation: a case report and review of the literature.","authors":"Amanda Reyes, Rebecca Pharaon, Atish Mohanty, Jae Kim, Erminia Massarelli","doi":"10.21037/tlcr-2024-1197","DOIUrl":"10.21037/tlcr-2024-1197","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer has the highest mortality rate world-wide, but treatments for non-small cell lung cancer (NSCLC) including immune check point inhibitors and targeted tyrosine kinase inhibitors have greatly improved survival. Many of the targeted tyrosine kinase inhibitors have already been approved in the first line in metastatic disease. The use of combination chemotherapy and immunotherapy treatment in the perioperative setting has been highly successful, but patients with driver alterations were largely left out including patients with mesenchymal epithelial transition exon 14 (<i>MET</i> Ex14) mutations. There are on-going randomized controlled clinical trials evaluating targeted kinase inhibitors in the perioperative setting. We also provide an in-depth overview of the MET pathway as well as the current state of <i>MET</i>-targeted peri-operative treatment in lung cancer and highlight the relevant trials.</p><p><strong>Case description: </strong>We discuss the rationale and clinical course of the use of neoadjuvant and adjuvant tepotinib in a case study of an elderly patient with a <i>MET</i> Ex14 mutation in surgically resectable stage IIB N0 NSCLC, who was not an optimal candidate for traditional chemotherapy for several reasons.</p><p><strong>Conclusions: </strong>From the single case report, we found that tepotinib was both safe and effective when used in the neoadjuvant setting with no evidence of recurrence after greater than one year of post-operative follow up. Adjuvant treatment was not as well tolerated and therefore stopped. We conclude with a discussion on the advantages and potential downfalls of <i>MET</i>-targeted tyrosine kinase inhibitors in the perioperative setting as well as some potential new areas of investigation.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 5","pages":"1870-1876"},"PeriodicalIF":4.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12170110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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}