Translational lung cancer research最新文献

{"title":"A novel optimization of cone beam CT frequency for lung radiation therapy based on an image-guided radiation therapy protocol and patient classification method.","authors":"Jinghao Zhou, Arun Gopal, Baoshe Zhang, Huijun Xu, Shifeng Chen, ByongYong Yi, Giovanni Lasio","doi":"10.21037/tlcr-24-606","DOIUrl":"10.21037/tlcr-24-606","url":null,"abstract":"<p><strong>Background: </strong>Cone beam computed tomography (CBCT) is a standard imaging modality in the management of lung cancer with radiation therapy. The optimal frequency of CBCT imaging during a course of radiotherapy is not currently strongly defined for many anatomical sites, including lung, and in clinical practice typically ranges from daily to weekly. There is a trade-off between clinical benefit derived from optimal soft tissue targeting with daily CBCT and the increased non-therapeutic dose that such imaging regimen entails. The aim of this study is to address this matter by proposing a new image-guided radiation therapy (IGRT) protocol and a patient classification method to achieve an optimal CBCT frequency for conventionally fractionated lung cancer radiation therapy.</p><p><strong>Methods: </strong>This Institutional Review Board (IRB)-approved study analyzes 110 lung cancer patients, with a total of 1616 CBCTs during treatment. The in-house IGRT protocol involves daily CBCT for the first three fractions followed by weekly CBCT for soft tissue alignment, along with daily kV-orthogonal for bony anatomy alignment. The eligibility of patient of using this IGRT protocol is determined by a criterion based on numbers of CBCT position matches (equal to 3 fractions match in the first three CBCTs, or great than or equal to 3 fractions match in the first four CBCTs). The fraction matching threshold values 40-70% of protocol-eligible group (eGroup) were applied, as well as the setup threshold (ST) values of 3, 4, and 5 mm were applied, respectively. Sensitivities, specificities and accuracies were computed to quantitate our proposed classification method.</p><p><strong>Results: </strong>With ST at 3, 4, and 5 mm, with the best fraction matching threshold of 50% found in current dataset, the eGroup included 83.5%, 96.2%, and 98.7% of patients, respectively. More patients are eligible to IGRT protocol if a larger pre-defined ST is used. Sensitivities for identifying a protocol-ineligible group (iGroup) patient were 0.69, 1.0, and 1.0, specificities for identifying an eGroup patient were 0.85, 0.93, and 0.96, while accuracies were 0.82, 0.94 and 0.96, respectively.</p><p><strong>Conclusions: </strong>We have proposed a new patient classification approach in the context of an IGRT protocol with optimized CBCT frequency for conventionally fractionated lung cancer radiation therapy. The first three CBCT helps predict patient eligibility of this IGRT protocol. We have evaluated different threshold criteria and found high sensitivity, specificities and accuracies are achievable. This study supports that weekly CBCT is sufficient for the most of the lung patients. The same method, proposed adaptive classification approach in this study, might also be applied for other anatomic sites.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 1","pages":"81-95"},"PeriodicalIF":4.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433670","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 features and outcomes of unresectable locally advanced lung adenocarcinoma with uncommon <i>EGFR</i> mutations: a retrospective multi-center Chinese study.","authors":"Kunpeng Xu, Xiao-Li Zheng, Ming Chen, Mingyan E, Li Zhang, Jianzhong Cao, Xu Zhang, Xiao Ding, Bing Xia, Lujun Zhao, Hongbin Wang, Jiancheng Li, Chen Hu, Wei Jiang, Hong Ge, Nan Bi, Luhua Wang","doi":"10.21037/tlcr-24-751","DOIUrl":"10.21037/tlcr-24-751","url":null,"abstract":"<p><strong>Background: </strong>Uncommon epidermal growth factor receptor (<i>EGFR</i>) gene mutant locally advanced non-small cell lung cancer (NSCLC) has been poorly documented in the literature. Our study aimed to investigate the clinical features and outcomes associated with these mutations.</p><p><strong>Methods: </strong>A multi-center retrospective study was conducted to review 511 patients with <i>EGFR</i> mutant unresectable stage III lung adenocarcinoma, treated between 2012 and 2018 across 12 Chinese institutions. The patients were categorized into three groups based on their primary treatment: chemoradiotherapy (CRT), <i>EGFR</i>-TKIs (tyrosine kinase inhibitors), and radiotherapy (RT) combined with <i>EGFR</i>-TKIs.</p><p><strong>Results: </strong>Among the 511 patients, 49 (9.6%) had uncommon <i>EGFR</i> mutations. Of these, 37 had detailed systemic treatment information. The uncommon mutations included exon 18 G719X (22.4%), exon 20 insertion (18.4%), exon 20 S768I (8.2%), T790M (8.2%), and exon 21 L861Q (4.1%). Compound mutations were identified in 34.7% of patients. There was a significant difference in progression-free survival (PFS) for uncommon and common mutation group (median 11.9 <i>vs.</i> 17.5 months, P=0.005). However, no significant difference was observed in overall survival (OS, P=0.14). The median PFS for the uncommon mutation group was 11.9 months for CRT (n=12, 32.4%), 5.0 months for <i>EGFR</i>-TKIs (n=16, 43.2%), and 14.8 months for RT combined with TKIs (n=9, 23.4%) (P=0.02). The median OS for the same groups were 43.6 months, 30.9 months, and not reached, respectively (P=0.18). Compared to <i>EGFR</i>-TKIs, both CRT and RT combined with TKIs significantly improved PFS (P=0.02, 0.04, respectively), and showed a trend toward superior OS compared to <i>EGFR</i>-TKIs (P=0.49, 0.06, respectively).</p><p><strong>Conclusions: </strong>This study was the first to systematically summarize the clinical features and outcomes of unresectable locally advanced lung adenocarcinoma, with uncommon <i>EGFR</i> mutations. RT combined with sensitivity <i>EGFR</i>-TKIs may be a promising treatment option, while CRT remains the primary treatment choice.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 1","pages":"96-106"},"PeriodicalIF":4.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433713","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":"Hyperthermic intrathoracic chemotherapy in overcoming tyrosine kinase inhibitor resistance in a patient with malignant pleural effusion: a case report.","authors":"Xiao-Long Jiang, Wei-Hao Deng, Zhen-Yu Hu, Wei-Jie Cai, Xian-Yu Qin, Hao-Sheng Zheng, Jian Tan, Yu-Zhen Zheng, Hong-Ying Liao","doi":"10.21037/tlcr-2024-1252","DOIUrl":"10.21037/tlcr-2024-1252","url":null,"abstract":"<p><strong>Background: </strong>Lung cancer remains a global health challenge, with an incidence of 23% and an overall 5-year survival of only 19%, as nearly half newly diagnosed cases are at the advanced stages. Among Asian patients, over 50% of lung cancer cases carry epidermal growth factor receptor (<i>EGFR</i>) mutations, highlighting the significance of targeted therapy, mainly <i>EGFR</i> tyrosine kinase inhibitors (TKIs). However, acquired resistance to <i>EGFR</i>-TKIs inevitably occurs, representing a persisting challenge in cancer therapy. Malignant pleural effusion, characterized by lack of blood circulation in the pleural cavity, is commonly found in patients who develop resistance to <i>EGFR</i>-TKIs. Therefore, with traditional drug administration methods, primarily oral or intravenous, drug concentration within the pleural cavity is often insufficient. Hence, traditional therapy, which consists of oral and intravenous medication, along with pleural cavity drainage, often fails to yield a satisfactory outcome.</p><p><strong>Case description: </strong>We report a case in which hyperthermic intrathoracic chemotherapy (HITHOC) was administered in a 50-year-old male patient with malignant pleural effusion and resistance to third-generation TKIs. HITHOC significantly reduced the tumor burden of the patient and helped restore sensitivity to third-generation TKIs.</p><p><strong>Conclusions: </strong>We believe that HITHOC can efficiently improve the drug concentration within the pleural cavity, thereby reducing the tumor burden and eliminating potential TKI-resistant tumor subclones in the patient. This mode of therapy may prove valuable in overcoming TKI resistance.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 1","pages":"292-299"},"PeriodicalIF":4.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433763","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":"Reirradiation using helical tomotherapy-based hypofractionated stereotactic radiotherapy for 19 brain metastases after the second recurrence of distant brain failure: a case report and literature review.","authors":"Tao Wang, Hongfu Zhao, Rafal Suwinski, Guanghui Cheng, Wei Guan","doi":"10.21037/tlcr-2024-1151","DOIUrl":"10.21037/tlcr-2024-1151","url":null,"abstract":"<p><strong>Background: </strong>A definitive optimal oncologic care regimen for recurrent multiple brain metastases (BMs) has yet to be established, and the accrual of high-quality evidence pertaining to helical tomotherapy-based stereotactic radiotherapy (HT-SRT) in patients with BMs is needed.</p><p><strong>Case description: </strong>We treated a 64-year-old male smoker initially diagnosed with non-small cell lung cancer (NSCLC) with BMs, and the initial schedule involved administering linear accelerator-based hypofractionated stereotactic radiotherapy (Linac-HSRT) targeting 6 intracranial lesions. Further chemotherapy was declined due to intolerance after one cycle of paclitaxel-albumin/carboplatin. Distant brain failure (DBF) and extracranial progression emerged 3 months subsequent to the initial SRT, and helical tomotherapy-based hypofractionated stereotactic radiotherapy (HT-HSRT) was replanned to 4 BMs, while helical tomotherapy-based intensity-modulated radiotherapy was employed for the extracranial lesions. Nevertheless, reirradiation with hippocampal-sparing HT-HSRT and simultaneous memantine approach were imminently delivered for confirmed DBF, as 19 newly identified intact intracranial lesions were observed at 5 months posttreatment. As assessed by the Hopkins Verbal Learning Test Revised Total Recall test, neither severe symptomatic radionecrosis (RN) nor neurocognitive dysfunction has manifested thus far, representing a survival period of 20.5 months. In the literature review, SRT delivery schedule to BMs, strategies for managing recurrent BMs and addressing RN, along with 6 summarized published studies of HT-SRT for BM were discussed.</p><p><strong>Conclusions: </strong>We posit that the administration of repeated SRT for recurrent BMs in a short-term interval may be viable, yet randomized, robust analyses are imperative to ascertain the potential benefits of HT-SRT in preserving neurocognition and confirm the efficacy of memantine and hippocampal avoidance during SRT.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 1","pages":"272-286"},"PeriodicalIF":4.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433778","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":"Intraoperative longitude-latitude-depth three-dimensional localization of pulmonary nodules.","authors":"Yue Zhao, Jianhao Qiu, Anna Bright, Renchang Zhao, Rongyang Li, Zhanpeng Tang, Weiming Yue, Hui Tian, Zhenguo Sun","doi":"10.21037/tlcr-2024-1170","DOIUrl":"10.21037/tlcr-2024-1170","url":null,"abstract":"<p><strong>Background: </strong>Identifying small pulmonary nodules during sublobar resection via video-assisted thoracoscopic surgery (VATS) poses certain challenges. Although preoperative computed tomography (CT)-guided localization is common, it is invasive and may lead to complications. This study aims to develop a novel, non-invasive technique for improving the accuracy of pulmonary nodule localization during VATS, with the goal of reducing complications associated with traditional methods.</p><p><strong>Methods: </strong>We developed the longitude-latitude-depth (LLD) localization method, a novel intraoperative approach for localizing small pulmonary nodules. The LLD method uses anatomical reference points derived from the lung's natural structure to guide nodule localization during surgery. This retrospective study compared patients with small pulmonary nodules (≤2 cm in diameter, consolidation tumor ratio ≤0.5, and outer one-third of the pulmonary parenchyma) undergoing either intraoperative LLD localization or preoperative CT-guided hook-and-wire localization followed by VATS at Qilu Hospital of Shandong University from March 2020 to November 2023. Propensity score matching (PSM) analysis was used to the compare clinical information and perioperative outcomes, with 176 patients in each group after matching was performed.</p><p><strong>Results: </strong>Compared to the CT-guided localization, the LLD method achieved higher accuracy (96.59%) during surgery and had a significantly reduced localization duration (5 <i>vs.</i> 18 min), needle-carrying time (0 <i>vs.</i> 81. min), localization complications (pain: 0% <i>vs.</i> 4.55%; hemothorax: 0% <i>vs.</i> 3.41%; pneumothorax: 0% <i>vs.</i> 4.55%; hemoptysis: 0% <i>vs.</i> 6.82%), estimated blood loss (37.5 <i>vs.</i> 55 mL), chest tube removal time (3 <i>vs.</i> 4 days), postoperative pain score (3 <i>vs.</i> 4 score), postoperative day (5 <i>vs.</i> 6 days), hospitalization cost (CNY ¥39764.25 <i>vs.</i> CNY ¥48458.41), and failure rate (3.41% <i>vs.</i> 8.52%).</p><p><strong>Conclusions: </strong>LLD localization is noninvasive, time-saving, and cost-effective and may be a feasible, safe, and effective technique for localizing small pulmonary nodules during surgery.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 1","pages":"260-271"},"PeriodicalIF":4.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433792","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":"Single-cell and spatial transcriptomics reveal a potential role of ATF3 in brain metastasis of lung adenocarcinoma.","authors":"Chaoliang Xu, Jingpiao Bao, Deshen Pan, Kehong Wei, Qing Gao, Weihong Lin, Yujie Ma, Meiqing Lou, Cheng Chang, Deshui Jia","doi":"10.21037/tlcr-24-784","DOIUrl":"10.21037/tlcr-24-784","url":null,"abstract":"<p><strong>Background: </strong>Brain metastasis (BrM) has been a challenge for lung cancer treatment, but the mechanisms underlying lung cancer BrM remain elusive. This study aims to dissect cellular components and their spatial distribution in human BrM tumors of lung adenocarcinoma (LUAD) and identify potential therapeutic targets.</p><p><strong>Methods: </strong>We performed single-cell RNA sequencing (scRNA-seq) and spatial transcriptomics (ST) on three LUAD BrMs, and validated our findings using public scRNA-seq data of 10 LUAD BrMs. Western blotting, quantitative real-time polymerase chain reaction (qRT-PCR) and functional experiments were employed for experimental studies.</p><p><strong>Results: </strong>By combining scRNA-seq and ST, our analysis revealed the inter- and intra-tumoral heterogeneity of cellular components and their spatial localization within LUAD BrMs. Through RNA velocity and transcription factor (TF) regulatory activity analyses, we identified ATF3 as a potential regulator of the mesenchymal-epithelial transition (MET) program, which plays crucial roles in the colonization of tumor cells at metastatic sites. Furthermore, we demonstrated that knockdown of <i>ATF3</i> significantly inhibited cancer cell proliferation while promoting cancer cell migration. Mechanistically, ATF3 knockdown could reverse the MET program. Additionally, we revealed that LGALS3/ANXA2-mediated cell-cell interaction between macrophage and tumor cells may also promote the MET program.</p><p><strong>Conclusions: </strong>Our study provides a single-cell atlas of the cellular composition in BrM of LUAD and identifies ATF3 as a potential therapeutic target for BrM treatment.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 1","pages":"209-223"},"PeriodicalIF":4.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433869","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":"<i>GNGT1</i> remodels the tumor microenvironment and promotes immune escape through enhancing tumor stemness and modulating the fibrinogen beta chain-neutrophil extracellular trap signaling axis in lung adenocarcinoma.","authors":"Lin-Lin Fan, Xiao-Wei Wang, Xiu-Mei Zhang, Zhi-Yong Wei, Hui-Yi Wu, Qin-Xin Yang, Da Fu, Ramon Andrade de Mello, Jie-Wei Lin, Hong Yu, Geng-Xi Jiang","doi":"10.21037/tlcr-2024-1200","DOIUrl":"10.21037/tlcr-2024-1200","url":null,"abstract":"<p><strong>Background: </strong>Despite the recent advancements in the treatment of cancer, the 5-year survival of patients with non-small cell lung cancer (NSCLC) remains unsatisfactory. Lung adenocarcinoma (LUAD) is NSCLC's most common subtype, and metastasis is the major cause of death in patients with cancer. Therefore, identifying novel targets associated with metastasis in NSCLC is crucial to improving treatment. This study aimed to characterize the expression of GNGT1 in LUAD and to clarify the mechanism underlying the association between the higher expression level of GNGT1 and worse prognosis in patients.</p><p><strong>Methods: </strong>The transcriptome datasets and clinical information of patients with LUAD were obtained from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database. Bioinformatics analyses were performed in 515 patients who were stratified into two groups (high- and low-GNGT1 expression group) according to the GNGT1 level. Overall survival, DNA promotor methylation, immune cell infiltration, gene set enrichment analysis (GSEA), and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed to elucidate the functions of GNGT1 and to identify the related hub genes in LUAD. Their expression and functions in LUAD were verified using tissues from patients and transgenic mice overexpressing GNGT1 under the control of a lung-specific promoter (Scgb1a1-Cre).</p><p><strong>Results: </strong>GNGT1 was overexpressed in patients with LUAD and was associated with poor prognosis. GNGT1 expression was significantly correlated with gene alteration and hypomethylated promoter status. High GNGT1 expression in patients with LUAD was associated with advanced lymph node metastasis and the degree of immune cell infiltration. Functional enrichment analyses indicated that differentially expressed genes (DEGs) in the high-GNGT1 group participated in DNA replication, DNA replication preinitiation, and M phase, while cell adhesion molecules, apoptosis, and natural killer cell-mediated cytotoxicity were all downregulated. Messenger RNA and protein levels were correspondingly regulated in human LUAD tissues and the Scgb1a1-Cre; LSL-GNGT1 mouse model (GNGT1^fl/+ mice).</p><p><strong>Conclusions: </strong>GNGT1 was associated with tumor cell proliferation via the enhancement of tumor cell stemness and interaction with driver genes. Elevated GNGT1 expression promoted epithelial-mesenchymal transformation, remodeled the tumor microenvironment, and led to tumor metastasis, ultimately worsening the survival-related prognosis of patients with LUAD.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 1","pages":"239-259"},"PeriodicalIF":4.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432490","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":"Video-assisted mediastinocopic lymphadenectomy (VAMLA) for restaging clinical N2-3 non-small cell lung cancer (NSCLC) after neoadjuvant treatment.","authors":"Nina Reig-Oussedik, Sergi Call, Carme Obiols, Bruno Garcia-Cabo, José Sanz-Santos, Lucía Reyes Cabanillas-Paredes, Juan Manuel Ochoa-Alba, Mireia Serra-Mitjans, Ramón Rami-Porta","doi":"10.21037/tlcr-24-841","DOIUrl":"10.21037/tlcr-24-841","url":null,"abstract":"<p><strong>Background: </strong>Reliable mediastinal restaging after neoadjuvant treatment to rule out persistent nodal disease is essential to select patients for resection. Main endpoints of this study are: to analyse the accuracy of video-assisted mediastinoscopic lymphadenectomy (VAMLA) and to determine the rate of persistent N2-3 in patients with clinical N2-3 (cN2-3) non-small cell lung cancer (NSCLC) after neoadjuvant treatment.</p><p><strong>Methods: </strong>Prospective observational single-centre study of patients with NSCLC and histologically proven mediastinal involvement (cN2-3), treated with neoadjuvant therapy who underwent VAMLA for restaging. Patients with negative VAMLA underwent lung resection. Systematic nodal dissection (SND) was considered the reference test to confirm negative VAMLAs. Staging values were calculated based on pathologic findings using the standard formulas.</p><p><strong>Results: </strong>From 2017 to 2023, 41 patients with cN2-3 NSCLC received neoadjuvant therapy and thereafter underwent VAMLA for restaging. Neoadjuvant treatments: concomitant cisplatin-based chemotherapy and radical radiotherapy (n=33), chemoradiotherapy and immunotherapy (n=2), chemotherapy (n=2), chemotherapy and immunotherapy (n=2), tyrosine kinase inhibitor and immunotherapy (n=1) and immunotherapy (n=1). VAMLA was feasible in all patients. Restaging values with VAMLA were: sensitivity, 1 [95% confidence interval (CI): 0.72-1]; negative predictive value (NPV), 1 (95% CI: 0.89-1); and diagnostic accuracy, 1 (95% CI: 0.91-1). Rate of persistent N2 of the whole series: 29% (12/41). Complication rate was 9.7%.</p><p><strong>Conclusions: </strong>This preliminary series of patients with cN2-3 NSCLC treated with neoadjuvant treatment and restaged by VAMLA demonstrated high accuracy and high rate of persistent N2. VAMLA should be included in restaging algorithms to select patients with potentially resectable cN2-3 NSCLC.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"14 1","pages":"58-71"},"PeriodicalIF":4.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433886","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":"Spontaneous ventilation video-assisted thoracoscopic surgery for octogenarian non-small cell lung cancer patients: a non-inferiority study.","authors":"Yulin Zhao, Xuanzhuang Lu, Runchen Wang, Keyao Dai, Huiwen Yu, Chongde Pan, Jiaqin Zhang, Xianzhe Fan, Yanwei Lin, Hengrui Liang, Jianxing He, Wei Wang, Lan Lan","doi":"10.21037/tlcr-24-725","DOIUrl":"https://doi.org/10.21037/tlcr-24-725","url":null,"abstract":"<p><strong>Background: </strong>The benefits of spontaneous ventilation (SV)-video-assisted thoracoscopic surgery (VATS) in octogenarian patients with non-small-cell lung cancer (NSCLC) have rarely been reported. This retrospective study was conducted to evaluate the safety and feasibility of SV-VATS in octogenarian patients with NSCLC.</p><p><strong>Methods: </strong>Patients with NSCLC aged >80 years who underwent SV-VATS or mechanical ventilation (MV)-VATS between 2017 and 2022 were included in this study. The baseline characteristics of the two groups were balanced by a 1:2 propensity score matching (PSM). Intraoperative and postoperative outcomes were compared. Overall survival (OS) and disease-free survival (DFS) were analyzed by Kaplan-Meier survival analysis and Cox regression.</p><p><strong>Results: </strong>A total of 251 patients were initially included, and after applying selection criteria and PSM, 22 patients were in the SV-VATS group and 44 in the MV-VATS group. Baseline characteristics were well balanced between the two groups. Compared with the MV-VATS group, the SV-VATS group had shorter post-anesthesia care unit (PACU) stay (88.8±22.3 <i>vs.</i> 111±38.8, P=0.01) and shorter resuscitation time (88.8±22.7 <i>vs.</i> 112±40.4, P=0.02). No statistically significant differences were observed in the surgical and anaesthesia times, chest tube duration, total volume of chest drainage, intraoperative blood loss, postoperative hospital stay, or complications in the PACU. The OS and DFS of patients who underwent SV-VATS were comparable to those of patients who underwent MV-VATS.</p><p><strong>Conclusions: </strong>SV-VATS appears to be a safe and feasible option for octogenarian patients with NSCLC, providing a new approach to surgical treatment. Large-scale prospective studies are required to further validate its feasibility.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"13 12","pages":"3555-3565"},"PeriodicalIF":4.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012333","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":"Construction of a neutrophil extracellular trap formation-related gene model for predicting the survival of lung adenocarcinoma patients and their response to immunotherapy.","authors":"Yuan Wang, Shuang Liang, Qian Hong, Juwei Mu, Yuxin Wu, Kexin Li, Yiling Li, Yue Wu, Xiaoying Lou, Danfei Xu, Wei Cui","doi":"10.21037/tlcr-24-463","DOIUrl":"https://doi.org/10.21037/tlcr-24-463","url":null,"abstract":"<p><strong>Background: </strong>Lung adenocarcinoma (LUAD) is associated with high morbidity and mortality rates. Increasing evidence indicates that neutrophil extracellular traps (NETs) play a critical role in tumor progression, metastasis and immunosuppression in the LUAD tumor microenvironment (TME). Nevertheless, the use of NET formation-related genes (NFRGs) to predict LUAD patient survival and response to immunotherapy has not been explored. Therefore, this study aimed to construct a NFRGs-based prognostic signature for stratifying LUAD patients and informing individualized management strategies.</p><p><strong>Methods: </strong>The cell composition of the LUAD TME was investigated using the single-cell sequencing data in Single-Cell Lung Cancer Atlas (LuCA). NFRGs were identified to construct a prognostic signature based on The Cancer Genome Atlas (TCGA) cohort which was validated in the Gene Expression Omnibus (GEO) dataset. The univariate Cox and least absolute shrinkage and selection operator (LASSO) Cox regression models, receiver operating characteristic (ROC) and Brier Score were applied to assess the prognostic model. A nomogram was established to facilitate the clinical application of the risk score. The Estimation of STromal and Immune cells in MAlignant Tumor tissues (ESTIMATE) and Tumor Immune Dysfunction and Exclusion (TIDE) algorithm were utilized to assess the TME and predict immunotherapy response. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was applied to quantify the expression levels of four NFRGs in LUAD paired tissue samples.</p><p><strong>Results: </strong>Single‑cell RNA sequence analysis showed the importance of neutrophils in LUAD TME. We developed and validated a 4-NFRG (CAT, CTSG, ENO1, TLR2) prognostic signature based on TCGA and GEO cohorts, which stratified patients into high-risk and low-risk groups. Univariate and multivariate analyses showed that our risk model could independently predict the survival of LUAD patients. Patients in the low-risk group exhibited a more active immune microenvironment, lower TIDE scores, lower half-maximal inhibitory concentration (IC50) values and higher immune checkpoint molecule expression. Our risk signature could serve as a biomarker for predicting immunotherapeutic benefits.</p><p><strong>Conclusions: </strong>We developed a novel prognostic signature for LUAD patients based on NFRGs and emphasized the critical role of this signature in predicting LUAD patient survival and immunotherapy response.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"13 12","pages":"3407-3425"},"PeriodicalIF":4.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11736607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012004","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}