Translational lung cancer research最新文献

{"title":"Combined association of genetic predisposition and healthy lifestyle with lung cancer risk: a population-based cohort study.","authors":"Zheng Li, Wenhai Fu, Yu Jiang, Yi Feng, Xusen Zou, Yulin Zhao, Peiling Chen, Runchen Wang, Caichen Li, Jianxing He, Wenhua Liang","doi":"10.21037/tlcr-2026-0548","DOIUrl":"10.21037/tlcr-2026-0548","url":null,"abstract":"<p><strong>Background: </strong>Polygenic susceptibility and modifiable lifestyle behaviors contribute to lung cancer, but their interaction and combined impact on lung cancer hazard and potential biological correlations remain incompletely characterised. This study aimed to evaluate the independent and combined associations of polygenic risk and healthy lifestyle with lung cancer hazard and to explore potential biological correlations underlying these associations.</p><p><strong>Methods: </strong>We analyzed data of 254,874 UK Biobank (UKB) participants. A five-component lifestyle score (smoking, alcohol intake, diet, physical activity and sedentary behavior) was summed [0-5] and categorized as unfavorable (0-1 factors), intermediate [2] and favorable [3-5]. An 18-single nucleotide polymorphism (SNP) polygenic risk score (PRS) was standardized and categorized into tertiles (low/intermediate/high). Cox proportional hazards models estimated associations with lung cancer hazard; additive interaction was assessed using the relative excess risk due to interaction (RERI). Mediation analyses of peripheral markers and circulating proteins were exploratory.</p><p><strong>Results: </strong>Among 254,874 UKB participants, 2,021 lung cancers occurred over a median of 11.69 years. A favorable lifestyle was associated with lower lung cancer hazard [hazard ratio (HR) 0.34; 95% confidence interval (CI): 0.30-0.38; P<0.001], while high PRS was associated with higher hazard (HR 1.62, 95% CI: 1.45-1.81; P<0.001). In the high PRS group, favorable lifestyle remained protective (HR 0.36, 95% CI: 0.30-0.44; P<0.001), whereas intermediate lifestyle was not statistically significant (HR 0.85, 95% CI: 0.68-1.05; P=0.13). The global multiplicative interaction between lifestyle class and PRS category was not significant (P for global interaction =0.49), although selected additive interaction signals were observed, including high PRS combined with intermediate lifestyle (RERI 0.92, 95% CI: 0.31-1.55). Exploratory mediation suggested partial signals for inflammatory markers and proteins (WFDC2, PIGR, PRSS8).</p><p><strong>Conclusions: </strong>This large-scale prospective study confirms the protective association of a healthy lifestyle with a lower lung cancer hazard. Importantly, in individuals with high genetic susceptibility, moderate lifestyle improvements may not fully offset the elevated hazard, underscoring the need for more comprehensive lifestyle interventions in this high genetic-susceptibility population. Mediation findings provide hypothesis-generating clues for future mechanistic work.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"242"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931175","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":"Marginal benefit of segmentectomy over lobectomy in minimally invasive surgery for stage IA lung cancer.","authors":"Yang Chen, Yiyang Wang, Chenlei Zhang, Sara Cattadori, Alessio Campisi, Sara Ricciardi, Shaoyuan Zhang, Wanpu Yan, Bofei Li, Rongji Mu, Hongxu Liu, Lijie Tan, Keneng Chen, Luigi Ventura, Maurizio Infante, Giuseppe Cardillo, Wentao Fang","doi":"10.21037/tlcr-2026-0929","DOIUrl":"10.21037/tlcr-2026-0929","url":null,"abstract":"<p><strong>Background: </strong>In the treatment of stage IA lung cancers, segmentectomy has been demonstrated to be oncologically noninferior to lobectomy, but its perioperative benefits remain unclear. This real-world study aimed to evaluate whether reducing resection extent in minimally invasive segmentectomy provides perioperative benefits compared with lobectomy.</p><p><strong>Methods: </strong>Data from consecutive patients undergoing minimally invasive segmentectomy or lobectomy at eight Chinese and Italian hospitals between January 2014 and December 2020 were retrospectively collected. Patients with previous thoracic surgery, disease above clinical stage IA, induction therapy, right-middle-lobe lesions, or extended resection were excluded. The primary endpoint was any postoperative complication of Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 grade ≥3 within 30 days. Perioperative outcomes were compared after propensity score matching (PSM). A nomogram was developed to identify patients at high risk of experiencing grade ≥3 complications after lobectomy. Stratified subgroup and Bayesian analyses were also performed.</p><p><strong>Results: </strong>Among 2,542 patients, 2,500 underwent surgery with curative intent (821 segmentectomies and 1,679 lobectomies), and 801 pairs were matched. Segmentectomy was associated with a numerically lower rate of grade ≥3 complications than lobectomy (4.7% <i>vs.</i> 7.1%; P=0.057), with a similar trend for prolonged air leak (PAL) (2.5% <i>vs.</i> 4.2%; P=0.07). In the nomogram-defined high-risk subgroup, segmentectomy had a 92.1% posterior probability of reducing PAL, with no difference in other complications. Segmentectomy involving <1/2 of the corresponding lobe had a 96.4% posterior probability of reducing PAL.</p><p><strong>Conclusions: </strong>Minimally invasive segmentectomy was associated with some short-term recovery advantages over lobectomy, but no statistically significant reduction in 30-day grade ≥3 complications or PAL was demonstrated. Its perioperative benefit in high-risk patients appeared limited and was mainly related to PAL.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"250"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931022","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":"Narrative review of research progress and future development of bispecific antibodies in lung cancer: opportunities and challenges.","authors":"Yunfei Dai, Jing Fei","doi":"10.21037/tlcr-2026-0977","DOIUrl":"10.21037/tlcr-2026-0977","url":null,"abstract":"<p><strong>Background and objective: </strong>Lung cancer remains a leading cause of cancer-related mortality worldwide. Despite the advances being achieved in the development of targeted therapies and immune checkpoint inhibitors (ICIs), tumor heterogeneity, acquired resistance, and the scarcity of effective salvage regimens continue to limit positive long-term outcomes. In recent years, bispecific antibodies (BsAbs) have garnered substantial attention as a promising modality for address these unmet needs. This review was conducted to characterize the research on BsAbs in lung cancer therapy, with a focus on their mechanisms of action, clinical development, current challenges, and future directions.</p><p><strong>Methods: </strong>A comprehensive literature search for clinical studies and reviews published in English from January 1, 2020 to May 1, 2026, was conducted in the PubMed, Web of Science, and ClinicalTrials.gov databases with keywords such as \"bispecific antibodies\" and \"lung cancer\".</p><p><strong>Key content and findings: </strong>BsAbs concurrently engage two distinct antigens to redirect immune effector cells or inhibit multiple oncogenic signaling pathways via four primary mechanisms: immune bridging, receptor blockade, immune checkpoint targeting, and bispecific antibody-drug conjugates (BsADCs). Recent years landmark trials have cemented the role of BsAbs in lung cancer such as MARIPOSA (amivantamab), HARMONi-A (ivonescimab) and DeLLphi-304 (tarlatamab), and more dual/multi-specific antibodies with new targets and new mechanisms of action have entered the clinical stage. However, how to reduce toxicity and enhance efficacy, as well as optimize the combined treatment strategies, still remains a major challenge in the future development of dual/multi-specific antibodies.</p><p><strong>Conclusions: </strong>BsAbs represent a promising therapeutic strategy for lung cancer. Continued advances in antibody engineering, target identification, and clinical application strategies are expected to further improve their therapeutic potential and expand their role in the treatment of lung cancer.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"263"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931028","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":"Association between oxidative stress index and lung cancer risk in idiopathic pulmonary fibrosis: an exploratory retrospective analysis.","authors":"Kiyofumi Shimoji, Tetsu Hirakawa, Kakuhiro Yamaguchi, Shinjiro Sakamoto, Yasushi Horimasu, Takeshi Masuda, Taku Nakashima, Hironobu Hamada, Hiroshi Iwamoto","doi":"10.21037/tlcr-2026-0585","DOIUrl":"10.21037/tlcr-2026-0585","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic pulmonary fibrosis (IPF) is a significant risk factor for lung cancer. However, early detection is often hindered by background fibrotic changes. This study assessed whether the oxidative stress index (OSI), which reflects the balance between systemic oxidative stress and antioxidant capacity, is associated with lung cancer development in patients with IPF.</p><p><strong>Methods: </strong>We retrospectively analyzed 90 patients with newly diagnosed IPF. Serum levels of derivatives of reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP) were measured at diagnosis to calculate the OSI (100 × d-ROMs/BAP). Using a 1-year landmark approach (n=83), the primary endpoint was lung cancer development during the follow-up period.</p><p><strong>Results: </strong>Fifteen patients (18.1%) developed lung cancer. Although individual d-ROMs showed no significant differences between cohorts, the baseline OSI was significantly higher in the lung cancer group than in the non-lung cancer group (P<0.001). Receiver operating characteristic analysis demonstrated high discriminative capacity of the OSI (area under the curve: 0.857), with an optimal cut-off of 14.39. Multivariate Cox regression analysis indicated an independent association between the OSI and lung cancer development, even after adjusting for antifibrotic use and macrophage proportion in bronchoalveolar lavage fluid (BALF). Notably, the OSI did not significantly predict all-cause mortality, suggesting its relative specificity for carcinogenesis in this population.</p><p><strong>Conclusions: </strong>Baseline OSI may serve as a potential biomarker associated with future lung cancer development in patients with IPF, independent of antifibrotic agent use and BALF macrophage proportion. Further large-scale prospective studies are needed to validate whether OSI-guided risk stratification can help optimize surveillance strategies for this high-risk population.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"230"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931097","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":"Neo-DIANA: descriptive results of a prematurely terminated phase II trial of neoadjuvant atezolizumab, chemotherapy and bevacizumab in resectable EGFR-mutated NSCLC.","authors":"Ana Collazo-Lorduy, Virginia Calvo, Ernest Nadal, Mariano Provencio","doi":"10.21037/tlcr-2026-0711","DOIUrl":"10.21037/tlcr-2026-0711","url":null,"abstract":"<p><p>Reducing postoperative recurrence remains an unmet need in locally advanced non-small-cell lung cancer (NSCLC), particularly in patients with epidermal growth factor receptor (EGFR)-mutated tumours, who are at higher risk of distant metastases after surgery; particularly brain metastases. Perioperative and neoadjuvant chemoimmunotherapy strategies have improved survival outcomes in unselected populations; however, the evidence in EGFR-mutated NSCLC remains limited because most pivotal trials-including NADIM, NADIM II, CheckMate 816, RATIONALE-315, CheckMate 77T and Neotorch-excluded patients with known EGFR mutations. This gap provides a rationale for exploring the use of anti-angiogenic agents combined with chemoimmunotherapy in a molecular subgroup that is usually less-immunoresponsive. While this strategy has demonstrated efficacy in the metastatic EGFR-mutated setting, as reported in IMpower150, ATTLAS/KCSG-LU19-04 or ORIENT-31 study, prospective evidence in resectable disease is lacking. The Neo-DIANA trial was a multicentre, open-label, non-randomised phase II clinical trial designed to investigate a neoadjuvant regimen combining atezolizumab, chemotherapy and bevacizumab, followed by surgery and adjuvant atezolizumab, in resectable stages IIIA and IIIB EGFR-mutated NSCLC. Because the trial was terminated early due to slow recruitment, no conclusions can be drawn regarding the efficacy of combination therapy in patients with resectable EGFR-mutated NSCLC. Further studies are still needed to explore perioperative strategies that may help reduce postoperative relapses in these patients.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"253"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931139","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":"Chest CT-detected pulmonary nodules across the COVID-19 pandemic in Guangzhou, China: a regression discontinuity-in-time study, 2013-2023.","authors":"Wenjun Ye, Wenhai Fu, Yi Feng, Weizheng Zhang, Deliang Xiong, Hui Zhou, Bo Cheng, Caichen Li, Qi Cai, Xiwen Liu, Peiling Chen, Jianxing He, Wenhua Liang","doi":"10.21037/tlcr-2026-0481","DOIUrl":"10.21037/tlcr-2026-0481","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chest computed tomography (CT) examinations became more frequent during and after the coronavirus disease 2019 (COVID-19) pandemic, increasing incidental pulmonary nodule detection and concern about surveillance burden and lung cancer risk. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause persistent focal pulmonary abnormalities that may resemble nodules on CT. Population-level evidence on changes in pulmonary nodule detection or progression after vaccination and widespread infection remains limited. We aimed to determine whether COVID-19 vaccination phases and the late-2022 SARS-CoV-2 infection wave were associated with abrupt changes in pulmonary nodule detection or CT-based progression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a retrospective cohort study using records from The First Affiliated Hospital of Guangzhou Medical University and the Guangzhou Cadre Health Management Center in Guangzhou, China. We analyzed 772,506 chest CT scans acquired from January 2013 to December 2023, including 627,164 inpatient scans, 46,411 hospital health-examination scans, and 98,931 cadre health-examination scans. Monthly pulmonary nodule detection and progression rates were calculated using 6-30 mm as the main nodule-size criterion and 0-30 mm as a secondary criterion. Regression discontinuity-in-time (RDiT) analyses examined four prespecified calendar time points: the first, second, and third COVID-19 vaccination phases in December 2020, June 2021, and September 2021, respectively, and the concentrated SARS-CoV-2 infection wave beginning in December 2022 after China's late-2022 policy restructuring.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The cohorts included 328,223 inpatients, 29,279 hospital health examinees, and 46,587 cadre health examinees. Median ages were 55 [interquartile range (IQR), 43-65], 46 (IQR, 36-54), and 50 (IQR, 43-57) years, respectively. Male proportions were 53.57%, 47.69%, and 66.81%. From 2013 to 2023, detection rates for 6-30 mm nodules increased from 25.85% to 31.19% in the inpatient cohort, from 12.11% to 21.64% in the hospital health-examination cohort, and from 18.38% to 29.49% in the cadre health-examination cohort. Nodules smaller than 6 mm accounted for an increasing share of detections over time. RDiT analyses showed no reproducible abrupt increase in 6-30 mm nodule detection around the three vaccination phases or the late-2022 SARS-CoV-2 infection wave. Detection P values ranged from 0.06 to 0.85, and progression P values, where estimable, ranged from 0.058 to 0.94. Secondary analyses using the 0-30 mm criterion and sex-specific inpatient analyses showed consistent patterns.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In these Guangzhou cohorts, the gradual increase in pulmonary nodule detection from 2013 to 2023 primarily reflected greater ascertainment of nodules smaller than 6 mm. COVID-19 vaccination phases and the late-2022 SARS-CoV-2 infection wave were not accompan","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"245"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931155","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":"Bronchoalveolar lavage fluid <i>EGFR</i> genotyping during bronchoscopic biopsy: concordance with tissue and additional molecular diagnostic yield in lung cancer.","authors":"Duk Ki Kim, Jae Young Hur, Hee Joung Kim, In Ae Kim, Jeong Eun Lee, Chaeuk Chung, Da Hyun Kang, So-Yun Kim, Green Hong, Dongil Park, Kye Young Lee","doi":"10.21037/tlcr-2026-0664","DOIUrl":"10.21037/tlcr-2026-0664","url":null,"abstract":"<p><strong>Background: </strong>Tissue-based <i>EGFR</i> genotyping during the initial diagnostic work-up for suspected lung cancer is often limited by inadequate bronchoscopic biopsy material, and the clinical utility of bronchoalveolar lavage fluid (BALF) <i>EGFR</i> genotyping remains unclear. This study aimed to assess concordance between tissue and BALF <i>EGFR</i> genotyping and to determine whether BALF <i>EGFR</i> testing provides additional molecular diagnostic yield beyond tissue-based testing.</p><p><strong>Methods: </strong>In this prospective single-center study, adults with suspected lung cancer underwent bronchoscopic biopsy with BALF collection for extracellular vesicle-derived DNA <i>EGFR</i> testing. The primary endpoint was concordance between tissue and composite BALF <i>EGFR</i> genotyping in pathologically confirmed lung adenocarcinoma. Secondary endpoints included positive percent agreement (PPA), negative percent agreement (NPA), and additional molecular detection yield. An exploratory stage-based concordance analysis compared early-stage (stage I-II) with advanced-stage (stage III-IV) disease.</p><p><strong>Results: </strong>Among 54 patients with histopathologically confirmed lung adenocarcinoma, 49 had evaluable tissue and composite BALF <i>EGFR</i> results and were included in the primary analysis. The overall concordance rate was 89.8% [44/49; 95% confidence interval (CI), 78.2-95.6%], with a PPA of 83.3% (20/24; 95% CI, 64.1-93.3%) and an NPA of 96.0% (24/25; 95% CI, 80.5-99.3%). Variant-level agreement among double-positive cases was 100.0% (20/20). In an exploratory subgroup analysis, concordance was similar between early-stage (stage I-II) and advanced-stage (stage III-IV) disease (89.2% <i>vs</i>. 91.7%; P>0.99). Additional molecular detection yield beyond tissue-based testing was observed in 3 of 30 patients (10.0%), including one case of genotyping rescue among tissue wild-type cases and two cases of <i>EGFR</i> mutation detection among patients with unavailable tissue genotyping results. Notably, both of the latter patients had non-diagnostic initial bronchoscopic biopsy results and were subsequently confirmed as having lung adenocarcinoma.</p><p><strong>Conclusions: </strong>BALF <i>EGFR</i> genotyping showed high concordance with tissue <i>EGFR</i> results and provided additional molecular detection yield. BALF <i>EGFR</i> genotyping may complement tissue biopsy and improve molecular diagnostic yield in suspected lung cancer.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 8","pages":"246"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148931172","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":"Predictors of prolonged hospital stay in patients with lung cancer undergoing sublobar resection.","authors":"Liang Xia, Xiaohu Hao, Ruichen Cui, Jiahan Cheng, Minzhang Guo, Wenjing Zhou, Shasha Li, Qiang Pu, Yunke Zhu","doi":"10.21037/tlcr-2026-0724","DOIUrl":"10.21037/tlcr-2026-0724","url":null,"abstract":"<p><strong>Background: </strong>Sublobar resection (SLR) has become the standard treatment for patients with peripheral early-stage non-small cell lung cancer (NSCLC). Identifying the risk factors contributing to prolonged length of stay (LOS) after SLR is critical to improving surgical service efficiency. This study aimed to identify the predictors of prolonged LOS in patients with NSCLC who have undergone SLR.</p><p><strong>Methods: </strong>This retrospective study included consecutive patients with NSCLC who underwent SLR between 2011 and 2021 at West China Hospital. The primary outcome was the association between clinicopathological factors and prolonged LOS (defined as an LOS exceeding the median LOS). Multivariate logistic regression analysis was performed to identify the predictors of prolonged LOS.</p><p><strong>Results: </strong>Overall, 4,173 patients were included in the study (wedge resection: n=1,287; segmentectomy: n=2,886). The median postoperative LOS was 3 and 4 days in the wedge resection and segmentectomy groups, respectively. Advanced age, male sex, symptoms at presentation, larger size of the main lesion, and longer operative time were significantly associated with prolonged LOS in both the wedge and segmentectomy groups. A higher percent predicted forced expiratory volume in the first second was a protective factor for prolonged LOS after SLR, whereas a higher percent predicted diffusion capacity for carbon monoxide was a protective factor specifically for segmentectomy.</p><p><strong>Conclusions: </strong>Male sex, advanced age, symptoms at presentation, larger main lesion size, longer operative time, and impaired lung function were risk factors for a prolonged LOS after SLR. Candidates for SLR with these risk factors require heightened attention during clinical planning and postoperative management.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 7","pages":"210"},"PeriodicalIF":3.4,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713813","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 retrospective cohort study integrating invasive mucinous adenocarcinoma into the IASLC grading system for lung adenocarcinoma.","authors":"Hanyue Li, Haoran Liu, Hui Shi, Rongji Mu, Lei Xu, Wentao Fang, Teng Mao","doi":"10.21037/tlcr-2026-0425","DOIUrl":"10.21037/tlcr-2026-0425","url":null,"abstract":"<p><strong>Background: </strong>The current International Association for the Study of Lung Cancer (IASLC) grading system for invasive pulmonary adenocarcinoma excludes invasive mucinous adenocarcinoma (IMA) and mixed IMA, limiting its prognostic scope. We aimed to refine the IASLC grading system by incorporating IMA and mixed IMA, and to validate it in large-scale cohorts.</p><p><strong>Methods: </strong>This single-institutional study included 692 patients with stage I-III lung invasive adenocarcinoma from Shanghai Chest Hospital (training cohort) and 7,862 from the Surveillance, Epidemiology, and End Results (SEER) database (validation cohort). We introduced IMA and reclassified the IASLC grading system. Prognostic performance was assessed using Harrell C-index, time-dependent receiver operating characteristic (ROC) curves and areas under the curve (AUCs). Overall survival (OS) curves were estimated via the Kaplan-Meier method, with log-rank test for difference comparison.</p><p><strong>Results: </strong>Mucinous predominant tumors with <20% of high-grade patterns (solid, micro papillary, complex glandular patterns) were classified as the Grade 2 (moderately differentiated). The proposed expanded grading system demonstrated improved prognostic accuracy, with C-index and AUC values of 0.713 and 0.739 in the training cohort, and 0.707 and 0.742 in the validation cohort, respectively. The 5-year OS rates for Grade 1, Grade 2, and Grade 3 were 87.5%, 73.1%, and 55.5% in the training cohort (P<0.001), and 80.2%, 67.3%, and 60.0% in the validation cohort (P<0.001). The proposed expanded grading system demonstrated superior prognostic performance compared to the current IASLC grading system in both cohorts.</p><p><strong>Conclusions: </strong>The proposed expanded IASLC grading system was practical and prognostic for lung invasive adenocarcinoma, and the introduction of IMA could improve its applicability.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 7","pages":"205"},"PeriodicalIF":3.4,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713769","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":"Promising benefits of MET inhibition combined with EGFR/ALK tyrosine kinase inhibitor in heavily treated non-small cell lung cancer patients with <i>EGFR</i>-mutant/<i>ALK</i> rearrangement and MET overexpression: a retrospective cohort study.","authors":"Qianxin Zhou, Jianing Qiu, Haizhou Yue, Dongsheng Xu, Shuyan Meng","doi":"10.21037/tlcr-2026-0448","DOIUrl":"10.21037/tlcr-2026-0448","url":null,"abstract":"<p><strong>Background: </strong>Resistance to epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) remains common in patients with <i>EGFR</i>-mutant or <i>ALK</i> rearrangement non-small cell lung cancer (NSCLC). Mesenchymal-epithelial transition (MET) overexpression plays a key role in acquired resistance. However, real-world evidence on combined tyrosine kinase inhibition targeting both EGFR/ALK drivers and MET is limited. This study aimed to evaluate the efficacy and safety of combined EGFR/ALK and MET inhibition in this population.</p><p><strong>Methods: </strong>We performed a single-center, retrospective cohort study of NSCLC patients with <i>EGFR</i> mutations or <i>ALK</i> rearrangements who developed resistance to prior EGFR/ALK-targeted therapies and exhibited MET overexpression. Eligible patients received combined treatment with EGFR/ALK TKIs and MET inhibitors. Treatment responses were assessed using Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1), and progression-free survival (PFS) and overall survival (OS) were estimated by the Kaplan-Meier method.</p><p><strong>Results: </strong>Data of a total of 23 patients were analyzed. The objective response rate (ORR) was 69.6%, with partial responses in 16 patients and stable disease in 6. Median PFS was 6.9 months. High-level MET overexpression, defined as immunohistochemistry (IHC) 3+, was associated with a higher response rate compared to MET IHC 2+. The treatment was generally well-tolerated, with most adverse events being low-grade and manageable.</p><p><strong>Conclusions: </strong>Dual inhibition of EGFR/ALK and MET offers promising antitumor activity with an acceptable safety profile in EGFR/ALK-mutant NSCLC patients with MET overexpression, providing a viable strategy for overcoming acquired resistance.</p>","PeriodicalId":23271,"journal":{"name":"Translational lung cancer research","volume":"15 7","pages":"198"},"PeriodicalIF":3.4,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13458663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713011","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}