Thoracic Cancer最新文献

{"title":"Pathological Complete Response to a Single Dose of Pembrolizumab-Based Chemoimmunotherapy for Squamous Cell Carcinoma of the Lung: A Case Report.","authors":"Yugo Matsumura, Seiya Ichihara, Kaori Nii, Kazumasa Nanjo, Naoki Kadota, Yoshio Okano, Hisanori Machida, Nobuo Hatakeyama, Hiroyuki Hino, Keishi Naruse, Tsutomu Shinohara, Shoji Sakiyama, Eiji Takeuchi","doi":"10.1111/1759-7714.15519","DOIUrl":"10.1111/1759-7714.15519","url":null,"abstract":"<p><p>We herein describe a patient with non-small-cell lung cancer who achieved pCR with a single dose of pembrolizumab-based chemoimmunotherapy followed by surgery. A 61-year-old man was referred to our hospital with wheezing and an abnormal chest shadow. Squamous cell carcinoma of the left lower lobe, cT2aN1M0 stage IIB, was diagnosed and pembrolizumab-based chemoimmunotherapy was initiated at the patient's request. One month later, chest CT revealed new ground-glass opacities of the lungs, which were judged to be a CTCAE grade 2 pneumonitis due to an immune-related adverse event (irAE). Therefore, steroid therapy was initiated. Prednisolone was tapered and discontinued as symptoms improved. A sleeve resection of the left lower lobe was performed, and a pathological complete response (pCR) was confirmed in a resected specimen. There has been no recurrence for 1 year and 7 months without treatment. This is the first case report of pCR to a single dose of chemoimmunotherapy followed by surgery for lung cancer. The present results suggest the potential of a single dose of chemoimmunotherapy to achieve pCR and cause irAEs in some patients.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":" ","pages":"e15519"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"USP8-Dependent Family Tyrosine Kinase Promotes the Malignant Progression of Esophageal Squamous Cell Carcinoma by Upregulating Protein Tyrosine Kinase 2 Expression.","authors":"Yuechang Wu, Dubiao Xian, Yunzhong Liu, Ding Huang, Qingfeng Liu, Shubo Yang","doi":"10.1111/1759-7714.15489","DOIUrl":"10.1111/1759-7714.15489","url":null,"abstract":"<p><strong>Background: </strong>Esophageal squamous cell carcinoma (ESCC) is a lethal malignancy, and the molecular underpinnings of its aggressive behavior are not fully understood. FYN proto-oncogene, Src family tyrosine kinase (FYN) has been linked to cancer progression, yet its role in ESCC remains elusive. This study investigated the influence of FYN on ESCC malignancy.</p><p><strong>Methods: </strong>Quantitative real-time polymerase chain reaction was used to assess the mRNA expression of FYN, while western blotting and immunohistochemistry (IHC) assays were performed to detect the protein expression of FYN, ubiquitin specific peptidase 8 (USP8) and protein tyrosine kinase 2 (PTK2). Cell viability was measured with a cell counting kit-8 assay, and cell apoptosis was evaluated using flow cytometry.</p><p><strong>Results: </strong>FYN expression was increased in ESCC tissues and cells when compared with normal esophageal tissues and normal esophageal epithelial cells. Knockdown of FYN inhibited cell invasion, migration, stem-like traits, and glycolysis, while promoting apoptosis. USP8 was shown to stabilize FYN protein expression through its deubiquitinating activity in ESCC cells. Overexpression of FYN reversed the effects of USP8 silencing on the malignant phenotypes of ESCC cells in vitro and in vivo. FYN upregulated PTK2 expression in both TE1 and KYSE150 cell lines. Furthermore, PTK2 overexpression reversed the effects of FYN silencing on the malignant phenotypes of ESCC cells. Further, USP8 silencing-induced inhibitory effect on PTK2 protein expression was counteracted after FYN overexpression.</p><p><strong>Conclusion: </strong>USP8-dependent FYN contributed to the malignant progression of ESCC by interacting with PTK2. Targeting this pathway may offer a novel therapeutic strategy for ESCC treatment.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":" ","pages":"e15489"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of FOXK2-FBXO32 in breast cancer tumorigenesis: Insights into ribosome-associated pathways.","authors":"Fuben Liao, Jinjin Zhu, Junju He, Zheming Liu, Yi Yao, Qibin Song","doi":"10.1111/1759-7714.15482","DOIUrl":"10.1111/1759-7714.15482","url":null,"abstract":"<p><strong>Objective: </strong>To search for a new biomarker that can predict the efficacy and prognosis of tumor immunotherapy.</p><p><strong>Method: </strong>FOXK2 genes were analyzed using single-cell sequencing in pan-cancer bulk RNA-seq from the TCGA database. We used algorithms to predict their immune infiltration. Functional enrichment and ChIP-seq identified potential downstream gene, FBXO32. FBXO32's role in cancer immune response was explored through analysis.</p><p><strong>Results: </strong>Significant up-regulation of FOXK2 was observed in prostate adenocarcinoma (PRAD), uterine corpus endometrial carcinoma (UCEC), bladder urothelial carcinoma (BLCA), colorectal cancer (CRC), pancreatic ductal adenocarcinoma (PDAC), and stomach adenocarcinoma (STAD), while no such increase was found in lung cancer (lung adenocarcinoma [LUAD], lung squamous cell carcinoma [LUSC]) or thyroid carcinoma (THCA) tumor and adjacent tissues. FOXK2 expression correlated with patient prognosis, with lower expression associated with better immune response and survival and higher expression of its downstream gene FBXO32 linked to worse overall survival (OS) and immune infiltration. FOXK2 has the potential to be used as a prognostic indicator and target for treatment in individuals with cancer.</p><p><strong>Conclusion: </strong>Our research provides insights into the significance of FOXK2 in cancer and indicates its potential as both a prognostic indicator and target for treatment. The ribosome-associated pathways involving FOXK2 and FBXO32 could be pivotal in the advancement of tumors, offering possible avenues for targeted and individualized immunotherapy approaches. Additional research is required to completely understand the mechanisms that are responsible for the participation of FOXK2 and its subsequent gene FBXO32 in cancer, as well as to explore the possible advantages of focusing on FOXK2 for cancer treatment.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":" ","pages":"e15482"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Study on Associations Between Lung Cancer Prognosis and Diagnostic Criteria Set by the European Palliative Care Research Collaboration and the Asian Working Group for Cachexia.","authors":"Utae Katsushima, Takuya Fukushima, Jiro Nakano, Naoya Ogushi, Kazuki Fujii, Yutaro Nagata, Keisuke Kamisako, Yukiko Okuno, Yuta Okazaki, Kentaro Nakanishi, Kiyori Yoshida, Tatsuki Ikoma, Yuki Takeyasu, Yuta Yamanaka, Hiroshige Yoshioka, Kimitaka Hase, Takayasu Kurata","doi":"10.1111/1759-7714.15503","DOIUrl":"10.1111/1759-7714.15503","url":null,"abstract":"<p><strong>Background: </strong>Cachexia is a poor prognostic factor in many advanced cancers. Cachexia diagnostic criteria of the European Palliative Care Research Collaboration (EPCRC) may underestimate cachexia in Asians; therefore, new criteria have been proposed by the Asian Working Group for Cachexia (AWGC). We compared both criteria to determine differences in diagnostic rates and their association with lung cancer prognosis.</p><p><strong>Patients and methods: </strong>This single-center, retrospective cohort study considered lung cancer outpatients receiving chemotherapy. Survival was analyzed using Kaplan-Meier curves and log-rank tests. The association between cachexia diagnosis and prognosis was examined for each set of criteria using a Cox proportional hazards model. C-statistic analysis was performed to compare the discriminative power for prognosis.</p><p><strong>Results: </strong>Among the 106 participants analyzed (median age, 75 [71-79] years; 75 males [70.8%]; 91 [85.9%] with performance status [PS] 0-1), 58 (54.7%) and 77 (72.6%) cachexia cases were diagnosed using the EPCRC and AWGC criteria, respectively. The latter encompassed all but one patient diagnosed using the EPCRC criteria. Patients with cachexia had a significantly poorer prognosis according to both criteria (EPCRC, p = 0.002; AWGC, p = 0.001). Both criteria had almost equal discriminative power for prognosis (EPCRC, C-statistic = 0.658; AWGC, C-statistic = 0.658). CRP in the AWGC criteria was most strongly related to prognosis.</p><p><strong>Conclusions: </strong>Cachexia was an independent poor prognostic factor in lung cancer patients receiving chemotherapy under the AWGC and EPCRC criteria, both of which had similar prognostic discriminatory power. Among CRP, anorexia, and grip strength, elevated CRP may be the most prognostically relevant parameter in the AWGC criteria.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":" ","pages":"e15503"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing trends in lung cancer disease burden between China and Australia from 1990 to 2019 and its predictions.","authors":"Dan Zhao, Haijun Mu, Ping Yu, Chao Deng","doi":"10.1111/1759-7714.15430","DOIUrl":"10.1111/1759-7714.15430","url":null,"abstract":"<p><strong>Purpose: </strong>Lung cancer (LC) is a leading cause of death and presents a substantial societal burden. This article compares its disease burden and risk factors between China and Australia to support health policymakers for LC prevention and treatment.</p><p><strong>Materials and methods: </strong>The data from the 2019 Global Burden of Disease Study were used to analyze disease temporal trends using Joinpoint regression model. The Bayesian age-period-cohort model was used for prediction. The population-attributable fraction (PAF) was used to analyze LC risk factors.</p><p><strong>Results: </strong>In 2019, the age-standardized rates (ASR) of incidence and of mortality of LC in China were 41.71/100 000 and 38.70/100 000, while Australia's rates were 30.45/100 000 and 23.46/100 000. It showed an increasing trend in China but a decreasing trend in Australia. By 2030, the ASR of incidence and mortality are predicted to be 47.21/100 000 and 41.54/100 000 in China, while Australia's rates will reach 30.09/100 000 and 23.3/100 000, respectively. Smoking is the most common risk factor for LC, followed by particulate matter and occupational carcinogenesis. The PAF of smoking dropped in Australia (from 68.38% to 53.75% in females; 77.41% to 58.47% in males) but increased in China (from 19.56% to 26.58% in females; 80.45% to 82.03% in males) from 1990 to 2019.</p><p><strong>Conclusions: </strong>The disease burden of LC in China is rising, whereas in Australia, it is declining. China still faces a heavy LC burden. Risk factor analysis supported for further improving the compliance and enforcement of polices on tobacco control and environmental management to reduce this disease burden.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":" ","pages":"e15430"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tepotinib for the Treatment of Lung Adenocarcinoma Harboring MET Y1003N Point Mutation: A Case Report.","authors":"Yukihiro Umeda, Satomi Kimura, Junya Kimura, Yoshiaki Imamura, Tamotsu Ishizuka","doi":"10.1111/1759-7714.15508","DOIUrl":"10.1111/1759-7714.15508","url":null,"abstract":"<p><p>The mesenchymal-epithelial transition factor (MET) Y1003 mutation, like MET ex14 skipping, is an oncogenic driver mutation that suppresses MET degradation. Herein, we report the case of a 63-year-old female patient with lung adenocarcinoma harboring the MET Y1003N mutation, who was treated with tepotinib, a selective type 1b MET tyrosine kinase inhibitor. To the best of our knowledge, no such cases have been reported. The woman was referred to our hospital with the chief complaint of chest pain. After a detailed examination, she was diagnosed with stage IVB lung adenocarcinoma. Next-generation sequencing revealed an MET Y1003N mutation in the tumor. Tepotinib was administered as the eighth-line treatment, and the best overall response was a partial response that lasted for 8 months. In lung adenocarcinomas harboring the MET Y1003 mutation, selective type 1b MET tyrosine kinase inhibitors may be an important treatment option, even in heavily pretreated settings.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":" ","pages":"e15508"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intratumor Heterogeneity Predicts Prognosis in Lepidic Predominant Lung Adenocarcinoma.","authors":"Benedikt Niedermaier, Michael Allgäuer, Thomas Muley, Marc A Schneider, Martin E Eichhorn, Hauke Winter, Laura V Klotz","doi":"10.1111/1759-7714.15536","DOIUrl":"10.1111/1759-7714.15536","url":null,"abstract":"<p><strong>Objective: </strong>Among the different subtypes of invasive lung adenocarcinoma, lepidic predominant adenocarcinoma (LPA) has been recognized as the lowest-risk subtype with good prognosis. The aim of this study is to provide insight into the heterogeneity within LPA tumors and to better understand the influence of other sub-histologies on survival outcome.</p><p><strong>Methods: </strong>Overall, 75 consecutive patients with LPA in pathologic stage I (TNM 8th edition) who underwent resection between 2010 and 2022 were included into this retrospective, single center analysis. The proportions of different growth patterns were reported in 5% increments according to the WHO classification.</p><p><strong>Results: </strong>All tumors exhibited a predominantly lepidic growth pattern (median proportion 70%, IQR 60%-85%). The invasive component included acinar (n = 66, 88%), papillary (n = 41, 55%), micropapillary (n = 14, 19%), and solid growth patterns (n = 4, 5%), with most tumors exhibiting more than one invasive growth pattern. The presence of high-risk growth, that is, micropapillary and solid, was associated with higher T stage (r = 0.423, p = 0.0002). A classification of patients as lepidic/high-risk or lepidic/low-risk based on the presence of micropapillary and solid growth patterns resulted in a significantly worse disease-free survival (p = 0.0169, 5-year DFS: lepidic/high-risk 73% vs. lepidic/low-risk: 95%) for the lepidic/high-risk group, while the groups did not differ in age, gender, smoking status, or extent of resection.</p><p><strong>Conclusion: </strong>Patients with stage I LPA exhibit considerable intratumor heterogeneity regarding growth patterns, which can be used for prognostic stratification. The occurrence of micropapillary and solid growth patterns in LPA is associated with poorer disease-free survival.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 1","pages":"e15536"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Primary Lung Adenocarcinoma With Recurrent Brain Metastasis due to Transformation to Small Cell Carcinoma During Adjuvant Atezolizumab Therapy.","authors":"Nao Kobayashi, Noriaki Sunaga, Masakiyo Yatomi, Ikuo Wakamatsu, Sohei Muto, Hayato Ikota, Rei Yamaguchi, Yoichi Ohtaki, Toshiteru Nagashima, Nobuteru Kubo, Tomomi Masuda, Yosuke Miura, Hiroaki Tsurumaki, Reiko Sakurai, Yasuhiko Koga, Takeshi Hisada, Toshitaka Maeno","doi":"10.1111/1759-7714.15512","DOIUrl":"10.1111/1759-7714.15512","url":null,"abstract":"<p><p>Histologic transformation from non-small cell to small cell lung cancer (SCLC) is a resistance mechanism to immune checkpoint inhibitors. We report herein a case of lung adenocarcinoma who developed liver and brain metastases during adjuvant atezolizumab therapy. The patient underwent a craniotomy to resect a brain metastasis, which was pathologically diagnosed as SCLC. He subsequently received platinum-based chemotherapy with durvalumab, resulting in sustained regression of the liver metastases. This case demonstrates a metastatic brain tumor-acquired resistance to atezolizumab through histologic transformation from adenocarcinoma to SCLC. Therefore, rebiopsy is needed if recurrent disease appears during immune checkpoint inhibitor treatment in patients with non-small cell lung cancer.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":" ","pages":"e15512"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indocyanine Green Fluorescence Plus Blue Dye for Sentinel Lymph Node Biopsy in Patients Undergoing Neoadjuvant Chemotherapy for Breast Cancer: A Multicenter, Prospective Cohort Study.","authors":"Miao Liu, Yang Yang, Bin Hua, Rui Feng, Tianyu Xu, Mengyuan Wang, Xiaowei Qi, Yingming Cao, Bo Zhou, Fuzhong Tong, Peng Liu, Hongjun Liu, Lin Cheng, Houpu Yang, Fei Xie, Siyuan Wang, Chaobin Wang, Yuan Peng, Danhua Shen, Lei Chen, Jun Jiang, Shu Wang","doi":"10.1111/1759-7714.15511","DOIUrl":"10.1111/1759-7714.15511","url":null,"abstract":"<p><strong>Background: </strong>Sentinel lymph node biopsy (SLNB) using radioisotope tracer plus blue dye is the gold standard after neoadjuvant chemotherapy (NAC) in initially cN1 breast cancer patients, but clinical use still has limitations. This study aims to examine diagnostic performance of dual indocyanine green (ICG) and methylene blue tracing for SLNB in patients who have completed NAC for breast cancer with initially cN1 disease.</p><p><strong>Methods: </strong>Adult women (20-80 years of age) scheduled to undergo NAC for biopsy-proven cT0-3N1M0 primary invasive breast cancer were consecutively enrolled in this prospective, multicenter, cohort study. Upon the completion of NAC, SLNB was conducted using ICG and methylene blue, followed by axillary lymph node dissection. The primary outcome was the detection rate (DR); secondary outcomes included the false-negative rate (FNR) and adverse events associated with the use of tracers.</p><p><strong>Results: </strong>A total of 156 patients were enrolled; all underwent SLNB after NAC. The median number of lymph nodes retrieved during SLNB was 3 (range: 0-11). The DR was 97.4% (152/156; 95% CI, 93.6%-99.0%). The FNR was 6.7% (4/60; 95% CI, 2.6%-15.9%). Negative predictive value was 95.7% (88/92; 95% CI, 89.4%-98.3%). In the subgroup analysis stratified by ycN status, FNR was 4.0% (1/25; 95% CI, 0.7%-19.5%) and 8.6% (3/35; 95% CI, 3.0%-22.4%) in the ycN0 and ycN+ subgroups, respectively. No allergic reaction was reported.</p><p><strong>Conclusions: </strong>SLNB with ICG plus methylene blue achieved a high DR and a very low FNR in breast cancer patients with initially cN1 disease.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (https://www.</p><p><strong>Clinicaltrials: </strong>gov/), NCT02869815.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":" ","pages":"e15511"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune Checkpoint Inhibitors +/- Chemotherapy for Patients With NSCLC and Brain Metastases: A Systematic Review and Network Meta-Analysis.","authors":"Lauren Julia Brown, Nicholas Yeo, Harriet Gee, Benjamin Y Kong, Eric Hau, Inês Pires da Silva, Adnan Nagrial","doi":"10.1111/1759-7714.15510","DOIUrl":"10.1111/1759-7714.15510","url":null,"abstract":"<p><strong>Background: </strong>Multiple studies have demonstrated the intracranial efficacy of immune checkpoint inhibitors (ICI) +/- chemotherapy. The efficacy of chemoimmunotherapy compared to ICI alone in patients with metastatic NSCLC and brain metastases (BM) remains unknown.</p><p><strong>Methods: </strong>A systematic review and network meta-analysis were performed to evaluate ICI efficacy and the influence of additional chemotherapy on survival outcomes in treatment-naïve metastatic NSCLC with BM. Randomized phase II/III studies with at least one treatment arm with an ICI were eligible. Overall survival (OS) and progression-free survival (PFS) in patients with and without BM were assessed.</p><p><strong>Results: </strong>Ten studies were included, totaling 6560 patients, 770 with BM. Pairwise meta-analysis revealed that patients with BM treated with ICI +/- chemotherapy had improved PFS (hazard ratio [HR] 0.49; 95% CI 0.40-0.60) and OS (HR 0.55; 95% CI 0.44-0.68) versus chemotherapy alone. Patients without BM treated with ICI +/- chemotherapy also had improved PFS and OS compared to chemotherapy alone. In the network meta-analysis of patients with BM, chemoimmunotherapy demonstrated improved PFS compared to ICI alone (HR 0.64; 95% CI 0.43-0.96; p = 0.03). No significant difference was observed in OS. In the population of patients without BM, no significant differences in PFS or OS were observed between chemoimmunotherapy versus ICI alone.</p><p><strong>Conclusion: </strong>This meta-analysis confirms that ICIs with or without chemotherapy are superior to chemotherapy alone for the first-line management of metastatic NSCLC with and without BM. This network meta-analysis suggests combination chemoimmunotherapy offers PFS benefit over ICI monotherapy in BM patients, warranting direct comparisons in clinical trials.</p><p><strong>Trial registration: </strong>PROSPERO: CRD42024501345.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 2","pages":"e15510"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}