Thoracic Cancer最新文献

{"title":"Sequential EGFR T790M, MET c.3010C>G-Associated Exon 14 Alteration, and RET-CCDC6 Fusion in EGFR-Mutant NSCLC: A Case Report.","authors":"Yan Zhu, Chan Wang, Nan-Lin Hu, Dan-He Wang, Shi-Kai Wu","doi":"10.1111/1759-7714.70322","DOIUrl":"10.1111/1759-7714.70322","url":null,"abstract":"<p><p>Acquired resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in EGFR-mutant non-small-cell lung cancer (NSCLC) is heterogeneous, and serial re-biopsy may uncover actionable mechanisms. We report a 55-year-old man with stage IVB lung adenocarcinoma harboring EGFR L858R and TP53 R282W. First-line icotinib produced a partial response (PR) with progression-free survival (PFS) of 7 months. Rebiopsy at progression identified acquired EGFR T790M together with a MET c.3010C>G exon 14-related alteration. Almonertinib induced a second PR lasting 7 months. After renewed progression, almonertinib plus savolitinib achieved another PR for 8 months, supporting MET-dependent bypass resistance. Biopsy of a newly progressive iliac metastasis then showed emergence of RET-CCDC6 fusion, whereas T790M and the MET alteration were no longer detected. Because selective RET inhibition was initially unaffordable, the patient received pemetrexed-carboplatin plus continued almonertinib, followed by selpercatinib plus almonertinib. Local radiotherapy to oligoprogressive bone and lung lesions prolonged benefit from systemic therapy. At the latest follow-up in January 2026, the patient remained alive nearly 50 months after diagnosis. This case illustrates clonal evolution under treatment pressure and highlights three practical lessons: repeat molecular testing at each clinically meaningful progression, matched combination targeted therapy for actionable bypass alterations, and local ablative radiotherapy for oligoprogression.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 14","pages":"e70322"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593405","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":"BAP1 Loss Might Be a Predictive Biomarker for Immunotherapy Response in Pleural Mesothelioma.","authors":"Reina Imase, Rie Sakakibara, Susumu Kirimura, Hironori Ishibashi, Kenichi Okubo, Yasunari Miyazaki","doi":"10.1111/1759-7714.70343","DOIUrl":"10.1111/1759-7714.70343","url":null,"abstract":"<p><strong>Introduction: </strong>Reliable predictive biomarkers for immune checkpoint inhibitors (ICIs) in pleural mesothelioma (PM) are lacking. Loss of BRCA1-associated protein 1 (BAP1) is a frequent molecular alteration in PM and may influence the tumor immune microenvironment. We evaluated whether BAP1 loss is associated with clinical outcomes following immunotherapy.</p><p><strong>Methods: </strong>We retrospectively analyzed 14 patients with PM who were treated with ICIs between April 2014 and May 2024. BAP1 status was assessed by immunohistochemical staining of resected tumor specimens. Patients were categorized into BAP1-loss and BAP1-positive groups. Progression-free survival (PFS), overall survival (OS), response rate (RR), and disease control rate (DCR) were compared.</p><p><strong>Results: </strong>BAP1 loss was observed in nine patients (64%). Median PFS was significantly longer in the BAP1-loss group compared with the BAP1-positive group (5.3 vs. 2.1 months; log-rank p = 0.03). Median OS was also prolonged in the BAP1-loss group (8.6 vs. 2.1 months; log-rank p = 0.03). RR and DCR were numerically higher among patients with BAP1 loss.</p><p><strong>Conclusion: </strong>BAP1 loss was associated with improved clinical outcomes following immunotherapy in PM. These findings support that a molecular profile that includes BAP1 deletion may serve as a biomarker for predicting response to immunotherapy in PM.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 13","pages":"e70343"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13321164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362485","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":"An Observational Study of Afatinib 30 mg Daily in Patients With Advanced Non-Small-Cell Lung Cancer Harboring Common EGFR Mutations Treated With Afatinib.","authors":"Kenneth Sooi, Pongwut Danchaivijtr, C K Wong, V D Tu, Manavi Sachdeva, B C Tai, Ross A Soo","doi":"10.1111/1759-7714.70331","DOIUrl":"10.1111/1759-7714.70331","url":null,"abstract":"<p><strong>Background: </strong>Afatinib is an approved first-line treatment for advanced non-small-cell lung cancer (NSCLC) harboring sensitizing EGFR mutations. At the standard 40 mg dose, 28%-53% of patients in randomized trials required dose reductions due to adverse events (AEs), predominantly cutaneous and gastrointestinal. This study evaluated whether a 30 mg starting dose could improve tolerability without compromising efficacy.</p><p><strong>Methods: </strong>This multicenter, single-arm phase 2 study enrolled treatment-naive patients with advanced EGFR-mutant NSCLC. Patients received afatinib 30 mg daily until progression or unacceptable toxicity. The primary endpoint was 6-month progression-free survival (PFS) rate. Secondary endpoints included median PFS, time-to-treatment failure (TTF), objective response rate (ORR), disease control rate (DCR), and safety. Using A'Hern's single-stage design (one-sided α = 0.1, 80% power), 62 patients were required to distinguish a target 6-month of PFS ≥ 75% from ≤ 62%.</p><p><strong>Results: </strong>The study was terminated early due to slow accrual; 30 patients were enrolled between May 2023 and May 2024. Median follow-up was 11.3 months (IQR 9.6-15.5). The 6-month PFS rate was 93.2% (95% CI 75.5-98.3), median PFS of 15.8 months (95% CI 13.4-not reached) and median TTF of 17.0 months. ORR was 80% and DCR 96.7%. Common treatment-related AEs included diarrhea (83.3%), mucositis (60.0%), paronychia (60.0%), and acneiform rash (46.7%). Grade ≥ 3 AEs occurred in 10.0% of patients, with no Grade 4-5 events. Dose modification was required in 13.3% of patients.</p><p><strong>Conclusion: </strong>Afatinib 30 mg daily was well tolerated and demonstrated encouraging efficacy, with a 6-month PFS of 93.2%, suggesting outcomes comparable to standard dosing.</p><p><strong>Trial registration: </strong>Registration number: NCT04909073; https://clinicaltrials.gov.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 13","pages":"e70331"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362464","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":"MET Dependence Oversteps EGFR Dependence via Balancing Dimerization of the Receptor Tyrosine Kinases in Osimertinib-Resistant MET-Amplified, EGFR-Mutated Non-Small Cell Lung Cancer.","authors":"Yuri Yagami, Takashi Sato, Hiroki Yamamoto, Hiromi Matsuo, Ryosuke Inoue, Ryouhei Tsutsumi, Mikiko Kakegawa, Yoshiro Nakahara, Jiichiro Sasaki, Katsuhiko Naoki","doi":"10.1111/1759-7714.70334","DOIUrl":"10.1111/1759-7714.70334","url":null,"abstract":"<p><strong>Background: </strong>Although epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have substantially improved the clinical outcomes of patients with EGFR-mutated non-small cell lung cancer (NSCLC), most patients ultimately develop acquired resistance. MET amplification is a common resistance mechanism to EGFR-TKIs; however, its effects on receptor dimerization and the resulting dependence on EGFR or MET signaling have not been fully elucidated.</p><p><strong>Methods: </strong>We established a classical lung cancer cell line model with acquired resistance to osimertinib, a third-generation EGFR-TKI, through exposure to the drug (HCC827OR). Activation profiles of phospho-receptor tyrosine kinases and genomic alterations were investigated, and drug sensitivity to osimertinib and the MET-TKI savolitinib was evaluated. EGFR and MET signaling status and dimerization/interaction of EGFR, MET, and ERBB3 were analyzed. In addition, exogenous MET overexpression was introduced into parental HCC827 cells to assess its effects on drug sensitivity and receptor dimerization.</p><p><strong>Results: </strong>HCC827OR cells exhibited MET amplification and showed sensitivity to savolitinib monotherapy. ERBB3 phosphorylation correlated with the efficacy of the TKIs. Consistently, we found reduced interaction between EGFR and ERBB3 and increased interaction between MET and ERBB3 in HCC827OR cells. MET homodimers and MET-EGFR interaction increased while EGFR homodimers decreased in those cells. Exogenous MET overexpression in the parental cells partially recapitulated the drug-resistant phenotype, showing partial sensitivity to savolitinib, increased MET homodimers, and decreased EGFR homodimers.</p><p><strong>Conclusions: </strong>MET amplification alters the balance of EGFR/MET/ERBB3 dimerization, leading to a shift in signaling dependence from EGFR to MET. These findings provide insight into therapeutic strategies for EGFR-mutated NSCLC.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 13","pages":"e70334"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362519","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":"Lobe-Specific Versus Systematic Lymph Node Dissection in Clinical Stage I Non-Small Cell Lung Cancer: A Propensity Score-Matched Analysis Based on the 8th Edition of the TNM Stage Classification.","authors":"Hirotsugu Notsuda, Ken Onodera, Sakiko Kumata, Satoshi Kamata, Toru Kawakami, Tatsuaki Watanabe, Yui Watanabe, Takashi Hirama, Takaya Suzuki, Hisashi Oishi, Hiromichi Niikawa, Yoshinori Okada","doi":"10.1111/1759-7714.70337","DOIUrl":"10.1111/1759-7714.70337","url":null,"abstract":"<p><strong>Background: </strong>The optimal extent of lymph node dissection (LND) in early-stage non-small cell lung cancer (NSCLC) remains controversial. This study aimed to compare perioperative and oncological outcomes between lobe-specific LND (LSD) and systematic LND (SND) in patients with clinical stage I NSCLC based on the 8th edition of the TNM classification.</p><p><strong>Methods: </strong>We retrospectively analyzed 390 patients with clinical stage I NSCLC who underwent lobectomy with LND between 2010 and 2020. Patients with tumors in the right middle lobe or left lingular segment were excluded. Propensity score matching (PSM; 1:1 nearest-neighbor matching) was performed using clinical and radiological covariates, yielding 140 matched patients in each group. Perioperative outcomes, postoperative complications (Clavien-Dindo grade ≥ II, with postoperative pneumonitis assessed according to CTCAE version 5.0), overall survival (OS), relapse-free survival (RFS), and recurrence patterns were compared.</p><p><strong>Results: </strong>After PSM, the LSD group had significantly shorter operative time, less blood loss, and shorter durations of chest tube placement and postoperative hospital stay than the SND group (all p < 0.05). Postoperative supraventricular tachyarrhythmia occurred more frequently in the SND group (0.7% vs. 7.1%, p = 0.006), whereas other complications were comparable. There were no significant differences in OS or RFS before or after PSM. Recurrence rates and patterns, including ipsilateral lymph node recurrence, were comparable.</p><p><strong>Conclusions: </strong>LSD appears to be an oncologically valid and less invasive alternative to SND in patients with clinical stage I NSCLC. LSD may reduce surgical invasiveness and postoperative morbidity without compromising survival or increasing the risk of recurrence.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 13","pages":"e70337"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13314383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353857","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":"Multi-Omics Analysis Reveals Differentially Expressed Proteins and Metabolites in Malignant Pleural Effusion.","authors":"Senlin Xue, Jinhong Huang, Zhicheng Zhang, Haixia Ma, Ying Liu, Xiufeng Zhou, Zhenming Sun, Zhenhua You, Tingwang Jiang","doi":"10.1111/1759-7714.70356","DOIUrl":"10.1111/1759-7714.70356","url":null,"abstract":"<p><strong>Background: </strong>Malignant pleural effusion (MPE) is a common manifestation in advanced malignancies. However, its differentiation from benign pleural effusions, such as parapneumonic effusion (PPE) and tuberculous pleural effusion (TPE), remains challenging. This study aimed to profile differentially expressed proteins and metabolites between MPE, PPE, and TPE.</p><p><strong>Methods: </strong>Pleural effusion samples from patients with MPE, PPE, and TPE were collected and subjected to proteomic and metabolomic profiling. Differentially expressed proteins (DEPs) and differentially abundant metabolites (DAMs) were identified, followed by functional enrichment analyzes. Integrated proteome-metabolome analysis was performed to construct protein-metabolite interaction networks and reveal key pathways associated with malignant and benign pleural effusions.</p><p><strong>Results: </strong>Proteomic and metabolomic profiles differed significantly between MPE and non-MPE. Arginine-proline and glutamate metabolism were commonly enriched at both protein and metabolite levels in MPE versus PPE and TPE. At the protein level, Isocitrate Dehydrogenase 1 (IDH1) was significantly upregulated in MPE compared with both PPE and TPE. At the metabolite level, sarcosine and l-glutamine were markedly elevated, while creatine was significantly decreased in MPE. Integrated analysis further indicated that these four molecules play important roles in distinguishing MPE from PPE and TPE.</p><p><strong>Conclusion: </strong>Combined proteomic and metabolomic analyzes revealed the critical involvement of IDH1 in glutamate metabolism and arginine and proline metabolic pathways during MPE metabolic reprogramming. Identified molecules, including IDH1, l-glutamine, creatine, and sarcosine, may serve as potential diagnostic biomarkers for differentiating malignant from benign pleural effusions.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 14","pages":"e70356"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13376349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473093","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":"Case Report: Rare Peripheral Neuropathy With Abdominal Wall Allodynia in Extensive-Stage Small-Cell Lung Cancer Treated Using Durvalumab.","authors":"Ruidan Li, Zhen Li, Xiaoqian Zhai, Jie Shao, Yaqin Wang, Qinghua Zhou, Jiewei Liu","doi":"10.1111/1759-7714.70368","DOIUrl":"10.1111/1759-7714.70368","url":null,"abstract":"<p><p>Immune checkpoint inhibitors (ICIs), such as PD-1/PD-L1 inhibitors, have revolutionized the treatment of extensive-stage small-cell lung cancer (ES-SCLC). Chemotherapy combined with PD-1 or PD-L1 inhibitors has become the standard first-line treatment for ES-SCLC. However, with the broad application of immunotherapy, adverse events associated with this therapy have been increasingly reported by clinicians. The identification of atypical and specific manifestations of immune-related adverse events (irAEs) requires accumulated experience on the part of clinicians. In this article, we report the case of a patient over 50 years of age who was initially diagnosed with ES-SCLC. Clinical symptoms mainly manifested as allodynia of the abdominal wall following PD-L1 inhibition immunotherapy. This symptom progressed with continued immunotherapy and resolved after cessation of immunization and treatment with prednisone. A peripheral neuropathy antibody test revealed anti-GM4 IgG antibody positivity. On the basis of the patient's clinical manifestations and medication history described above, a diagnosis of immune-related peripheral neuropathy was made. In this case, the irAE severely hindered the treatment process and impaired the patient's quality of life. Through this case report and a review of the literature, we aim to explore how to timely and accurately identify irAEs in immunotherapy, especially nonspecific irAEs, and provide timely treatment to improve patient quality of life and survival and immunotherapy precision and safety.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 14","pages":"e70368"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148593356","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 Predictive Value of Neutrophil-To-Lymphocyte Ratio (NLR) for Response to Neoadjuvant Immunochemotherapy in Resectable IIA-IIIB Non-Small Cell Lung Cancer in Real-World Practice.","authors":"Di Meng, Jiacong Liu, Gaoqi Ye, Linhai Zhu, Xuhua Huang, Xiayi Lv, Jian Hu","doi":"10.1111/1759-7714.70315","DOIUrl":"10.1111/1759-7714.70315","url":null,"abstract":"<p><strong>Objective: </strong>A significant clinical challenge remains the identification of non-small cell lung cancer (NSCLC) patients who will derive maximum benefit from neoadjuvant immunochemotherapy. The neutrophil-to-lymphocyte ratio (NLR) may offer critical insights into the host's capacity to mount an effective anti-tumor response.</p><p><strong>Methods: </strong>This retrospective study consecutively included patients with stage IIA-IIIB NSCLC who received 2-4 cycles of platinum-based immunochemotherapy prior to planned resection at the Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine from 2017 to 2022.</p><p><strong>Results: </strong>A total of 317 patients were included in our study and divided into two groups according to the median baseline NLR (3.27) of the whole population: low NLR (< 3.27) group (160 patients) and high NLR (≥ 3.27) group (157 patients). The rate of MPR in the low NLR group was significantly higher than that in the high NLR group (58.3% vs. 38.5%, p = 0.008). The median PFS in the low NLR group was not reached and 21.6 months (95% confidence interval [CI], 16.9 to 26.3) in the high NLR group (hazard ratio [HR] for disease progression, disease recurrence, or death, 0.431; 95% CI, 0.312 to 0.594; p < 0.001). The median OS in the low NLR group was not reached and 33.2 months (95% CI, 18.8 to 47.6) in the high NLR group (HR for death, 0.416; 95% CI, 0.295 to 0.586; p < 0.001).</p><p><strong>Conclusions: </strong>A low pre-treatment NLR is a predictive marker of enhanced pathological response and improved survival outcomes in IIA-IIIB NSCLC patients undergoing neoadjuvant immunochemotherapy.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 13","pages":"e70315"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377158","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":"Impact of Thyroid Transcription Factor-1 Expression on Outcomes of Platinum-Based Chemoimmunotherapy in Advanced or Recurrent Non-Squamous Non-Small Cell Lung Cancer.","authors":"Ryohei Kamada, Hiroshi Yokouchi, Shohei Mizobuchi, Ken Kuwahara, Yasushi Mizukami, Hidenori Mizugaki, Noriyuki Yamada, Hajime Asahina, Hirofumi Adachi, Yoshihiro Matsuno, Satoshi Oizumi","doi":"10.1111/1759-7714.70335","DOIUrl":"10.1111/1759-7714.70335","url":null,"abstract":"<p><strong>Background: </strong>Thyroid transcription factor-1 (TTF-1) is a diagnostic biomarker in non-squamous (non-sq) non-small cell lung cancer (NSCLC). TTF-1 negativity has been associated with poor outcomes following immunotherapy and pemetrexed-based chemotherapy in advanced non-sq NSCLC. However, the impact of TTF-1 expression on chemoimmunotherapy efficacy regimens remains unclear.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with advanced or recurrent non-sq NSCLC who received first-line platinum and pemetrexed plus pembrolizumab (Platinum/PEM/Pembro) or carboplatin and nab-paclitaxel plus atezolizumab (CBDCA/nab-PTX/Atezo) between March 2019 and May 2025 at our institution.</p><p><strong>Results: </strong>Among 67 patients, 44 were TTF-1 positive and 23 were TTF-1 negative. In the overall cohort, TTF-1-positive patients had significantly longer progression-free survival (PFS) and overall survival (OS) than TTF-1-negative patients. In the Platinum/PEM/Pembro group, PFS and OS did not differ by TTF-1 status (median PFS: 8.5 vs. 7.0 months; hazard ratio [HR], 0.85; 95% confidence interval [CI], 0.39-1.86, and median OS: 23.7 vs. 26.1 months; HR, 0.93; 95% CI, 0.36-2.35). In univariate analysis of the overall population, TTF-1 expression and performance status (PS) were significantly associated with PFS, while TTF-1 expression, PS, and histological type were significantly associated with OS. The Platinum/PEM/Pembro group had a higher relative dose intensity of concomitant chemotherapy, a greater median number of immune checkpoint inhibitor cycles, and a longer median treatment duration. Immune-related adverse events (irAEs) were more frequent with Platinum/PEM/Pembro (50.0% vs. 17.4%, p = 0.0164).</p><p><strong>Conclusions: </strong>Platinum/PEM/Pembro may be a therapeutic option for TTF-1-negative non-sq NSCLC with good PS and adenocarcinoma histology, although careful management of irAE is required.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 13","pages":"e70335"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362453","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":"Surgical Result for Patients Who Simultaneously Presented With Myasthenia Gravis and Thymoma.","authors":"Po-Chun Chang, Ping-Chung Tsai, Ching-Feng Wu, Yau-Lin Tseng, En-Kuei Tang, Tzu-Ping Chen, Yi-Ting Yen, Ching-Yang Wu","doi":"10.1111/1759-7714.70350","DOIUrl":"10.1111/1759-7714.70350","url":null,"abstract":"<p><strong>Background: </strong>Patients who present concurrently with thymoma and myasthenia gravis (MG) constitute a unique clinical population in whom both oncologic control and stabilization of MG symptoms are essential treatment goals. Although extended thymectomy is traditionally recommended, the necessity of radical thymic tissue removal in this subgroup remains uncertain. This study compared surgical outcomes between thymomectomy and extended thymectomy in this specific population.</p><p><strong>Methods: </strong>We retrospectively analyzed 145 patients with concurrent thymoma and MG treated across four tertiary centers between 2013 and 2023. Clinical characteristics, surgical approaches, postoperative complications, MG medication adjustments, and plasmapheresis requirements were compared between patients undergoing thymomectomy (n = 37) and extended thymectomy (n = 108). A 1:1 propensity score matching (PSM) was performed to balance age (n = 37 per group). Freedom from recurrence (FFR) and overall survival (OS) were compared between patients undergoing thymomectomy and extended thymectomy.</p><p><strong>Results: </strong>Patients undergoing thymomectomy were older with higher anesthesia risk. Despite a higher rate of R1 resections, thymomectomy achieved FFR and OS comparable to extended thymectomy across the entire cohort and within different Masaoka stages. No significant differences were observed in MG medication reduction, plasmapheresis rates, or postoperative MG crisis. Thymomectomy was associated with shorter operative times and avoided the risks related to thymic vein division, a major source of hemorrhagic complications in extended thymectomy.</p><p><strong>Conclusion: </strong>Thymomectomy provides oncologic and neurologic outcomes comparable to extended thymectomy in patients with thymoma-associated MG while reducing operative risks. These findings challenge the necessity of routine extended thymectomy and support thymomectomy as an effective, less invasive alternative in appropriately selected patients.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"17 14","pages":"e70350"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148456079","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}