Clinical Respiratory Journal最新文献

{"title":"A Meta-Analysis of Efficacy and Safety of Neoadjuvant Immunotherapy Plus Chemotherapy for Resectable Non-Small Cell Lung Cancer","authors":"Xinru Sun,&nbsp;Tianhua Kang,&nbsp;Baodong Liu,&nbsp;Yin Zhang,&nbsp;Guangming Huang","doi":"10.1111/crj.70019","DOIUrl":"10.1111/crj.70019","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Neoadjuvant immunotherapy plus chemotherapy has ushered in a new era for surgical treatment for patients with NSCLC. This study aimed to examine the efficacy and safety of neoadjuvant immunotherapy plus chemotherapy in NSCLC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eligible studies were identified from PubMed, Embase, Web of Science, Cochrane Library, ClinicalTrials.gov, and conference meeting abstracts. The endpoints included major pathological response (MPR), complete pathological response (pCR), surgical resection rate, R0 resection, treatment-related adverse events (TRAEs), severe adverse events (SAEs), surgical complications, treatment discontinuation, surgical delay, and treatment-related death. Stata 18 software was used for statistical analysis, and <i>p</i> &lt; 0.05 was considered statistically significant. Twenty-two studies including a total of 1108 patients were eligible for this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the patients who received neoadjuvant immunotherapy plus chemotherapy, the pooled MPR rate was 51% (95% CI [0.44–0.58]), and pCR rate was 34% (95% CI [0.28–0.40]). The pooled surgical resection rate was 85% (95% CI [0.81–0.89]), and the pooled R0 rate was 94% (95% CI [0.91–0.96]). The pooled rate of pathological tumor downstaging was 84% (95% CI [0.79–0.88]), and the pooled rate of pathological nodal downstaging was 38% (95% CI [0.23–0.57]). During the treatment of neoadjuvant immunotherapy plus chemotherapy with or without surgery, the pooled rate of TRAEs (any grade) was 84% (95% CI [0.73–0.91]), and the pooled rate of SAEs was 29% (95% CI [0.21–0.38]). Surgical complications pooled rate was 25% (95% CI [0.14–0.41]). The pooled rate of treatment discontinuation (11%, 95% CI [0.09–0.13]), surgical delay (3%, 95% CI [0.02–0.05]), and treatment-related death (2%, 95% CI [0.02–0.03]) were conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Neoadjuvant immunotherapy plus chemotherapy provides a high pathological response, surgical resection rate, R0 resection rate, and pathological downstage rate and has a low risk of increasing the incidence of SAEs, surgical complications, treatment discontinuation, surgical delay, and treatment-related death. The validation of prospective and large sample studies is needed to confirm this conclusion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Efficacy and Safety of Different Guided Technologies Combined With Ultrathin Bronchoscopic Biopsy for Peripheral Pulmonary Lesions","authors":"Zhihan Zhang,&nbsp;Junbao Zhang,&nbsp;Xi Chen,&nbsp;Junfeng Yan,&nbsp;Cao Zeng,&nbsp;Ping Xu","doi":"10.1111/crj.70012","DOIUrl":"https://doi.org/10.1111/crj.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Various bronchoscopic guidance techniques have emerged to improve the diagnostic yield of peripheral pulmonary lesions (PPLs), especially when combined with ultra-thin bronchoscopy. However, uncertainties exists in the convenience, accuracy rate, and complications of these techniques. We compared the feasibility, accuracy rate, and complication rates of transbronchial biopsy of PPLs sampled by the standard thin-layer CT navigation combined with ultrathin bronchoscopy (CTNUTB), the Lungpro virtual navigation combined with ultrathin bronchoscopy (VNUTB), and electromagnetic navigation combined with ultrathin bronchoscopy (ENUTB).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospectively identified were 256 patients sampled with transbronchial biopsy of PPLs. Eligible patients referred for CTNUTB, VNUTB, and ENUTB from January 2017 to December 2021 were included. We comprehensively compared the accuracy rate, feasibility, and complication rates for each method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was no significant difference in the accuracy rate of CTNUTB, VNUTB, and ENUTB (<i>p</i> = 0.293). The operation time via Lungpro navigation was the shortest (14.4 min, <i>p</i> &lt; 0.001). The planning time via CT planning was the shortest (7.36 min, <i>p</i> &lt; 0.001). There was no difference in the incidence of complications such as hemorrhage, pneumonia, and pneumothorax (<i>p</i> = 0.123). Besides, ENUTB costs more than $2000, while CTNUTB and VNUTB cost only about $130–230.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CTNUTB is still the main bronchoscopy method we recommended, which has low cost, simple operation, and safety no less than the others. In contrast, ENUTB provides a higher accuracy rate for small diameter nodules (less than 2 cm), which has a high use value and is worth promoting in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chest X-Ray Comparison Between Drug-Resistant and Drug-Sensitive Pulmonary Tuberculosis in Children","authors":"Saffanah Az Zuhriyyah,&nbsp;Harry Galuh Nugraha,&nbsp;Djatnika Setiabudi,&nbsp;Prayudi Santoso,&nbsp;Heda Melinda Nataprawira","doi":"10.1111/crj.70010","DOIUrl":"https://doi.org/10.1111/crj.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Chest X-ray (CXR) remains one of the tools used in diagnosing tuberculosis (TB). However, few studies about such tools exist, specifically in children in Indonesia. We aim to investigate and compare the CXR findings of children with pulmonary drug-resistant TB (DR-TB) and drug-sensitive TB (DS-TB) that could help in the evaluation and management of TB cases in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective analysis with cross-sectional approach was conducted in children (&lt;18 years old) diagnosed with pulmonary DR-TB and DS-TB from January 2018 to December 2021. Documented data were collected from the Paediatric Respirology Registry and Tuberculosis Information System at Dr. Hasan Sadikin General Hospital Bandung. Characteristics of children, CXR findings, and TB severity were assessed and compared using the chi-square and Fisher's exact tests with significance levels set at <i>p</i> value &lt;0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-nine children (DR-TB 31 children vs. DS-TB 38 children) were assessed. Of the 31 children with DR-TB, 65% were classified as multidrug-resistant TB (MDR-TB), followed by rifampicin-resistant TB (RR-TB), pre-extensively drug-resistant TB (pre-XDR-TB), and extensively drug-resistant TB (XDR-TB). The most common CXR findings in DR-TB are consolidation (68%), fibrosis (42%), and cavity (29%), whereas in DS-TB, it is pleura effusion (37%). Severe TB accounts for 50% of DR-TB (<i>p</i> = 0.008).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Consolidation, fibrosis, cavities, and findings of severe TB are most common in DR-TB. Pleural effusion is the most common in DS-TB. These findings have the potential to be considered in further examination of children with pulmonary DR-TB and DS-TB; hence, more extensive studies are needed to confirm these results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142316982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detection of the Fatty Acid Metabolism-Linked Genes in Lung Adenocarcinoma as Biomarkers for Clinical Prognosis and Immunotherapeutic Targets","authors":"Jingwei Shi,&nbsp;Rusong Yang,&nbsp;Xinyi Jiang,&nbsp;Kangle Zhu,&nbsp;Zhengcheng Liu","doi":"10.1111/crj.70013","DOIUrl":"https://doi.org/10.1111/crj.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lung cancer, on a global scale, leads to the most common cases of cancer mortalities. Novel therapeutic approaches are urgently needed to disrupt this lethal disease. The rapid development of tumor immunology combining breakthroughs involving fatty acid metabolism brings possibilities. Directing fatty acid metabolism is supposed to help discover potential prognostic biomarkers and treatment targets for lung cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Through searching the GSE140797 dataset, we identified genes related to fatty acid metabolism as well as fatty acid metabolism-related differentially expressed genes (DEGs). We applied various methods to ascertain the independent prognostic value of the DEGs. The methods we utilized entail prognostic analysis, differential expression analysis, as well as univariate and multivariate Cox regression analyses. The lasso Cox regression model was utilized in examining how DEGs correlate with the immune score, immune checkpoint, ferroptosis, methylation, and OCLR score. The expression levels of ACAT1 and ACSL3 in tissues derived from normal lung and lung adenocarcinoma (LUAD) tissues were compared by qRT-PCR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this study, ACSL3 and ACAT1 were identified as fatty acid metabolism-related genes utilizing independent prognostic value and as a result, the risk prognostic model was built using these factors. qRT-PCR results implied that ACSL3 and ACAT1 expressions were upregulated and downregulated, correspondingly in tumor tissues. Additional evaluations suggested that ACSL3 and ACAT1 were affirmed to be remarkably correlated with the immune score, methylation, immune checkpoint, OCLR score, and ferroptosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ACSL3 and ACAT1 were effective prognostic biomarkers and potential immunotherapeutic targets in LUAD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is It Time to (Re)define the N-Category for Metastatic Lymph Nodes in Non–Small Cell Lung Cancer?","authors":"Koen C. H. A. Verkoulen,&nbsp;Jean H. T. Daemen,&nbsp;Aimée J. P. M. Franssen,&nbsp;Juliette H. R. J. Degens,&nbsp;Karel W. E. Hulsewé,&nbsp;Yvonne L. J. Vissers,&nbsp;Erik R. de Loos","doi":"10.1111/crj.70016","DOIUrl":"https://doi.org/10.1111/crj.70016","url":null,"abstract":"&lt;p&gt;In a recent issue of &lt;i&gt;The Clinical Respiratory Journal&lt;/i&gt;, Guo et al. published a study that evaluated the correlation between the rate and number of resected metastatic lymph nodes and survival in patients undergoing an anatomical resection for non–small cell lung cancer (NSCLC) [&lt;span&gt;1&lt;/span&gt;]. To date, nodal staging is key in the work-up and treatment guidance for NSCLC as it is an important determinant of survival [&lt;span&gt;2, 3&lt;/span&gt;]. As opposed to some other cancer types, nodal staging for lung cancer is based on the anatomic location of the respective regional and mediastinal lymph node stations rather than the number of metastasis [&lt;span&gt;4-6&lt;/span&gt;]. Hence, the ongoing debate concerning the potential prognostic value of the number and rate of lymph node metastases in NSCLC continues. Over the last decade, numerous studies have aimed to address this issue [&lt;span&gt;7-10&lt;/span&gt;]. However, they are generally limited by their retrospective design and inherent bias, as well as methodological disparity [&lt;span&gt;11&lt;/span&gt;]. How does the current report add to the evidence collected for over more than a decade?&lt;/p&gt;&lt;p&gt;Guo et al. carried out the first population-based study concerning this subject. They revealed that both the number and rate of positive lymph nodes after lymphadenectomy concomitant to an anatomical lung parenchyma resection are a predictor for overall survival, independent of the anatomical location of the nodal station that is affected, being either N1 or N2. These results are in line with prior retrospective studies and a recently published meta-analysis [&lt;span&gt;8, 10, 12&lt;/span&gt;]. However, the number and rate of metastatic lymph nodes was only examined in postoperative patients that underwent lymphadenectomy, in whom the lymph nodes were completely dissected (defined as examination of more than 15 dissected lymph nodes) instead of biopsied stations. Thus, these results are only applicable as a prognostic tool and in treatment decision-making processes for postoperative patients. To be of an even greater importance for treatment plan composition, for example, one should repeat this study for preoperative clinical lymph node staging (cTNM) using minimally invasive staging techniques like endosonographic lymph node staging (EUS/EBUS) or surgical video-assisted mediastinoscopy (VAM) or video-assisted mediastinoscopic lymphadenectomy (VAMLA). However, a recent publication showed in a noninferiority study that VAMLA might not be of added value in patients that underwent systemic EUS/EBUS [&lt;span&gt;13&lt;/span&gt;]. Additionally, VAM/VAMLA or EUS is mainly used to assess N2 nodes. Hence, the vast majority of metastatic N1 nodes cannot be evaluated through these techniques. These drawbacks illustrate the challenges of the current TNM classification, and lymph node staging, especially for clinical lymph node staging. The sensitivity of preoperative lymph node staging modalities like (PET)-CT scan and EUS/EBUS ranges from 20% to 70%, resulting in a ","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 10","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142324464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison Between Endobronchial-Guided Transbronchial Biopsy and Computed Tomography–Guided Transthoracic Lung Biopsy for the Diagnosis of Central Pulmonary Lesions","authors":"Cheng Zhang,&nbsp;Senlin Zhu,&nbsp;Yanliang Yuan,&nbsp;Shenhui Dai","doi":"10.1111/crj.70015","DOIUrl":"10.1111/crj.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lung cancer is one of the most common malignant tumors at present. This study aimed to compare the diagnostic accuracy, complication rates, and predictive values of computed tomography (CT)–guided percutaneous transthoracic needle biopsy (PTNB) and electronic bronchoscopy–guided transbronchial lung biopsy (TBLB) for patients with central pulmonary lesions (CPLs) with a diameter ≥ 3 cm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively included 110 patients with CPLs with a diameter ≥ 3 cm who underwent preoperative PTNB and TBLB examinations and ultimately underwent surgery to remove CPLs and obtained pathological results. Detailed information was collected in order to compare whether there was a difference between two groups. Data were processed using SPSS software (Version 26.0; IBM Corp). Data were compared by <i>t</i>-test or chi-square test. <i>p</i> &lt; 0.05 was considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All patients underwent surgical treatment at the department of thoracic surgery and obtained a final pathological diagnosis. The rate of positive predictive value (PPV) was comparable between the two methods, and the negative predictive value (NPV) was significantly higher in the PTNB group compared with the TBLB group (<i>p</i> &lt; 0.05). In addition, PTNB was more sensitive and accurate than TBLB (<i>p</i> &lt; 0.05). However, the PTNB group had a higher probability of complications, and TBLB was a relatively safer examination method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PTNB demonstrated a higher accuracy and sensitivity than TBLB in the treatment of CPLs with a diameter ≥ 3 cm, but the complication rates of PTNB are relatively high. These methods exhibited different diagnostic accuracies and therefore should be selected based on different medical conditions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linoleic Acid Promotes Mitochondrial Biogenesis and Alleviates Acute Lung Injury","authors":"Jie Liu,&nbsp;Yu Jiang,&nbsp;Qiuhong Zhang,&nbsp;Yin Qin,&nbsp;Kexin Li,&nbsp;Yu Xie,&nbsp;Tingting Zhang,&nbsp;Xiaoliang Wang,&nbsp;Xi Yang,&nbsp;Li Zhang,&nbsp;Gang Liu","doi":"10.1111/crj.70004","DOIUrl":"10.1111/crj.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Acute lung injury (ALI) is a critical and lethal medical condition. This syndrome is characterized by an imbalance in the body's oxidation stress and inflammation. Linoleic acid (LA), a polyunsaturated fatty acid, has been extensively studied for its potential health benefits, including anti-inflammatory and antioxidant activities. However, the therapeutic effects of LA on ALI remain unexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Lipopolysaccharide (LPS), found in gram-negative bacteria's outer membrane, was intraperitoneally injected to induce ALI in mice. In vitro model was established by LPS stimulation of mouse lung epithelial 12 (MLE-12) cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>LA treatment demonstrated a significant amelioration in LPS-induced hypothermia, poor state, and pulmonary injury in mice. LA treatment resulted in a reduction in the concentration of bronchoalveolar lavage fluid (BALF) protein and an increase in myeloperoxidase (MPO) activity in LPS-induced mice. LA treatment reduced the generation of white blood cells. LA treatment reduced cell-free (cfDNA) release and promote adenosine triphosphate (ATP) production. LA increased the levels of superoxide dismutase (SOD) and glutathione (GSH) but decreased the production of malondialdehyde (MDA). LA treatment enhanced mitochondrial membrane potential. LA attenuated LPS-induced elevations of inflammatory cytokines in both mice and cells. Additionally, LA exerted its protective effect against LPS-induced damage through activation of the peroxisome proliferator-activated receptor γ coactivator l alpha (PGC-1α)/nuclear respiratory factor 1 (NRF1)/transcription factor A of the mitochondrion (TFAM) pathway.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LA may reduce inflammation and stimulate mitochondrial biogenesis in ALI mice and MLE-12 cells.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunotherapy Improves the Survival of Stage 4 Non–Small Cell Lung Cancer Patients at the US Population Level: The Real-World Evidence","authors":"Yuxuan Wei,&nbsp;Rui Zhang,&nbsp;Ruikang Yin,&nbsp;Shijie Wang,&nbsp;Jianglong Han,&nbsp;Ruyan Chen,&nbsp;Zhenming Fu","doi":"10.1111/crj.70000","DOIUrl":"https://doi.org/10.1111/crj.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Immunotherapy has revolutionized the management of lung cancer and improved lung cancer survival in trials, but its real-world impact at the population level remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using data obtained from eight Surveillance, Epidemiology, and End Results (SEER) registries from 2004 through 2019, we addressed the long-term trends in the incidence, incidence-based mortality (IBM), and survival of lung cancer patients in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The incidence and IBM of both non–small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) all significantly decreased steadily from 2004 to 2019. The 1-year survival (1-YS) of both NSCLC and SCLC improved over time, with the best improvement observed for Stage 4 NSCLC. Two significant turning points of Stage 4 NSCLC 1-YS were observed over the years: 0.63% (95% confidence interval [CI]: 0.33%–0.93%) from 2004 to 2010, 0.81% (95% CI: 0.41%–1.21%) from 2010 to 2014 and a striking 2.09% (95% CI: 1.70%–2.47%) from 2014 to 2019. The same two turning points in 1-YS were pronounced for Stage 4 NSCLC in women, which were coincident with the introduction of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and immunotherapy. However, for Stage 4 NSCLC in men, only one significant turning point in the 1-YS starting in 2014 was found, which might only correspond to immunotherapy. Significant period effects in reduced IBM were also observed for both Stage 4 AD and Stage 4 SQCC during the period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This SEER analysis found that immunotherapy improved the survival of Stage 4 NSCLC patients at the population level in the United States. This real-world evidence confirms that immunotherapy has truly revolutionized the management of lung cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atezolizumab-Induced Immune-Related Pneumonia on Rounded Atelectasis","authors":"Satoru Yanagisawa,&nbsp;Takaya Yui,&nbsp;Hiroki Takechi,&nbsp;Satoshi Wasamoto","doi":"10.1111/crj.70008","DOIUrl":"10.1111/crj.70008","url":null,"abstract":"&lt;p&gt;Dear editor:&lt;/p&gt;&lt;p&gt;An 82-year-old man with a heavy smoking history (35 pack-years) was diagnosed with right upper lung small cell lung cancer (extensive-disease, cT1cN3M1c: cStage IVB, LYM, OSS, HEP) in June 2023. He was a retired electrician who had been exposed to construction dust and asbestos fibers for decades. Chest computed tomography (CT) revealed partially calcified pleural plaques and posterior left lower lobe rounded atelectasis (RA) with “comet tail sign” [&lt;span&gt;1&lt;/span&gt;] (Figure 1A,B). Retrospectively, the RA appeared to remain the same shape and size since 2017. Positron emission tomography revealed &lt;sup&gt;18&lt;/sup&gt;F-fluorodeoxyglucose uptake in the right upper lobe primary tumor, but not in the pleural plaque or RA (Figure 1C–E). Subsequently, the patient was treated with carboplatin/etoposide plus atezolizumab as first-line chemotherapy in July 2023. Soon after atezolizumab infusion, he developed a transient fever; thereafter, he gradually complained of worsening dyspnea on exertion, with mild desaturation. On day 9 after chemotherapy induction, chest CT showed a new-onset consolidative shadow on the left lower lung that appeared around the preexisting RA (Figure 2A,B). The laboratory test results, including infectious serology and culture results, were unremarkable. Additional inflammatory serologies (antinuclear and antineutrophil cytoplasmic antibodies) were negative. Due to hypoxemia, further diagnostic studies, such as bronchoscopy, could not be conducted. We suspected that the lesion was consistent with atezolizumab-induced interstitial lung disease (immune-related adverse event [irAE]) and started intravenous prednisolone (40 mg daily). After the initiation of steroid treatment, his hypoxemia and lung shadow were almost completely cleared (Figure 2C,D), which supported the diagnosis of irAE pneumonia in RA. We decided to refrain from atezolizumab treatment and continued carboplatin/etoposide therapy alone without recurrence of irAEs.&lt;/p&gt;&lt;p&gt;RA [&lt;span&gt;2&lt;/span&gt;], also known as “folded lung” or “Blesovsky's syndrome,” is a subtype of lung atelectasis caused by invagination of the redundant visceral pleura [&lt;span&gt;3&lt;/span&gt;]. Although most RA are believed to be associated with asbestos lung exposure [&lt;span&gt;4&lt;/span&gt;], it is sometimes difficult to differentiate RA from other asbestos exposure-associated malignant diseases such as lung cancer and malignant pleural mesothelioma [&lt;span&gt;5&lt;/span&gt;]. RA usually maintains the same volume and even shrinks on serial scans [&lt;span&gt;4-6&lt;/span&gt;], which supports the benign feature of the lesion and justifies careful follow-up without intervention. However, there are some reports of RA that gradually enlarge and eventually necessitate surgical biopsy or excision [&lt;span&gt;7&lt;/span&gt;]. Although the precise mechanism of RA enlargement is yet to be elucidated, persistent chronic pleural inflammation may be associated. In our case, subpleural consolidation around the RA expanded after the initiation of atezo","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bronchoscopic Interventional Therapy Combined With Pembrolizumab in the Treatment of Pulmonary Large Cell Neuroendocrine Carcinoma: A Case Report","authors":"Yingyi Fan,&nbsp;Yingying Wang,&nbsp;Yanrong Ji,&nbsp;Shuang Li,&nbsp;Jian Zhang,&nbsp;Xingliang Hao","doi":"10.1111/crj.70009","DOIUrl":"10.1111/crj.70009","url":null,"abstract":"<p>This study reports a significant clinical outcome following the use of bronchoscopic interventional therapy combined with pembrolizumab for treating pulmonary large cell neuroendocrine carcinoma (LCNEC), showcasing a novel approach in managing this aggressive cancer.</p>","PeriodicalId":55247,"journal":{"name":"Clinical Respiratory Journal","volume":"18 9","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/crj.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}