Clinical lung cancer最新文献

英文中文

Dose Escalation Trial of the Combination of Osimertinib and Quaratusugene Ozeplasmid Gene Therapy in Patients with Advanced NSCLC 奥西替尼联合奎拉舒金厄泽质粒基因治疗晚期非小细胞肺癌的剂量递增试验

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical lung cancer

Pub Date : 2025-11-17 DOI: 10.1016/j.cllc.2025.11.009

Alexander I. Spira , David Berz , Robert M. Jotte , Krishna K. Pachipala , Mark S. Berger

Background

Expression of TUSC2, a tumor suppressor gene, is decreased in 82% of patients with NSCLC. Quaratusugene ozeplasmid gene therapy consists of a plasmid containing the TUSC2 gene encapsulated in lipid nanoparticles that restores TUSC2 expression, and thus is a new approach to cancer treatment.

Patients and Methods

Patients had NSCLC with EGFR mutations and progression on osimertinib regimens. Quaratusugene ozeplasmid was administered IV every 21 days at 3 dose levels with osimertinib 80 mg PO daily. Dexamethasone, acetaminophen, and diphenhydramine were administered prophylactically. Dose limiting toxicities (DLTs) were generally defined as ≥ Grade (Gr) 3 adverse events (AEs).

Results

Twelve patients were enrolled (3M/9F), median age 59.5, with 3 at 0.06 mg/kg, 4 at 0.09 mg/kg, and 5 at 0.12 mg/kg. There were no DLTs. There was a delayed infusion-related reaction with muscle aches, headache, and pyrexia. One patient at the 0.06 mg/kg dose level had a partial response (PR) and no progression for more than 32 months. Two other patients had stable disease (SD) for 22 and 9 months before disease progression.

Conclusion

Among the 12 patients treated with escalating doses of quaratusugene ozeplasmid and standard doses of osimertinib there were 3 patients with prolonged time to progression, including 1 with continuing PR. Quaratusugene ozeplasmid administration was associated with a delayed infusion-related reaction managed with prophylactic steroids, acetaminophen and diphenhydramine. There were no DLTs. The recommended phase II dose of quaratusugene ozeplasmid in combination with osimertinib in patients with NSCLC progressing after osimertinib treatment is 0.12 mg/kg.

TUSC2是一种肿瘤抑制基因，在82%的NSCLC患者中表达降低。Quaratusugene ozeplasmid基因治疗是将含有TUSC2基因的质粒包裹在脂质纳米颗粒中，从而恢复TUSC2的表达，因此是一种新的癌症治疗方法。患者和方法患者为EGFR突变的非小细胞肺癌，在奥西替尼方案下进展。Quaratusugene ozeplasmid每21天静脉注射3个剂量水平，奥希替尼80mg PO每日。预防性给予地塞米松、对乙酰氨基酚和苯海拉明。剂量限制性毒性（dlt）通常定义为≥3级（Gr）不良事件（ae）。结果12例患者（3M/9F），中位年龄59.5岁，0.06 mg/kg组3例，0.09 mg/kg组4例，0.12 mg/kg组5例。没有dlt。患者出现迟发性输液相关反应，伴有肌肉疼痛、头痛和发热。1例0.06 mg/kg剂量水平的患者部分缓解（PR），超过32个月无进展。另外2例患者在疾病进展前病情稳定（SD） 22个月和9个月。结论在12例患者中，增加剂量的quaratusugene ozeplasmid和标准剂量的osimertinib治疗中，有3例患者进展时间延长，包括1例持续PR。使用quaratusugene ozeplasmid与预防性类固醇、对乙酰氨基酚和苯海拉明管理的延迟输注相关反应相关。没有dlt。在非小细胞肺癌（NSCLC）治疗后进展的患者中，quaratusugene ozeplasmid联合奥西替尼的推荐II期剂量为0.12 mg/kg。

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引用次数: 0

Re: “Changing Lung Cancer Resection Outcomes Over Two Decades” 回复：“二十年来肺癌切除结果的变化”。

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical lung cancer

Pub Date : 2025-11-12 DOI: 10.1016/j.cllc.2025.11.003

Mehmet Mutlu ÇATLI, Arif Hakan Önder

引用次数: 0

Response to the letter to the Editor on “The Changing Landscape of Lung Cancer Resection Outcomes Over the Past Two Decades” 就《过去二十年肺癌切除结果的变化》致编辑的信的回应

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical lung cancer

Pub Date : 2025-11-11 DOI: 10.1016/j.cllc.2025.11.004

Charles-Antoine Guay , Alexandre Suhani , Laurie Perreault , Vicky Mai , Anne-Sophie Laliberté , Catherine Labbé , Steeve Provencher

引用次数: 0

Letter to the Editor: Durvalumab Consolidation in PD-L1 Negative Stage III NSCLC: Real-World Evidence Beyond Regulatory Boundaries 致编辑的信：Durvalumab在PD-L1阴性III期NSCLC中的巩固：超越监管界限的现实证据。

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical lung cancer

Pub Date : 2025-11-10 DOI: 10.1016/j.cllc.2025.11.008

Pınar Peker

引用次数: 0

Factors Associated With Provider Decision-Making of Early-Stage Lung Cancer Patients Treated With Stereotactic Body Radiation Therapy or Sublobar Resection 早期肺癌患者接受立体定向放射治疗或肺叶下切除术的相关因素

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical lung cancer

Pub Date : 2025-11-09 DOI: 10.1016/j.cllc.2025.11.006

Agostina E. Velo , Jeremy Mudd , Christopher G. Slatore , Raja Flores , Scott Swanson , Cardinale B. Smith , Mark Chidel , Kenneth E. Rosenzweig , Jeffrey A. Kern , Juan P. Wisnivesky

Background

Treatment decision-making for early-stage non–small cell lung cancer (NSCLC) in patients who have high-operative risk is complex. Identifying patient factors that influence physicians’ choices between sublobar resection and stereotactic body radiotherapy (SBRT) is important for guiding cancer care.

Methods

In this multicenter prospective study, patients with stage I NSCLC at high surgical risk were treated with either sublobar resection or SBRT. We collected data on demographics, comorbidities, lung function, functional status, and tumor characteristics. Before treatment, the primary physician rated each patient’s candidacy for SBRT versus sublobar resection on a 0 to 100 scale. Linear regression was used to identify factors influencing treatment recommendations.

Results

Among 331 patients, 62% received SBRT. Older age (mean difference [MD] 0.66 per year; 95% confidence interval [CI], 0.18 to 1.14) and chronic obstructive pulmonary disease (MD 9.77; 95% CI, 0.54 to 18.99) were associated with higher likelihood of SBRT candidacy. In contrast, higher forced expiratory volume (MD −0.23 per % increase; 95% CI, −0.42 to −0.04), larger tumor size (MD −4.13 per cm increase; 95% CI, −8.13 to −0.12), and better functional scores (MD −0.99; 95% CI, −1.64 to −0.35) decreased the likelihood of being considered for SBRT.

Conclusions

In patients with early-stage NSCLC with high-operative risk, treatment decisions are influenced by age, comorbidities, lung function, and tumor features. These findings can guide clinicians in evaluating treatment options and support shared decision-making.

背景：高手术风险的早期非小细胞肺癌（NSCLC）患者的治疗决策是复杂的。确定影响医生在叶下切除和立体定向放射治疗（SBRT）之间选择的患者因素对指导癌症治疗具有重要意义。方法：在这项多中心前瞻性研究中，手术风险高的I期NSCLC患者接受叶下切除术或SBRT治疗。我们收集了人口统计学、合并症、肺功能、功能状态和肿瘤特征的数据。治疗前，主治医生对每位患者进行SBRT和叶下切除术的候选性评分，评分范围从0到100。采用线性回归确定影响治疗建议的因素。结果：331例患者中，62%接受了SBRT治疗。年龄较大（平均差异[MD]每年0.66；95%可信区间[CI] 0.18至1.14）和慢性阻塞性肺疾病（MD 9.77； 95%可信区间[CI] 0.54至18.99）与SBRT候选可能性较高相关。相反，较高的用力呼气量（MD增加-0.23 %;95% CI, -0.42至-0.04）、较大的肿瘤大小（MD每厘米增加-4.13;95% CI, -8.13至-0.12）和较好的功能评分（MD -0.99; 95% CI, -1.64至-0.35）降低了考虑进行SBRT的可能性。结论：在手术风险高的早期NSCLC患者中，治疗决策受年龄、合并症、肺功能和肿瘤特征的影响。这些发现可以指导临床医生评估治疗方案并支持共同决策。

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引用次数: 0

Neoadjuvant Chemo-Immunotherapy for Surgically Resectable Non-Small Cell Lung Cancer: Balancing Promise and Pitfalls 手术切除的非小细胞肺癌的新辅助化疗-免疫治疗：平衡希望和缺陷。

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical lung cancer

Pub Date : 2025-11-08 DOI: 10.1016/j.cllc.2025.11.007

Parth Anil Desai, Hossein Borghaei, Martin J. Edelman

Abstract

Definitive resection has long anchored curative therapy for early–stage and locally advanced non–small cell lung cancer (NSCLC), with adjuvant platinum doublets—and now adjuvant immune–checkpoint inhibitors (ICIs)—providing incremental gains in disease–free survival. Neoadjuvant chemo–immunotherapy may amplify benefit by expanding tumour–specific T–cell clones in situ, thereby addressing occult micrometastatic disease. Randomised trials (CheckMate 816, KEYNOTE–671, AEGEAN, CheckMate 77T) consistently improve event–free survival, pathological response, and in some cases overall survival over neoadjuvant chemotherapy alone. However, none compared directly with the long–standing standard of upfront surgery followed by adjuvant therapy, and 15–24 % of enrolled patients never reach the operating room—most commonly because of radiographic progression (5–8 %) or evolving surgical ineligibility. Consequently, roughly one in five potentially curable patients may lose their window for resection, highlighting a clinically meaningful tradeoff. These findings underscore three priorities: (i) rigorous prospective comparison of perioperative versus purely adjuvant systemic strategies—now underway in the PROSPECT–LUNG trial (NCT06632327); (ii) biomarker discovery to predict primary resistance and identify patients better served by immediate surgery; and (iii) nuanced shared decision–making that balances hoped–for systemic control against the risk of surgical attrition. Realising the full promise of ICIs in resectable NSCLC will require optimising both treatment sequencing and patient selection.

长期以来，决定性切除术一直是早期和局部晚期非小细胞肺癌（NSCLC）的根治性治疗，辅助铂双药和现在的辅助免疫检查点抑制剂（ICIs）提供了无病生存期的增量收益。新辅助化学免疫治疗可以通过原位扩增肿瘤特异性t细胞克隆来扩大益处，从而解决隐匿的微转移性疾病。随机试验（CheckMate 816, KEYNOTE-671， AEGEAN, CheckMate 77T）持续提高无事件生存期，病理反应，在某些情况下，与单独新辅助化疗相比，总生存期。然而，没有直接与长期标准的前期手术后辅助治疗进行比较，15- 24%的入组患者从未进入手术室，最常见的原因是放射学进展（5- 8%）或逐渐不适合手术。因此，大约五分之一的潜在可治愈的患者可能会失去切除的机会，这突出了临床上有意义的权衡。这些发现强调了三个重点：(i)围手术期与纯辅助全身策略的严格前瞻性比较——目前正在进行的PROSPECT-LUNG试验（NCT06632327）；（ii）发现生物标志物，以预测原发性耐药性，并确定最好立即手术治疗的患者；（三）细致入微的共同决策，以平衡所希望的系统控制和手术损耗的风险。实现ICIs在可切除的非小细胞肺癌中的全部前景，将需要优化治疗顺序和患者选择。

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引用次数: 0

Brief Report: Lung Cancer Diagnoses among Lung Cancer Screening Program Participants With Family History of Lung Cancer 简要报告：有肺癌家族史的肺癌筛查项目参与者的肺癌诊断

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical lung cancer

Pub Date : 2025-11-07 DOI: 10.1016/j.cllc.2025.11.005

Julia G. Katcher , Christine C. Shusted , Padmanabh Bhatt , Brooke M. Ruane , Jenna Markle , Gregory C. Kane , Kuang-Yi Wen , Hee-Soon Juon , Julie A. Barta

•
Among screening-eligible adults, lung cancer is diagnosed more often in those with family history of lung cancer
•
Patients with family history had higher frequency of stage IV disease
•
Considering family history in risk assessment could improve lung cancer screening strategies

•在符合筛查条件的成年人中，有肺癌家族史的人更常被诊断出肺癌•有家族史的患者患IV期疾病的频率更高•在风险评估中考虑家族史可以改善肺癌筛查策略

引用次数: 0

Letter to the Editor: “Prognostic Implications of Lymph Node Status in Non–Small-Cell Lung Cancer Patients Before and After Neoadjuvant Chemoimmunotherapy: A Multicenter Retrospective Study” 致编辑的信：“新辅助化疗免疫治疗前后非小细胞肺癌患者淋巴结状态对预后的影响：一项多中心回顾性研究”

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical lung cancer

Pub Date : 2025-11-07 DOI: 10.1016/j.cllc.2025.11.001

Parth Aphale, Shashank Dokania, Himanshu Shekhar

引用次数: 0

Association Between Lung Volume Reduction and Symptomatic Radiation Pneumonitis in Lung Cancer Patients Undergoing Definitive Concurrent Chemoradiotherapy. 肺癌患者接受明确的同步放化疗时肺体积缩小与症状性放射性肺炎的关系。

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical lung cancer

Pub Date : 2025-11-05 DOI: 10.1016/j.cllc.2025.10.007

Jeong Won Lee, Sea-Won Lee, Hyeseon Kang, Yun Hee Lee

Purpose: This study assessed lung volume alterations during radiotherapy (RT) and their predictive value for symptomatic radiation pneumonitis (RP) in lung cancer patients undergoing definitive concurrent chemoradiotherapy (CCRT) MATERIALS AND METHODS: This retrospective study included 49 patients who underwent re-simulation four-dimensional (4D) computed tomography (CT) during RT. Lung volume was measured on the 30% phase of 4D CT at initial and re-simulation scans. Associations between volume changes and symptomatic RP were analyzed using the Mann-Whitney U test. To determine the optimal cut-off value, ROC analysis and the Youden index were utilized. RP was graded based on CTCAE v5.0.

Results: Among the 49 patients, seven (14.3%) developed symptomatic RP. Dosimetric parameters did not differ significantly between patients with and without RP. However, changes in ipsilateral lung volume were significantly associated with symptomatic RP. A volume decrease >130 cm³ or a relative reduction <-7% was predictive of RP (P = .001). The area under the ROC curve for absolute change and relative change of ipsilateral lung volume were 0.905 and 0.883, respectively.

Conclusion: Ipsilateral lung volume reduction during RT may serve as an early predictor of symptomatic RP, independent of traditional dosimetric factors. Monitoring volume changes with re-simulation CT could enhance RP risk assessment and guide adaptive RT planning.

目的：本研究评估肺癌患者在放疗（RT）期间肺体积的改变及其对确诊同步放化疗（CCRT）的症状性放射性肺炎（RP）的预测价值。材料和方法：本回顾性研究包括49例患者，他们在放疗期间接受了重新模拟四维计算机断层扫描（CT）。在初次扫描和重新模拟扫描时，在4D CT的30%期测量肺体积。使用Mann-Whitney U检验分析容积变化与症状性RP之间的关系。为了确定最佳临界值，采用ROC分析和约登指数。RP评分基于CTCAE v5.0。结果：49例患者中，7例（14.3%）出现症状性RP。剂量学参数在RP患者和非RP患者之间没有显著差异。然而，同侧肺体积的变化与症状性RP显著相关。结论：放疗期间同侧肺体积缩小可作为症状性RP的早期预测指标，独立于传统剂量学因素。再模拟CT监测体积变化可增强RP风险评估，指导适应性RT计划。

{"title":"Association Between Lung Volume Reduction and Symptomatic Radiation Pneumonitis in Lung Cancer Patients Undergoing Definitive Concurrent Chemoradiotherapy.","authors":"Jeong Won Lee, Sea-Won Lee, Hyeseon Kang, Yun Hee Lee","doi":"10.1016/j.cllc.2025.10.007","DOIUrl":"https://doi.org/10.1016/j.cllc.2025.10.007","url":null,"abstract":"<p><strong>Purpose: </strong>This study assessed lung volume alterations during radiotherapy (RT) and their predictive value for symptomatic radiation pneumonitis (RP) in lung cancer patients undergoing definitive concurrent chemoradiotherapy (CCRT) MATERIALS AND METHODS: This retrospective study included 49 patients who underwent re-simulation four-dimensional (4D) computed tomography (CT) during RT. Lung volume was measured on the 30% phase of 4D CT at initial and re-simulation scans. Associations between volume changes and symptomatic RP were analyzed using the Mann-Whitney U test. To determine the optimal cut-off value, ROC analysis and the Youden index were utilized. RP was graded based on CTCAE v5.0.</p><p><strong>Results: </strong>Among the 49 patients, seven (14.3%) developed symptomatic RP. Dosimetric parameters did not differ significantly between patients with and without RP. However, changes in ipsilateral lung volume were significantly associated with symptomatic RP. A volume decrease >130 cm³ or a relative reduction <-7% was predictive of RP (P = .001). The area under the ROC curve for absolute change and relative change of ipsilateral lung volume were 0.905 and 0.883, respectively.</p><p><strong>Conclusion: </strong>Ipsilateral lung volume reduction during RT may serve as an early predictor of symptomatic RP, independent of traditional dosimetric factors. Monitoring volume changes with re-simulation CT could enhance RP risk assessment and guide adaptive RT planning.</p>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145457905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Minimally Invasive Surgery Versus SABR in Stage IA NSCLC: Interpreting Real-World Evidence with Caution 微创手术与SABR治疗IA期非小细胞肺癌：谨慎解读现实证据

IF 3.3 3区医学 Q2 ONCOLOGY

Clinical lung cancer

Pub Date : 2025-11-04 DOI: 10.1016/j.cllc.2025.11.002

Asim Armagan Aydin , Erkan Kayikcioglu

引用次数: 0

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