JTO Clinical and Research Reports最新文献

{"title":"First Central Asian Forum on Lung Cancer","authors":"Jandos Amankulov MD, PhD ,&nbsp;David F. Yankelevitz MD ,&nbsp;Amangeldi Mukhamejan MD ,&nbsp;Rowena Yip PhD, MPH ,&nbsp;Emanuela Taioli MD, PhD ,&nbsp;Bruce Pyenson FSA, MAAA ,&nbsp;James Mulshine MD ,&nbsp;Claudia I. Henschke PhD, MD","doi":"10.1016/j.jtocrr.2025.100898","DOIUrl":"10.1016/j.jtocrr.2025.100898","url":null,"abstract":"<div><div>The First Central Asian Forum on Lung Cancer was held at the National Academy of Sciences of the Republic of Kazakhstan on April 8 and 9, 2025. Organized by the Kazakhstan Cancer Society, KazIOR, and the I-ELCAP/IELCART consortia, the forum brought together regional and international experts to address the urgent challenge of late-stage lung cancer diagnosis in Central Asia. National data show that fewer than one-third of patients are diagnosed at stages I and II, while over 70% present with advanced disease. High smoking prevalence, environmental exposures such as radon, asbestos, and industrial pollution, and strong geographic variation in risk highlight the need for tailored screening programs. Kazakhstan is well-positioned to scale up low-dose CT (LDCT) screening given its CT scanner capacity, mobile units for underserved regions, and prior pilot screening successes. Conference sessions emphasized risk modeling, cost-effectiveness, artificial intelligence applications, and the added value of LDCT for detecting cardiovascular disease and emphysema. Plans are underway for collaborative projects and future conferences to strengthen regional capacity for early detection and treatment.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"7 1","pages":"Article 100898"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145651847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct Comparison of Tumor-Informed and Tumor-Naive Circulating Tumor DNA Assays for Recurrence Detection in Early-Stage NSCLC","authors":"Van-Anh Nguyen Hoang MSc ,&nbsp;Ngoc Nguyen BSc ,&nbsp;Tu Nguyen MSc ,&nbsp;Duy Sinh Nguyen MD, PhD ,&nbsp;Hoai-Nghia Nguyen PhD ,&nbsp;Lan N. Tu PhD","doi":"10.1016/j.jtocrr.2025.100927","DOIUrl":"10.1016/j.jtocrr.2025.100927","url":null,"abstract":"<div><h3>Background</h3><div>Circulating tumor DNA (ctDNA) is a promising prognostic biomarker in early-stage NSCLC. The typical tumor-informed method of ctDNA testing requires tissue specimens of high quality, which is a challenge in developing countries. Tumor-naive approach is an alternative, but the performance of the two methods has not been directly compared using the same samples and platform.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed tumor and blood samples of patients with early-stage NSCLC enrolled in our published study. For analytical performance, pretreatment samples of 42 patients and 50 healthy donors were used to assess the accuracy of ctDNA detection. For clinical performance, 176 postsurgical blood samples of 76 patients with NSCLC were analyzed to compare the ctDNA status with recorded clinical recurrence. The tumor-informed method evaluated personalized mutations and a fixed 500-hotspot panel, whereas the tumor-naive method combined predesigned mutation panels and nonmutation genome-wide features of ctDNA.</div></div><div><h3>Results</h3><div>The tumor-informed assay had 66.7% sensitivity and 99.3% specificity for detecting ctDNA in early-stage NSCLC, higher than the tumor-naive assay with 52.6% sensitivity and 95.7% specificity. Postsurgical ctDNA status determined by both methods had significant prognostic value to predict recurrence ahead of clinical diagnosis (hazard ratio &gt;100, <em>p</em> &lt; 0.0001). Tumor-informed ctDNA achieved 86.7% sensitivity to detect recurrence, and the 500-hotspot panel improved the ctDNA detection rate for cases with suboptimal tissue specimens. Tumor-naive ctDNA had 80.0% sensitivity to detect recurrence, and integration of nonmutation features was crucial.</div></div><div><h3>Conclusions</h3><div>Both methods exhibited high accuracy in detecting residual cancer in NSCLC. The tumor-naive approach is a reliable alternative when high-quality tissue specimens are unavailable.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"7 1","pages":"Article 100927"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145798010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmasking the Hidden Cardiopulmonary Cost of Lobectomy: A Paradigm Shift Demanded by Exercise Hemodynamics","authors":"Qiang Wu MD,&nbsp;Zhenyang Lv MMed,&nbsp;Zhe Fan MMed,&nbsp;Ze Wang MMed,&nbsp;Hao Su MMed,&nbsp;Ting Lei MD","doi":"10.1016/j.jtocrr.2025.100936","DOIUrl":"10.1016/j.jtocrr.2025.100936","url":null,"abstract":"","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"7 1","pages":"Article 100936"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight, BSA, Toxicity, and Efficacy of Tyrosine Kinase Inhibitors for ALK-Mutated NSCLC","authors":"Beatriz Jimenez Munarriz MD ,&nbsp;Sameena Khan MBChB, PhD ,&nbsp;Katrina Hueniken MPH, MSc ,&nbsp;Shirley Tam MD ,&nbsp;Devalben Patel BSc, MLT ,&nbsp;Luna Zhan MPH ,&nbsp;Catherine Brown MSc ,&nbsp;Lawson Eng MD, SM, FRCPC ,&nbsp;Adrian Sacher MMSc, MD ,&nbsp;Penelope Bradbury MB, BCh, FRACP, MD ,&nbsp;Natasha Leighl MMSc, MD, BSc ,&nbsp;Geoffrey Liu MSc, MD ,&nbsp;Frances A. Shepherd MD, FRCPC","doi":"10.1016/j.jtocrr.2025.100918","DOIUrl":"10.1016/j.jtocrr.2025.100918","url":null,"abstract":"<div><h3>Introduction</h3><div>ALK tyrosine kinase inhibitors (ALK TKIs) are started at a standard dose regardless of patients’ weight and body surface area (BSA). In this retrospective analysis, the authors explored whether body size variables were associated with toxicity and efficacy.</div></div><div><h3>Methods</h3><div>Retrospective data for <em>ALK-</em>positive patients at the Princess Margaret Cancer Centre were extracted from electronic health records. Associations between BSA/weight quartiles and dose reductions (DRs), temporary interruptions (TIs), and permanent discontinuation due to toxicity were evaluated using generalized linear mixed modeling. Survival analysis was conducted using Kaplan-Meier curves and log-rank tests.</div></div><div><h3>Results</h3><div>Among 142 patients with <em>ALK</em>-positive NSCLC treated between July 2012 and March 2024, the median age was 58 years, 54% were female, 78% never-smokers, 49% were Asian, and 37% were Caucasian. A significantly higher proportion of males were in the highest BSA Q4 (89%, <em>p</em> &lt; 0.001), whereas more females (91%, <em>p</em> &lt; 0.001) and Asians were in the lowest BSA Q1 (80%, <em>p</em> &lt; 0.001).</div><div>Higher weight at ALK TKI initiation was associated with an increased likelihood of DR at any time (adjusted odds ratio [aOR] = 1.20 per 10-kg increase, 95% confidence interval: 1.0–1.4, <em>p =</em> 0.04), as was having higher BSA (aOR = 2.00 per 0.5-U increase, 95% confidence interval: 1.0–3.9, <em>p =</em> 0.04). TIs were associated with higher weight (10-kg increase, aOR = 1.28, <em>p =</em> 0.006), BMI (5-U BMI increase, aOR = 1.40, <em>p =</em> 0.02), and BSA (0.5-U increase, aOR = 2.59, <em>p =</em> 0.005). These weight/BSA results were statistically significant in patients during alectinib or lorlatinib treatment. In contrast, permanent discontinuation was associated with higher weight/BSA in brigatinib/ceritinib/crizotinib-treated patients. In multivariable analysis, older age and male sex were independently associated with more DRs and TIs. Weight and BSA quartiles were not associated with progression-free survival (<em>p =</em> 0.4) or overall survival (<em>p =</em> 0.6).</div></div><div><h3>Conclusions</h3><div>Higher weight and larger BSA at the start of ALK TKI treatment were associated with higher likelihood of toxicity, leading to more DRs and TIs—particularly in males and patients receiving alectinib and lorlatinib. However, weight and BSA were not associated with treatment outcomes.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"7 1","pages":"Article 100918"},"PeriodicalIF":3.5,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145734620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DLL3 Immunohistochemical Expression in Neuroendocrine-Transformed EGFR-Mutant Lung Cancer and Two Cases of Tarlatamab Therapy","authors":"Jacqueline V. Aredo MD, MS ,&nbsp;Surbhi Singhal MD ,&nbsp;Gerald J. Berry MD ,&nbsp;Farshad Moradi MD, PhD ,&nbsp;Heather A. Wakelee MD ,&nbsp;Nathaniel J. Myall MD ,&nbsp;Kavitha J. Ramchandran MD ,&nbsp;Millie Das MD ,&nbsp;Carlos J. Suarez MD, MS ,&nbsp;Joel W. Neal MD, PhD ,&nbsp;Jonathan W. Riess MD, MS","doi":"10.1016/j.jtocrr.2025.100913","DOIUrl":"10.1016/j.jtocrr.2025.100913","url":null,"abstract":"<div><h3>Introduction</h3><div>Histologic transformation to high-grade neuroendocrine carcinoma occurs in resistance to EGFR targeted treatment in approximately 3% to 4% of patients with <em>EGFR</em>-mutant lung cancer and is associated with poor outcomes. The bispecific T-cell engager, tarlatamab, targets DLL3 and CD3 and has exhibited activity in classical SCLC. We evaluated DLL3 expression in patients with neuroendocrine-transformed <em>EGFR</em>-mutant lung cancer and present two cases who received tarlatamab.</div></div><div><h3>Methods</h3><div>Patients with high-grade neuroendocrine <em>EGFR</em>-mutant lung cancer <em>de novo</em> or after treatment with osimertinib were evaluated at two academic centers. DLL3 expression in neuroendocrine tissue was assessed by immunohistochemistry using the VENTANA SP347 assay (Roche Diagnostics International AG, Rotkreuz, Switzerland).</div></div><div><h3>Results</h3><div>Twelve patients were identified. Initial histologic diagnoses included adenocarcinoma (n = 10), adenosquamous (n = 1), and combined small cell carcinoma with an adenocarcinoma component (n = 1), with eight having <em>EGFR</em> exon 19 deletions and four with <em>EGFR</em> L858R. <em>TP53</em> co-mutations and <em>RB1</em> loss were detected in all patients tested (10 and 7, respectively). The median time from osimertinib initiation to neuroendocrine transformation was 27.8 months (range 3.6–52.9). DLL3 expression was positive in 11 patients with 15 samples (median 80%, range 1–100) and negative in one patient. Two patients with small cell transformation and 100% tumor DLL3 expression underwent treatment with tarlatamab with progression; osimertinib was subsequently added to tarlatamab in one patient with substantial improvement in all lesions.</div></div><div><h3>Conclusions</h3><div>In this study, neuroendocrine-transformed <em>EGFR</em>-mutant lung cancer exhibited variable DLL3 expression. Tarlatamab appeared effective when added to osimertinib. Further analysis of the combination of bispecific DLL3 T-cell engager and EGFR tyrosine kinase inhibitor is warranted to confirm these findings.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 12","pages":"Article 100913"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Durvalumab in Patients With Treatment-Naive Stage IV NSCLC With an ECOG Performance Status of 2 to 3 and High PD-L1 Tumor Expression (IFCT-1802 SAVIMMUNE): A Multicenter Phase 2 Trial","authors":"Valérie Gounant MD ,&nbsp;Laurent Greillier MD, PhD ,&nbsp;Céline Mascaux MD, PhD ,&nbsp;François Pinquie MD ,&nbsp;Delphine Carmier MD ,&nbsp;Lionel Moreau MD ,&nbsp;Benoît Roch MD ,&nbsp;Didier Debieuvre MD ,&nbsp;Xavier Dhalluin MD ,&nbsp;Etienne Giroux-Leprieur MD, PhD ,&nbsp;Elodie Berton MD ,&nbsp;Audrey Rabeau MD ,&nbsp;Judith Raimbourg MD ,&nbsp;Adrien Dixmier MD ,&nbsp;Charles Naltet MD ,&nbsp;Antoine Khalil MD, PhD ,&nbsp;Lynn Ezzeddine MD ,&nbsp;Mostafa El Hajjam MD, PhD ,&nbsp;Alexandra Langlais MSc ,&nbsp;Franck Morin MSc ,&nbsp;Michael Duruisseaux MD, PhD","doi":"10.1016/j.jtocrr.2025.100908","DOIUrl":"10.1016/j.jtocrr.2025.100908","url":null,"abstract":"<div><h3>Introduction</h3><div>Eastern Cooperative Oncology Group performance status 2 to 3 is associated with poor survival and chemotherapy-related adverse events (AEs). The impact of poor PS on the safety and efficacy of immune checkpoint inhibitors has not been elucidated. This study aimed to assess first-line durvalumab in patients with PS 2 to 3 with advanced NSCLC and high programmed cell death-ligand 1 (PD-L1) expression.</div></div><div><h3>Methods</h3><div>In this single-arm, prospective, multicenter, phase II trial, patients with PS 2 to 3 aged 18 to 75 years with metastatic NSCLC and PD-L1 tumor proportion score more than or equal to 25% received durvalumab until progression or toxicity. Primary end point was safety, that is incidence of grade more than or equal to 3 TRAEs during the first 8 weeks. Secondary end points included blinded independent central review overall response rate, progression-free survival, duration of response, overall survival (OS), and PS improvement at 8 weeks and health-related quality of life.</div></div><div><h3>Results</h3><div>A total of 50 patients were enrolled. Median follow-up was 26.2 (19.9–35.2) months. Prevalence of grade more than or equal to 3 TRAEs during the first 8 weeks was 10.0% (five of 50, 95% confidence interval [CI] 1.7–18.3), and no grade 5 occurred. Overall response rate at 8 weeks was 26% (95% CI 13.8–38.2). Median duration of response, progression-free survival, and OS were 11.8 months (95% CI, 7.2-not reached), 2.3 months (95% CI 1.7–5.6), and 7.1 months (95% CI 3.9–14.5), respectively. The 12-month OS rate was 40% (95% CI 26.5–53.1). Median OS in patients with PS 2 and PS 3 was 11.4 (95% CI 4.4–32.8) and 3.0 (95% CI 0.2–5.6) months, respectively. Of 27 patients, 12 (44.4%) still receiving durvalumab at 8 weeks had improved PS (<em>p</em> = 0.0096). Mean global QLQ-C30 score significantly increased at 8 weeks.</div></div><div><h3>Conclusions</h3><div>In patients with a PS of 2 to 3 with advanced NSCLC and high PD-L1 expression, first-line durvalumab was safe with 40% 1-year OS.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 12","pages":"Article 100908"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145469061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RELAY+: Final Overall Survival With Ramucirumab Plus Gefitinib in Patients With Untreated EGFR-Mutated Metastatic NSCLC","authors":"Makoto Nishio MD, PhD ,&nbsp;Takashi Seto MD, PhD ,&nbsp;Martin Reck PhD ,&nbsp;Edward B. Garon MD ,&nbsp;Kazuto Nishio MD, PhD ,&nbsp;Kazuo Kasahara MD, PhD ,&nbsp;Kazumi Nishino MD, PhD ,&nbsp;Miyako Satouchi MD, PhD ,&nbsp;Kiyotaka Yoh MD ,&nbsp;Hidetoshi Hayashi MD, PhD ,&nbsp;Kazuko Sakai PhD ,&nbsp;Sotaro Enatsu MD, PhD ,&nbsp;Tomoko Matsui BSc, RPh ,&nbsp;Sunoj Chacko Varughese MSc ,&nbsp;Michelle Carlsen MS ,&nbsp;Carla Visseren-Grul MD ,&nbsp;Kazuhiko Nakagawa MD, PhD","doi":"10.1016/j.jtocrr.2025.100912","DOIUrl":"10.1016/j.jtocrr.2025.100912","url":null,"abstract":"<div><h3>Introduction</h3><div>Ramucirumab (RAM) plus gefitinib (GEF) exhibited favorable efficacy and safety as first-line treatment in the primary analysis of the RELAY+ study of East Asian patients with metastatic <em>EGFR</em>-mutated NSCLC. We report the final overall survival (OS) and safety.</div></div><div><h3>Methods</h3><div>This open-label, two-period, single-arm exploratory study included patients with untreated NSCLC having <em>EGFR</em> ex19del or L858R mutations and no central nervous system metastasis or <em>EGFR</em> T790M mutation. Patients received RAM (10 mg/kg every 2 wk) plus GEF (250 mg once daily) until disease progression (period 1); patients with disease progression who acquired a T790M mutation received RAM plus osimertinib (80 mg once daily) (period 2).</div></div><div><h3>Results</h3><div>At final OS data cutoff (October 20, 2023; median follow-up: 42.5 mo), median (95% confidence interval [CI]) OS was 47.4 (35.9‒57.6) months, and the 3-year OS rate was 61.8%. In the L858R and ex19del subgroups, median OS was 51.9 and 38.4 months, and 3-year OS rates were 70.2% and 52.8%, respectively. Overall, 85.4% of patients received subsequent systemic therapy post study treatment discontinuation. Grade 3 or higher treatment-related adverse events (AEs) were reported by 51 (62.2%) patients. The most common grade 3 or higher treatment-emergent AE of special interest was hypertension (25.6%; grade 3 event only). Treatment-emergent T790M rate post progression was 81.3%.</div></div><div><h3>Conclusions</h3><div>RELAY+ revealed a favorable benefit-risk profile for RAM plus GEF in East Asian patients with untreated <em>EGFR</em>-mutated metastatic NSCLC, supporting RAM plus GEF as an alternative first-line treatment option, particularly in those with an L858R mutation.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 12","pages":"Article 100912"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine Learning Models Using General and Tissue-Specific Feature Extractors for Accurate Subtyping of Biopsy Samples: Advancing Lung Cancer Diagnosis in Latin America","authors":"Viviane Teixeira Loiola de Alencar MD, PhD candidate ,&nbsp;Felipe Navarro Balbino Alves BSc, MSc ,&nbsp;Guilherme de Souza Velozo BSc, MSc ,&nbsp;Luiz Edmundo Lopes Mizutani BSc, MSc ,&nbsp;Iusta Caminha MD, MSc, PhD candidate ,&nbsp;Gabriel Barbosa Silva BSc in Biomedical Science ,&nbsp;Vladmir Cláudio Cordeiro de Lima MD, PhD ,&nbsp;Fábio Rocha Fernandes Távora MD, PhD","doi":"10.1016/j.jtocrr.2025.100906","DOIUrl":"10.1016/j.jtocrr.2025.100906","url":null,"abstract":"<div><h3>Introduction</h3><div>Lung cancer is the leading cause of cancer-related deaths worldwide, with accurate histologic subtype classification critical for diagnosis and treatment planning. Diagnostic variability and resource disparities, particularly in underrepresented regions such as Latin America, pose substantial challenges. This study developed and evaluated novel artificial intelligence models trained on both global and Latin American pathology samples for subtype classification of hematoxylin and eosin (HE)–stained whole-slide images (WSIs).</div></div><div><h3>Methods</h3><div>Two DinoV2-based feature extractors, LungDino and OncoDino, trained on large data sets for task-specific and general pathology applications, were developed. The training data set consisted of 1308 HE-stained WSIs, including 412 adenocarcinomas, 323 squamous cell carcinomas, 41 small cell carcinomas, and 532 benign tissue samples, sourced from The Cancer Genome Atlas and an in-house Latin American data set. A ResNet model trained on ImageNet served as the baseline. Models were evaluated on 79 Latin American WSIs using receiver operating characteristic curves, and heatmaps were generated for tumor localization.</div></div><div><h3>Results</h3><div>The DinoV2-based models outperformed the ResNet baseline. LungDino achieved the highest overall performance, with area under the curves of 0.97 for adenocarcinoma and 0.96 for squamous cell carcinoma. OncoDino excelled in underrepresented categories, achieving an area under the curve of 0.99 for small cell carcinoma, demonstrating its generalizability. Both models generated interpretable heatmaps, with LungDino demonstrating precise tumor localization. In the subset of samples classified as poorly differentiated or undifferentiated in HE pathology reports, the DinoV2 models also maintained high classification performance.</div></div><div><h3>Conclusion</h3><div>These findings underscore the effectiveness of task-specific and general feature extractors in delivering accurate, explainable results and address a gap in artificial intelligence–driven histopathology advancements, paving the way for future clinical applications.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 12","pages":"Article 100906"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145468351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crizotinib in Patients With ROS1-Positive NSCLC With or Without Brain Metastases: Post Hoc Analysis of Phase II METROS Trial","authors":"Lorenza Landi MD ,&nbsp;Rita Chiari MD ,&nbsp;Marcello Tiseo MD, PhD ,&nbsp;Giulio Metro MD ,&nbsp;Filippo de Marinis MD ,&nbsp;Angelo Delmonte MD ,&nbsp;Silvia Novello MD ,&nbsp;Diego Luigi Cortinovis MD ,&nbsp;Domenico Galetta MD ,&nbsp;Laura Bonanno MD ,&nbsp;Cesare Gridelli MD ,&nbsp;Alessandro Morabito MD ,&nbsp;Francesco Grossi MD ,&nbsp;Andrea Torchia MD ,&nbsp;Diana Giannarelli PhD ,&nbsp;Gloria Borra MD ,&nbsp;Francesca Mazzoni MD ,&nbsp;Sara Pilotto MD ,&nbsp;Federico Cappuzzo MD","doi":"10.1016/j.jtocrr.2025.100909","DOIUrl":"10.1016/j.jtocrr.2025.100909","url":null,"abstract":"<div><h3>Introduction</h3><div>Crizotinib, the first approved targeted therapy for <em>ALK</em>-positive advanced NSCLC, is also indicated for <em>ROS1</em>-rearranged NSCLC. This post hoc analysis of the phase II METROS trial explores long-term survival outcomes with crizotinib, focusing on the impact of baseline brain metastases (BM).</div></div><div><h3>Methods</h3><div>This post hoc analysis of the METROS study assessed survival outcomes in patients with <em>ROS1</em>-rearranged NSCLC, evaluating progression-free survival (PFS), overall survival (OS), and the incidence and severity of adverse events, both in the overall cohort and by baseline BM status.</div></div><div><h3>Results</h3><div>Among 64 patients with <em>ROS1</em>-positive NSCLC with a median follow-up of 54.4 months, median PFS and OS were 13.8 months (95% CI: 7.4–20.2) and 40.5 months (95% CI: 27.9–53.1), respectively. Patients with BM (N = 17) had significantly shorter PFS (6.8 versus 17.4 mo) and OS (16.4 versus 42.8 mo) than those without BM. The safety profile of crizotinib remained consistent with previous reports, with most adverse events being grade 1 or 2 and no new safety concerns identified.</div></div><div><h3>Conclusion</h3><div>This analysis supports the efficacy of crizotinib in patients with advanced NSCLC and <em>ROS1</em> rearrangements, although its activity in patients with BM remains limited, highlighting the need for brain-penetrant tyrosine kinase inhibitors to improve outcomes in this patient group.</div></div>","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 12","pages":"Article 100909"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145469065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing Global Disparities in Lung Cancer Screening: Lessons From Puerto Rico and Beyond","authors":"Patrick Goodley MBBChir ,&nbsp;Matthew Evison MD","doi":"10.1016/j.jtocrr.2025.100919","DOIUrl":"10.1016/j.jtocrr.2025.100919","url":null,"abstract":"","PeriodicalId":17675,"journal":{"name":"JTO Clinical and Research Reports","volume":"6 12","pages":"Article 100919"},"PeriodicalIF":3.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}