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Genomic landscape of stage 0–IA lung adenocarcinoma identified by on-site reflex targeted NGS 通过现场反射靶向NGS鉴定0-IA期肺腺癌的基因组图谱
IF 4.4 2区 医学 Q1 ONCOLOGY Pub Date : 2026-01-29 DOI: 10.1016/j.lungcan.2026.108943
Marius Ilié , Simon Heeke , Guylène Rignol , Radu Pirlog , Samantha Goffinet , Elodie Long-Mira , Sandra Lassalle , Virginie Lespinet-Fabre , Olivier Bordone , Virginie Tanga , Caroline Lacoux , Christelle Bonnetaud , Jonathan Benzaquen , Jacques Boutros , Charlotte Cohen , Abel Gomez-Caro , Charles Hugo Marquette , Jean-Philippe Berthet , Véronique Hofman , Paul Hofman

Introduction

Early molecular profiling in non-squamous non-small cell lung carcinoma (NSCLC), particularly lung adenocarcinoma (LUAD), is critical for guiding individualized treatment strategies. Limited data exist on the genomic landscape of Stage 0–IA LUAD. This study assessed the feasibility and clinical relevance of reflex targeted next-generation sequencing (NGS) performed on-site at diagnosis in resected early-stage LUAD.

Methods

We retrospectively analyzed 239 consecutive Stage 0–IA LUAD cases diagnosed between 2022 and 2024 at a single institution. Ultra-fast reflex DNA- and RNA-based NGS was performed on resected specimens using a 50-gene targeted panel. Alterations were classified according to the ESMO Scale for Clinical Actionability of Molecular Targets (ESCAT). Associations between genomic alterations, histologic subtypes, and tumor grades were evaluated.

Results

Stage IA1 was the most frequent diagnosis (46%). High-quality sequencing data were obtained in all cases, with a median turnaround time of 102 h. At least one genomic alteration was detected in 80% of tumors. KRAS mutations were most frequent (35.8%), including KRAS G12C in 16%. EGFR mutations were present in 27.2%, primarily classical sensitizing alterations. Other actionable findings included ALK fusions (3.3%), RET rearrangements (1.2%), MET exon 14 skipping (2.4%), HER2 mutations (3.7%), and BRAF V600E (0.8%). ESCAT Level I alterations were found in 34% of tumors; 20% of these co-occurred with TP53 mutations. Significant associations were observed between genomic alterations, histologic subtypes, and tumor grades.

Conclusions

Reflex NGS at diagnosis in resected Stage 0–IA LUAD is feasible, rapid, and reveals a high rate of actionable alterations, which may support its integration in the future into early-stage diagnostic workflows.
非鳞状非小细胞肺癌(NSCLC),特别是肺腺癌(LUAD)的早期分子谱分析对于指导个体化治疗策略至关重要。关于0-IA期LUAD的基因组图谱数据有限。本研究评估了在切除的早期LUAD诊断现场进行反射靶向下一代测序(NGS)的可行性和临床相关性。方法回顾性分析同一医院于2022年至2024年间诊断的239例连续0-IA期LUAD病例。采用50个基因靶向面板对切除标本进行超快速反射DNA和基于rna的NGS。根据ESMO分子靶点临床可操作性量表(ESCAT)对改变进行分类。评估了基因组改变、组织学亚型和肿瘤分级之间的关系。结果IA1期诊断最多(46%)。所有病例均获得了高质量的测序数据,平均周转时间为102小时。在80%的肿瘤中检测到至少一种基因组改变。KRAS突变发生率最高(35.8%),其中KRAS G12C突变发生率为16%。27.2%的患者发生EGFR突变,主要是经典的致敏性改变。其他可操作的发现包括ALK融合(3.3%),RET重排(1.2%),MET外显子14跳变(2.4%),HER2突变(3.7%)和BRAF V600E(0.8%)。在34%的肿瘤中发现ESCAT I级改变;其中20%与TP53突变同时发生。在基因组改变、组织学亚型和肿瘤分级之间观察到显著的关联。结论反射性NGS在诊断切除的0-IA期LUAD时是可行的,快速的,并且显示了高可操作的改变率,这可能支持其在未来整合到早期诊断工作流程中。
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引用次数: 0
Corrigendum to "Radiotherapy outcomes in patients with interstitial lung disease and interstitial lung abnormalities: Adverse events and survival from a UK tertiary centre" [Lung Cancer 211 (2026) 108873. “间质性肺疾病和间质性肺异常患者的放疗结果:来自英国三级中心的不良事件和生存率”[肺癌211(2026)108873]的更正。
IF 4.4 2区 医学 Q1 ONCOLOGY Pub Date : 2026-01-29 DOI: 10.1016/j.lungcan.2026.108942
Sarah Bowen Jones, Gerard Gurumurthy, Conal Hayton, Ahmad Lodhi, Aqeel Umar, Corinne Faivre-Finn
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引用次数: 0
Immune-inflammatory predictors of early and brain recurrence in young patients with resected non-small cell lung cancer 非小细胞肺癌切除术后年轻患者早期和脑复发的免疫炎症预测因子
IF 4.4 2区 医学 Q1 ONCOLOGY Pub Date : 2026-01-26 DOI: 10.1016/j.lungcan.2026.108946
Debora Brascia , Giuseppe Mangiameli , Maria Teresa Congedo , Maria Giovanna Mastromarino , Chiara Catelli , Marco Schiavon , Veronica Giudici , Alessia Senatore , Alessandro Bonis , Marco Lucchi , Luca Luzzi , Stefano Magaritora , Federico Rea , Giuseppe Marulli

Objectives

Non–small-cell lung cancer (NSCLC) diagnosed before the age of 50 is uncommon and remains poorly characterized from a prognostic perspective. This study aimed to identify clinical, pathological, and inflammatory–immune predictors of recurrence, early recurrence, and brain metastasis after curative resection in young patients.

Methods

This multicenter retrospective study included 224 consecutive patients aged <50 years who underwent anatomical lung resection between 2015 and 2024 at five Italian centers. Recurrence-free survival (RFS) was analyzed using Fine–Gray competing-risk regression and overall survival (OS) using Cox proportional hazards models. Early recurrence was defined as occurring within 12 months after surgery. The prognostic value of preoperative neutrophil-to-lymphocyte ratio (NLR), PD-L1 expression, and their combined phenotypes was explored. An exploratory ROC-derived NLR cut-off of 2.35 was used for stratification.

Results

During follow-up, 65 patients (29.0%) experienced recurrence, with brain metastases representing the most frequent distant site (10.3% overall). Early recurrence occurred in 11.6% of patients. On multivariable analysis, higher NLR independently predicted recurrence (sHR 1.37, 95% CI 1.09–1.73), mortality (HR 1.82, 95% CI 1.27–2.61), and early recurrence (OR 3.61, 95% CI 1.07–12.21). PD-L1 expression alone was not prognostic; however, when combined with NLR, it identified inflammatory–immunologic phenotypes with different risks of brain metastasis among patients who recurred (p = 0.051).

Conclusions

Young-onset NSCLC is characterized by a high burden of early and distant recurrence, particularly involving the brain. Preoperative NLR is a robust predictor of recurrence, early relapse, and mortality. Combined NLR–PD-L1 phenotypes identify a subgroup at increased risk of neurotropic relapse.
目的:50岁前诊断的非小细胞肺癌(NSCLC)并不常见,从预后的角度来看,其特征仍然很差。本研究旨在确定年轻患者治愈性切除后复发、早期复发和脑转移的临床、病理和炎症免疫预测因素。方法本多中心回顾性研究纳入了224例年龄50岁的连续患者,这些患者于2015年至2024年在意大利5个中心接受了解剖性肺切除术。采用Fine-Gray竞争风险回归分析无复发生存期(RFS),采用Cox比例风险模型分析总生存期(OS)。早期复发定义为术后12个月内发生。探讨术前中性粒细胞与淋巴细胞比值(NLR)、PD-L1表达及其联合表型的预后价值。采用roc衍生的探索性NLR截止值为2.35进行分层。结果随访期间,65例患者(29.0%)出现复发,其中脑转移是最常见的远端部位(10.3%)。11.6%的患者出现早期复发。在多变量分析中,较高的NLR独立预测了复发(sHR 1.37, 95% CI 1.09-1.73)、死亡率(HR 1.82, 95% CI 1.27-2.61)和早期复发(OR 3.61, 95% CI 1.07-12.21)。单独的PD-L1表达不影响预后;然而,当联合NLR时,它确定了复发患者中具有不同脑转移风险的炎症免疫表型(p = 0.051)。结论年轻发病的非小细胞肺癌的特点是早期和远处复发的负担高,特别是累及大脑。术前NLR是复发、早期复发和死亡率的可靠预测指标。联合NLR-PD-L1表型确定了嗜神经性复发风险增加的亚组。
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引用次数: 0
Response to the letter of Peng Bai and Jun Zhang on Cost-effectiveness of Adjuvant Alectinib in ALK-positive NSCLC—Considerations for Broader Applicability 对白鹏、张军关于alk阳性nsclc中佐剂Alectinib的成本-效果的回复——对更广泛适用性的考虑
IF 4.4 2区 医学 Q1 ONCOLOGY Pub Date : 2026-01-26 DOI: 10.1016/j.lungcan.2026.108944
Romain Supiot , Léopoldine du Manoir de Juaye , Christos Chouaid
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引用次数: 0
Methodological considerations in assessing the clinical impact of TP53 classifications in advanced NSCLC 评估晚期非小细胞肺癌TP53分类的临床影响的方法学考虑
IF 4.4 2区 医学 Q1 ONCOLOGY Pub Date : 2026-01-23 DOI: 10.1016/j.lungcan.2026.108937
Xiaorong Lu, Shanshan Yuan
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引用次数: 0
Targeting HGF/MET and CXCL1/CXCR2 axes bypasses resistance to KRASG12C inhibitors in NSCLC 靶向HGF/MET和CXCL1/CXCR2轴可绕过NSCLC对KRASG12C抑制剂的耐药性。
IF 4.4 2区 医学 Q1 ONCOLOGY Pub Date : 2026-01-21 DOI: 10.1016/j.lungcan.2026.108939
A. Cavazzoni , M. Pagano Mariano , A. Palladini , G. Digiacomo , S. La Monica , M. Bonelli , M. Galetti , I. Pace , R. Roncarati , E. Giovannetti , P. Aretini , R. Minari , M. Treccani , M. Pluchino , C.A. Lagrasta , S. Angelicola , G. Mazzaschi , P. Bordi , F. Gelsomino , F. Agustoni , R. Alfieri

Background

Resistance to KRASG12C inhibitors sotorasib and adagrasib, approved for KRASG12C-mutant advanced Non-Small Cell Lung Cancer (NSCLC), involves multiple subclonal events, raising significant concerns about overcoming the resistant phenotype. Cytokines, chemokines, and growth factors are key mediators of drug resistance and targeting their signaling pathways is an emerging strategy in cancer therapy.

Methods

We generated cell clones from KRASG12C-mutated NSCLC cells treated with KRAS inhibitors and cell cultures from a sotorasib-resistant patient-derived xenograft (PDX). Gene mutations and changes in gene expression were evaluated using NGS, RNAseq. The mRNA and protein levels encoded by the Hepatocyte Growth Factor (HGF) and CXCL1 genes were quantified using RT-PCR and ELISA assay. The effect of drug combination was obtained by the Sulforhodamine-B assay and analyzed by Combenefit Software. Cell death was detected by Annexin-V assay. Cell signaling and epithelial-to-mesenchymal transition were evaluated by Western blotting.

Results

NSCLC cell clones and PDX cell cultures with acquired and intrinsic resistance to KRASG12C inhibitors exhibited elevated levels of CXCL1 and HGF expression and secretion, with activation of CXCR2 and c-MET signalling pathways. The combination of CXCR2 and c-MET inhibitors led to synergistic inhibition of cell growth and reduced cell viability by inhibiting the ERK1/2 and AKT signalling pathways. This combination also reversed EMT and induced apoptosis in sotorasib- and adagrasib-resistant clones, regardless of the genetic alterations responsible for resistance.

Conclusions

CXCL1/CXCR2 and HGF/c-MET may represent compensatory pathways that sustain proliferation and survival in resistance to KRASG12C inhibitors. The simultaneous blockade of these signals may offer a novel strategy for bypassing resistance.
背景:KRASG12C抑制剂sotorasib和adagasib的耐药被批准用于KRASG12C突变的晚期非小细胞肺癌(NSCLC),涉及多个亚克隆事件,引起了对克服耐药表型的重大关注。细胞因子、趋化因子和生长因子是耐药的关键介质,靶向它们的信号通路是癌症治疗的新兴策略。方法:我们从KRAS抑制剂处理的krasg12c突变的非小细胞肺癌细胞和来自sotorasib耐药患者来源的异种移植物(PDX)的细胞培养中获得细胞克隆。采用NGS、RNAseq检测基因突变及基因表达变化。采用RT-PCR和ELISA法定量检测肝细胞生长因子(HGF)和CXCL1基因编码的mRNA和蛋白水平。联合用药效果采用硫代丹- b法测定,并用Combenefit软件进行分析。Annexin-V法检测细胞死亡情况。Western blotting检测细胞信号转导和上皮-间质转化。结果:对KRASG12C抑制剂具有获得性和内在抗性的NSCLC细胞克隆和PDX细胞培养表现出CXCL1和HGF表达和分泌水平升高,CXCR2和c-MET信号通路被激活。CXCR2和c-MET抑制剂联合使用可通过抑制ERK1/2和AKT信号通路协同抑制细胞生长和降低细胞活力。该组合还逆转了sotorasib和adagrasib耐药克隆的EMT并诱导细胞凋亡,而不考虑导致耐药的遗传改变。结论:CXCL1/CXCR2和HGF/c-MET可能是KRASG12C抑制剂耐药过程中维持增殖和存活的代偿途径。同时阻断这些信号可能提供一种新的策略来绕过阻力。
{"title":"Targeting HGF/MET and CXCL1/CXCR2 axes bypasses resistance to KRASG12C inhibitors in NSCLC","authors":"A. Cavazzoni ,&nbsp;M. Pagano Mariano ,&nbsp;A. Palladini ,&nbsp;G. Digiacomo ,&nbsp;S. La Monica ,&nbsp;M. Bonelli ,&nbsp;M. Galetti ,&nbsp;I. Pace ,&nbsp;R. Roncarati ,&nbsp;E. Giovannetti ,&nbsp;P. Aretini ,&nbsp;R. Minari ,&nbsp;M. Treccani ,&nbsp;M. Pluchino ,&nbsp;C.A. Lagrasta ,&nbsp;S. Angelicola ,&nbsp;G. Mazzaschi ,&nbsp;P. Bordi ,&nbsp;F. Gelsomino ,&nbsp;F. Agustoni ,&nbsp;R. Alfieri","doi":"10.1016/j.lungcan.2026.108939","DOIUrl":"10.1016/j.lungcan.2026.108939","url":null,"abstract":"<div><h3>Background</h3><div>Resistance to KRAS<sup>G12C</sup> inhibitors sotorasib and adagrasib, approved for KRAS<sup>G12C</sup>-mutant advanced Non-Small Cell Lung Cancer (NSCLC), involves multiple subclonal events, raising significant concerns about overcoming the resistant phenotype. Cytokines, chemokines, and growth factors are key mediators of drug resistance and targeting their signaling pathways is an emerging strategy in cancer therapy.</div></div><div><h3>Methods</h3><div>We generated cell clones from KRAS<sup>G12C</sup>-mutated NSCLC cells treated with KRAS inhibitors and cell cultures from a sotorasib-resistant patient-derived xenograft (PDX). Gene mutations and changes in gene expression were evaluated using NGS, RNAseq. The mRNA and protein levels encoded by the Hepatocyte Growth Factor (HGF) and CXCL1 genes were quantified using RT-PCR and ELISA assay. The effect of drug combination was obtained by the Sulforhodamine-B assay and analyzed by Combenefit Software. Cell death was detected by Annexin-V assay. Cell signaling and epithelial-to-mesenchymal transition were evaluated by Western blotting.</div></div><div><h3>Results</h3><div>NSCLC cell clones and PDX cell cultures with acquired and intrinsic resistance to KRAS<sup>G12C</sup> inhibitors exhibited elevated levels of CXCL1 and HGF expression and secretion, with activation of CXCR2 and c-MET signalling pathways. The combination of CXCR2 and c-MET inhibitors led to synergistic inhibition of cell growth and reduced cell viability by inhibiting the ERK1/2 and AKT signalling pathways. This combination also reversed EMT and induced apoptosis in sotorasib- and adagrasib-resistant clones, regardless of the genetic alterations responsible for resistance.</div></div><div><h3>Conclusions</h3><div>CXCL1/CXCR2 and HGF/c-MET may represent compensatory pathways that sustain proliferation and survival in resistance to KRAS<sup>G12C</sup> inhibitors. The simultaneous blockade of these signals may offer a novel strategy for bypassing resistance.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"213 ","pages":"Article 108939"},"PeriodicalIF":4.4,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Prognostic significance of consolidation-to-tumor ratio in stage IA solid predominant non-mucinous adenocarcinoma: a paradigm for risk stratification IA期实性非黏液性腺癌的实变与肿瘤比值的预后意义:一种风险分层的范例
IF 4.4 2区 医学 Q1 ONCOLOGY Pub Date : 2026-01-21 DOI: 10.1016/j.lungcan.2026.108934
Yura Ahn , Geun Dong Lee , SeHoon Choi , Hyeong Ryul Kim , Yong-Hee Kim , Dong Kwan Kim , Seung-Il Park , Jooae Choe , Jae Kwang Yun

Objective

The optimal consolidation-to-tumor ratio (CTR) cutoff for survival stratification in radiologically solid-predominant adenocarcinoma (CTR > 0.5) remains unclear. This study aimed to evaluate the prognostic significance of CTR in clinical-stage IA non-mucinous lung adenocarcinoma with CTR > 0.5.

Materials and methods

We retrospectively analyzed patients who underwent curative resection for clinical stage IA non-mucinous adenocarcinoma with CTR > 0.5 between 2011 and 2021. Optimal cutoffs for overall survival (OS) and freedom from recurrence (FFR) were determined using maximized log-rank statistics. Patients were stratified according to the derived CTR cutoff values, and OS and FFR were compared among the CTR groups before and after propensity score matching (PSM).

Results

Among 2,789 patients included, the optimal CTR cutoffs for OS and FFR were 0.84 and 0.85, respectively. Based on the 0.85 cutoff, patients were categorized into three groups: 0.5 < CTR ≤ 0.85 (n = 672), 0.85 < CTR < 1 (n = 229), and CTR = 1 (n = 1,888). OS and FFR were significantly worse in the 0.85 < CTR < 1 group compared to the 0.5 < CTR ≤ 0.85 group (p < 0.05) but not significantly different from the CTR = 1 group (p > 0.05). These trends persisted after PSM. The 0.85 < CTR < 1 group exhibited a higher proportion of pathological risk factors (high-grade patterns, lymphovascular invasion, and nodal metastasis) than the 0.5 < CTR ≤ 0.85 group (all p < 0.05) and was comparable to the CTR = 1 group, except for lymphovascular invasion (p = 0.045). Dichotomization into 0.5 < CTR ≤ 0.85 and 0.85 < CTR ≤ 1 revealed significantly worse OS and FFR in the 0.85 < CTR ≤ 1 group across PSM cohorts for both lobectomy and sublobar resection.

Conclusion

A CTR cutoff of 0.85 effectively distinguishes survival outcomes in patients with clinical stage IA adenocarcinoma and CTR > 0.5 and may inform risk stratification and postoperative surveillance.
目的对放射学上以实性为主的腺癌进行生存分层的最佳实变-肿瘤比(CTR > 0.5)界限尚不清楚。本研究旨在评价CTR在临床期非黏液肺腺癌(CTR = 0.5)中的预后意义。材料和方法回顾性分析2011年至2021年间CTR为0.5的临床IA期非粘液腺癌行根治性切除术的患者。总生存(OS)和复发自由(FFR)的最佳截止使用最大对数秩统计确定。根据得到的CTR截断值对患者进行分层,比较倾向评分匹配(PSM)前后CTR组的OS和FFR。结果在纳入的2789例患者中,OS和FFR的最佳CTR截止值分别为0.84和0.85。根据0.85的截点将患者分为3组:0.5 < CTR≤0.85 (n = 672)、0.85 < CTR < 1 (n = 229)和CTR = 1 (n = 1888)。0.85 < CTR <; 1组的OS和FFR显著低于0.5 < CTR≤0.85组(p < 0.05),但与CTR = 1组无显著差异(p > 0.05)。这些趋势在PSM之后依然存在。CTR = 0.85 <; 1组的病理危险因素(高级别病变、淋巴血管浸润和淋巴结转移)比例高于CTR = 0.5 < CTR≤0.85组(p < 0.05),除淋巴血管浸润外,与CTR = 1组相当(p = 0.045)。将患者分为0.5 < CTR≤0.85和0.85 <; CTR≤1两组,无论是肺叶切除术还是叶下切除术,在PSM队列中,0.85 <; CTR≤1组的OS和FFR均明显较差。结论CTR截断值为0.85可有效区分临床分期IA期腺癌患者的生存结局,CTR截断值为0.5,可提示风险分层和术后监测。
{"title":"Prognostic significance of consolidation-to-tumor ratio in stage IA solid predominant non-mucinous adenocarcinoma: a paradigm for risk stratification","authors":"Yura Ahn ,&nbsp;Geun Dong Lee ,&nbsp;SeHoon Choi ,&nbsp;Hyeong Ryul Kim ,&nbsp;Yong-Hee Kim ,&nbsp;Dong Kwan Kim ,&nbsp;Seung-Il Park ,&nbsp;Jooae Choe ,&nbsp;Jae Kwang Yun","doi":"10.1016/j.lungcan.2026.108934","DOIUrl":"10.1016/j.lungcan.2026.108934","url":null,"abstract":"<div><h3>Objective</h3><div>The optimal consolidation-to-tumor ratio (CTR) cutoff for survival stratification in radiologically solid-predominant adenocarcinoma (CTR &gt; 0.5) remains unclear. This study aimed to evaluate the prognostic significance of CTR in clinical-stage IA non-mucinous lung adenocarcinoma with CTR &gt; 0.5.</div></div><div><h3>Materials and methods</h3><div>We retrospectively analyzed patients who underwent curative resection for clinical stage IA non-mucinous adenocarcinoma with CTR &gt; 0.5 between 2011 and 2021. Optimal cutoffs for overall survival (OS) and freedom from recurrence (FFR) were determined using maximized log-rank statistics. Patients were stratified according to the derived CTR cutoff values, and OS and FFR were compared among the CTR groups before and after propensity score matching (PSM).</div></div><div><h3>Results</h3><div>Among 2,789 patients included, the optimal CTR cutoffs for OS and FFR were 0.84 and 0.85, respectively. Based on the 0.85 cutoff, patients were categorized into three groups: 0.5 &lt; CTR ≤ 0.85 (n = 672), 0.85 &lt; CTR &lt; 1 (n = 229), and CTR = 1 (n = 1,888). OS and FFR were significantly worse in the 0.85 &lt; CTR &lt; 1 group compared to the 0.5 &lt; CTR ≤ 0.85 group (p &lt; 0.05) but not significantly different from the CTR = 1 group (p &gt; 0.05). These trends persisted after PSM. The 0.85 &lt; CTR &lt; 1 group exhibited a higher proportion of pathological risk factors (high-grade patterns, lymphovascular invasion, and nodal metastasis) than the 0.5 &lt; CTR ≤ 0.85 group (all p &lt; 0.05) and was comparable to the CTR = 1 group, except for lymphovascular invasion (p = 0.045). Dichotomization into 0.5 &lt; CTR ≤ 0.85 and 0.85 &lt; CTR ≤ 1 revealed significantly worse OS and FFR in the 0.85 &lt; CTR ≤ 1 group across PSM cohorts for both lobectomy and sublobar resection.</div></div><div><h3>Conclusion</h3><div>A CTR cutoff of 0.85 effectively distinguishes survival outcomes in patients with clinical stage IA adenocarcinoma and CTR &gt; 0.5 and may inform risk stratification and postoperative surveillance.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"213 ","pages":"Article 108934"},"PeriodicalIF":4.4,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Osimertinib dose-reduction and survival in 1L EGFR-mutated metastatic non-small cell lung cancer (mNSCLC) 奥西替尼在1L egfr突变的转移性非小细胞肺癌(mNSCLC)中的剂量减少和生存率
IF 4.4 2区 医学 Q1 ONCOLOGY Pub Date : 2026-01-20 DOI: 10.1016/j.lungcan.2026.108936
Adam Barsouk , Alec Heidlauf , Keshav Goel , Lynn Rushkin , Anna Anran Huang , Omar Elghawy , Connie Yu , Lucy Wang , David Yang , Martin Kurian , Lauren Reed-Guy , Lova Sun , Aditi Singh , Charu Aggarwal , Roger B. Cohen , Corey Langer , Melina E. Marmarelis

Introduction

Osimertinib has become standard of care in 1 L EGFR- mutated(mt) mNSCLC following the FLAURA trial. However, limited data are available on the effect of osimertinib dose-reduction on outcomes compared to full-dose.

Methods

We performed a single-institution, retrospective analysis of pts with EGFR-mt mNSCLC treated with 1 L osimertinib from 2018 to 2023. Pts who underwent dose-reduction were compared to those maintained on full dose (80 mg daily). Baseline demographics, disease characteristics, treatment history, toxicity, and clinical outcomes were abstracted from the electronic medical record and compared using independent sample t-tests and chi-square analyses as appropriate. Median progression free survival (mPFS), time to discontinuation (mTTD), and overall survival (mOS) were compared via Kaplan-Meier log-rank test and Cox regression analysis with time-varying covariate.

Results

Of 171 pts with mNSCLC treated with 1 L osimertinib, 26 (15%) required dose-reduction. Sex (p = 0.458), race (p = 0.421), ECOG PS > 1 at diagnosis (p = 0.730) and smoking history (p = 0.485) were comparable between reduced-dose and full-dose pts. 44% vs 34% of reduced dose and full dose pts, respectively, had CNS metastases at diagnosis (p = 0.192). All dose-reduced pts experienced adverse events (AEs), compared to 48% of full-dose pts (p < 0.001). Dose-reduced pts had shorter mPFS compared to full-dose pts (17.0 vs 24.6 mos; p = 0.043). Median PFS with dose-reduction was shorter compared to full-dose in pts with (p = 0.041) or without CNS metastases (p = 0.048). On time-variate, multivariable analysis, dose-reduction was associated with inferior PFS (p = 0.047) regardless of baseline characteristics. TTD was comparable in pts with and without dose-reduction (21.3 vs 25.2 mos; p = 0.521) OS was comparable in pts with and without dose-reduction (36.7vs 39.2 mos; p = 0.749). 14 pts (8%) discontinued osimertinib due to AEs, of whom 9 (64%) were previously dose-reduced. mPFS was comparable (p = 0.334) between pts who discontinued and those who did not, as was mOS (p = 0.910).

Conclusion

Dose-reduction of osimertinib was relatively uncommon and associated with shorter PFS (primarily CNS progression), but similar TTD and OS in 1 L patients with EGFR-mutated mNSCLC.
简介:在FLAURA试验之后,奥西替尼已成为治疗legfr突变(mt)mNSCLC的标准药物。然而,与全剂量相比,奥西替尼减量对结果的影响数据有限。方法:我们对2018年至2023年接受1l奥西替尼治疗的gfr -mt小细胞肺癌患者进行了单机构回顾性分析。接受减量治疗的患者与维持全剂量治疗(每日80mg)的患者进行比较。从电子病历中提取基线人口统计学、疾病特征、治疗史、毒性和临床结果,并酌情使用独立样本t检验和卡方分析进行比较。通过Kaplan-Meier log-rank检验和带时变协变量的Cox回归分析比较中位无进展生存期(mPFS)、停药时间(mTTD)和总生存期(mOS)。结果:171名接受1l奥西替尼治疗的小细胞肺癌患者中,26名(15%)患者需要减量。性别(p = 0.458)、种族(p = 0.421)、诊断时ECOG PS bb0.1 (p = 0.730)和吸烟史(p = 0.485)在减剂量组和全剂量组之间具有可比性。减少剂量组和全剂量组在诊断时有中枢神经系统转移的比例分别为44%和34% (p = 0.192)。与全剂量患者的48%相比,所有减量患者都经历了不良事件(ae) (p)。结论:奥西替尼减量相对罕见,与较短的PFS(主要是中枢神经系统进展)相关,但在1l例gfr突变的小细胞肺癌患者中,TTD和OS相似。
{"title":"Osimertinib dose-reduction and survival in 1L EGFR-mutated metastatic non-small cell lung cancer (mNSCLC)","authors":"Adam Barsouk ,&nbsp;Alec Heidlauf ,&nbsp;Keshav Goel ,&nbsp;Lynn Rushkin ,&nbsp;Anna Anran Huang ,&nbsp;Omar Elghawy ,&nbsp;Connie Yu ,&nbsp;Lucy Wang ,&nbsp;David Yang ,&nbsp;Martin Kurian ,&nbsp;Lauren Reed-Guy ,&nbsp;Lova Sun ,&nbsp;Aditi Singh ,&nbsp;Charu Aggarwal ,&nbsp;Roger B. Cohen ,&nbsp;Corey Langer ,&nbsp;Melina E. Marmarelis","doi":"10.1016/j.lungcan.2026.108936","DOIUrl":"10.1016/j.lungcan.2026.108936","url":null,"abstract":"<div><h3>Introduction</h3><div>Osimertinib has become standard of care<!--> <!-->in 1 L<!--> <em>EGFR</em>-<!--> <!-->mutated(mt)<!--> <!-->mNSCLC following the FLAURA trial.<!--> <!-->However, limited data are available on the effect of osimertinib dose-reduction<!--> <!-->on outcomes compared to<!--> <!-->full-dose.</div></div><div><h3>Methods</h3><div>We performed a single-institution, retrospective analysis of pts with<!--> <em>EGFR</em>-mt mNSCLC treated with 1 L osimertinib from 2018 to 2023. Pts who underwent dose-reduction were compared to those<!--> <!-->maintained on full dose (80 mg daily). Baseline demographics, disease characteristics, treatment history, toxicity, and clinical outcomes were abstracted from the electronic medical record and compared using independent sample t-tests and chi-square analyses as appropriate. Median progression free survival (mPFS), time to discontinuation (mTTD), and overall survival (mOS) were compared via Kaplan-Meier log-rank test and Cox regression analysis with time-varying covariate.</div></div><div><h3>Results</h3><div>Of 171 pts with mNSCLC treated with 1 L osimertinib, 26 (15%) required dose-reduction. Sex (p = 0.458), race (p = 0.421), ECOG PS &gt; 1 at diagnosis (p = 0.730) and smoking history (p = 0.485) were comparable between reduced-dose and full-dose pts. 44% vs 34% of reduced dose and full dose pts, respectively, had CNS metastases at diagnosis (p = 0.192). All dose-reduced pts experienced adverse events (AEs), compared to 48% of full-dose pts (p &lt; 0.001). Dose-reduced pts had shorter mPFS compared to full-dose pts (17.0 vs 24.6 mos; p = 0.043). Median PFS with dose-reduction was shorter compared to full-dose in pts with (p = 0.041) or without CNS metastases (p = 0.048). On time-variate, multivariable analysis, dose-reduction was associated with inferior PFS (p = 0.047) regardless of baseline characteristics. TTD was comparable in pts with and without dose-reduction (21.3 vs 25.2 mos; p = 0.521) OS was comparable in pts with and without dose-reduction (36.7vs 39.2 mos; p = 0.749). 14 pts (8%) discontinued osimertinib due to AEs, of whom 9 (64%) were previously dose-reduced. mPFS was comparable (p = 0.334) between pts who discontinued and those who did not, as was mOS (p = 0.910).</div></div><div><h3>Conclusion</h3><div>Dose-reduction of osimertinib was relatively uncommon and associated with shorter PFS (primarily<!--> <!-->CNS progression), but similar TTD and OS in 1 L patients with<!--> <em>EGFR</em>-mutated mNSCLC.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"213 ","pages":"Article 108936"},"PeriodicalIF":4.4,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Immune-related disorders in patients with Thymic Epithelial Tumors: from pathogenesis to tailored interventions 胸腺上皮肿瘤患者的免疫相关疾病:从发病机制到量身定制的干预措施
IF 4.4 2区 医学 Q1 ONCOLOGY Pub Date : 2026-01-17 DOI: 10.1016/j.lungcan.2026.108915
Erica Pietroluongo , Giovannella Palmieri , Paolo Antonio Ascierto , Margaret Ottaviano

Background and objective

Thymic epithelial tumors (TETs) are rare malignancies often associated with immunological disorders (IDs), including autoimmune diseases and paraneoplastic syndromes. Myasthenia gravis (MG) is the most frequently reported condition, although other IDs can manifest across various organ systems. This review aims to give an overview of the current knowledge on the epidemiology, pathogenesis, and management of IDs associated with TETs, emphasizing their prognostic impact and challenges in clinical practice.

Methods

We performed a narrative review using PubMed and Embase databases to identify relevant literature published between January 1971 and October 2024. Keywords included “thymic epithelial tumors”, “immunological disorders,” “autoimmune diseases,” and “paraneoplastic syndromes.” Only peer-reviewed articles in English were included.

Key content and findings

This review examines the association of TETs with the most frequent IDs, including MG, pure red cell aplasia, and Good’s syndrome. The prognostic implications of IDs in TETs remain unclear, and the available literature presents conflicting data. While some studies suggest correlations with favourable outcomes, others fail to establish IDs as independent prognostic factors for recurrence-free survival (RFS) or overall survival (OS).

Conclusions

The management of TETs with associated IDs requires a multidisciplinary approach that integrates tumor-specific treatments and tailored interventions for immune-related disorders. Advances in understanding molecular mechanisms have shed light on their pathogenesis. Nevertheless, gaps persist regarding prognostic implications and long-term management. Future efforts should focus on identifying predictive biomarkers for immune complications, optimizing therapies, and enhancing international data collection to clarify the impact of IDs on patient outcomes.
背景和目的:胸腺上皮性肿瘤(TETs)是一种罕见的恶性肿瘤,通常与免疫性疾病(IDs)相关,包括自身免疫性疾病和副肿瘤综合征。重症肌无力(MG)是最常见的报道条件,尽管其他id可以表现在不同的器官系统。本文综述了与tet相关的IDs的流行病学、发病机制和管理方面的最新知识,强调了它们在临床实践中的预后影响和挑战。方法:我们使用PubMed和Embase数据库进行叙述性回顾,以确定1971年1月至2024年10月期间发表的相关文献。关键词包括“胸腺上皮肿瘤”、“免疫紊乱”、“自身免疫性疾病”和“副肿瘤综合征”。只收录了同行评议的英文文章。主要内容和发现:本综述探讨了tet与最常见的IDs(包括MG、纯红细胞发育不全和Good’s综合征)的关系。测试中id的预后含义尚不清楚,现有文献提供了相互矛盾的数据。虽然一些研究表明与有利结果相关,但其他研究未能将IDs作为无复发生存期(RFS)或总生存期(OS)的独立预后因素。结论:TETs与相关IDs的管理需要多学科的方法,结合肿瘤特异性治疗和针对免疫相关疾病的量身定制的干预措施。分子机制的研究进展揭示了其发病机制。然而,在预后影响和长期管理方面仍然存在差距。未来的努力应集中在确定免疫并发症的预测性生物标志物,优化治疗,并加强国际数据收集,以阐明id对患者预后的影响。
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引用次数: 0
FAM83A promotes the progression of lung squamous cell carcinoma by inducing the epithelial–mesenchymal transition and inhibiting apoptosis via ERK pathway FAM83A通过ERK通路诱导上皮-间质转化,抑制细胞凋亡,促进肺鳞状细胞癌的进展
IF 4.4 2区 医学 Q1 ONCOLOGY Pub Date : 2026-01-12 DOI: 10.1016/j.lungcan.2026.108917
Xiang Fei , Hao Wu , Mengxing Li , Jianmang Yu , Junyi Huang , Siqi Cao , Shiyou Wei , Qiuyun Wang , Wei Zhu , Zhize Yuan

Background

The protein Family with Sequence Similarity 83, Member A (FAM83A) is associated with the advancement of various tumors. This study examines the biological function and fundamental processes of FAM83A in lung squamous cell carcinoma (LUSC).

Methods

The GSE33479 dataset was used to compare FAM83A expression levels in LUSC, while the GSE73403 dataset explored its prognostic relevance. FAM83A was knocked down or over-expressed in LUSC cell lines, and CCK-8, colony formation, Transwell, and flow cytometry assays were performed to evaluate the effects of altered FAM83A expression on LUSC cell proliferation, apoptosis, invasion, and migration. Organoids and animal models were utilized to validate the impact of FAM83A knockdown on tumor growth. Finally, FAM83A-overexpressing LUSC cells were treated with SCH772984, a specific ERK inhibitor, to elucidate the potential mechanism underlying the oncogenic effect of FAM83A.

Results

FAM83A was upregulated in LUSC tissues and cell lines, with high expression correlating with shorter overall survival. Depletion of FAM83A reduced the migration, invasion, and proliferation of LUSC cells, accompanied by cell cycle arrest and increased apoptotic rate. Western blotting analyses showed that FAM83A knockdown upregulated E-cadherin, BAX, and Cleaved-PARP/Caspase 3, while downregulating N-cadherin, Vimentin, BCL2, and Cyclin D1. Conversely, overexpression of FAM83A in LUSC cells yielded the opposite phenotypes. In both organoid cultures and in vivo models, inhibition of FAM83A attenuated tumor growth. Rescue experiments demonstrated that SCH772984 reversed the malignant phenotypes induced by FAM83A over-expression, indicating that FAM83A promoted cell cycle progression, inhibits apoptosis, and enhances epithelial-mesenchymal transition (EMT) in LUSC through activating the ERK signaling pathway.

Conclusion

FAM83A is crucial in the advancement and spread of LUSC, as it promotes EMT and inhibits apoptosis via the activation of the ERK pathway. These findings highlight its potential as a strategic molecular target for the treatment of LUSC.
具有序列相似性83,成员A的蛋白家族(FAM83A)与多种肿瘤的进展有关。本研究探讨FAM83A在肺鳞状细胞癌(LUSC)中的生物学功能和基本过程。方法使用GSE33479数据集比较FAM83A在LUSC中的表达水平,而使用GSE73403数据集探讨其与预后的相关性。FAM83A在LUSC细胞系中被敲低或过表达,通过CCK-8、集落形成、Transwell和流式细胞术检测FAM83A表达改变对LUSC细胞增殖、凋亡、侵袭和迁移的影响。利用类器官和动物模型验证FAM83A敲低对肿瘤生长的影响。最后,用特异性ERK抑制剂SCH772984处理过表达FAM83A的LUSC细胞,以阐明FAM83A致癌作用的潜在机制。结果fam83a在LUSC组织和细胞系中表达上调,高表达与总生存期缩短相关。FAM83A的缺失减少了LUSC细胞的迁移、侵袭和增殖,并伴有细胞周期阻滞和凋亡率升高。Western blotting分析显示,FAM83A敲低可上调E-cadherin、BAX和Cleaved-PARP/Caspase 3,下调N-cadherin、Vimentin、BCL2和Cyclin D1。相反,FAM83A在LUSC细胞中的过表达产生相反的表型。在类器官培养和体内模型中,抑制FAM83A可减弱肿瘤生长。营救实验表明,SCH772984逆转了FAM83A过表达诱导的恶性表型,表明FAM83A通过激活ERK信号通路,促进LUSC细胞周期进程,抑制细胞凋亡,增强上皮-间质转化(EMT)。结论fam83a通过激活ERK通路促进EMT和抑制凋亡,在LUSC的进展和扩散中起着至关重要的作用。这些发现突出了它作为治疗LUSC的战略性分子靶点的潜力。
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引用次数: 0
期刊
Lung Cancer
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