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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。
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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。
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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。
{"title":"Immune-related disorders in patients with Thymic Epithelial Tumors: from pathogenesis to tailored interventions","authors":"Erica Pietroluongo ,&nbsp;Giovannella Palmieri ,&nbsp;Paolo Antonio Ascierto ,&nbsp;Margaret Ottaviano","doi":"10.1016/j.lungcan.2026.108915","DOIUrl":"10.1016/j.lungcan.2026.108915","url":null,"abstract":"<div><h3>Background and objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Key content and findings</h3><div>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).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"213 ","pages":"Article 108915"},"PeriodicalIF":4.4,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029993","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
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
KRAS-mutant advanced NSCLC: efficacy and clinical outcomes from network meta-analysis and real-world evidence kras突变晚期NSCLC:来自网络荟萃分析和真实世界证据的疗效和临床结果
IF 4.4 2区 医学 Q1 ONCOLOGY Pub Date : 2026-01-12 DOI: 10.1016/j.lungcan.2026.108930
Xiaoyu Gang , Yige Sun , Junli Hao , Suya Zhao , Yizheng Wang , Xinrui Yang , Heming Li , Mingfang Zhao

Background

KRAS is a common driver gene in non-small cell lung cancer (NSCLC). Owing to the absence of universally effective targeted agents and marked heterogeneity, optimal treatment selection for KRAS-mutant NSCLC remains uncertain. This study combined network meta-analysis (NMA) with real-world evidence to inform precision treatment strategies.

Methods

Thirteen randomized controlled trials were included in a Bayesian NMA to compare efficacy outcomes across regimens in KRAS-mutant and KRAS G12C-mutant NSCLC. In parallel, real-world data from advanced KRAS-mutant NSCLC patients treated at our center were analyzed.

Results

Across KRAS and G12C NMAs, immunotherapy-based regimens generally outperformed chemotherapy-based regimens. PD-(L)1 inhibitors monotherapy ranked highest for overall survival (OS), while chemotherapy plus PD-(L)1 inhibitors and anti-angiogenic therapy (anti-VEGF) ranked highest for progression-free survival (PFS). Chemotherapy plus dual immune checkpoint blockade (PD-(L)1 and CTLA-4) yielded a greater improvement in OS than in PFS. In our real-world cohort, first-line PD-(L)1 monotherapy achieved the best outcomes (objective response rate: 88.9%; median PFS: 22.2 months), followed by chemotherapy plus PD-(L)1 ± anti-VEGF. On multivariable analysis, ECOG performance status 0–1, PD-L1 TPS ≥ 50%, TMB ≥ 10 mut/Mb, and chemotherapy plus PD-(L)1 ± anti-VEGF were independently associated with longer first-line PFS. In subsequent lines, G12C inhibitors significantly improved outcomes versus other therapies, whereas non-G12C disease derived limited benefit from available strategies.

Conclusions

Immunotherapy constitutes the cornerstone of first-line therapy for KRAS-mutant NSCLC. Within this framework, PD-(L)1 monotherapy may be appropriate for carefully selected patients with high PD-L1 expression, whereas chemoimmunotherapy can extend benefit to broader subgroups; escalation with anti-VEGF or anti-CTLA-4 agents appears clinically promising and merits biomarker-driven prospective evaluation. KRAS G12C inhibitors are effective in later lines, while treatment options for non-G12C disease remain limited.
kras是非小细胞肺癌(NSCLC)中常见的驱动基因。由于缺乏普遍有效的靶向药物和明显的异质性,kras突变型NSCLC的最佳治疗选择仍然不确定。本研究将网络荟萃分析(NMA)与现实世界证据相结合,为精确治疗策略提供信息。方法在贝叶斯NMA中纳入13项随机对照试验,比较KRAS突变体和KRAS g12c突变体NSCLC不同方案的疗效结果。同时,我们分析了在本中心治疗的晚期kras突变NSCLC患者的真实数据。结果在KRAS和G12C nma中,基于免疫治疗的方案通常优于基于化疗的方案。PD-(L)1抑制剂单药治疗在总生存期(OS)中排名最高,而化疗加PD-(L)1抑制剂和抗血管生成治疗(抗vegf)在无进展生存期(PFS)中排名最高。化疗加双免疫检查点阻断(PD-(L)1和CTLA-4)对OS的改善比PFS更大。在我们的现实世界队列中,一线PD-(L)1单药治疗取得了最好的结果(客观缓解率:88.9%;中位PFS: 22.2个月),其次是化疗加PD-(L)1±抗vegf。在多变量分析中,ECOG表现状态0-1、PD- l1 TPS≥50%、TMB≥10 mut/Mb、化疗加PD-(L)1±抗vegf与较长的一线PFS独立相关。在随后的研究中,与其他疗法相比,G12C抑制剂显著改善了结果,而非G12C疾病从现有策略中获得的益处有限。结论免疫治疗是kras突变型非小细胞肺癌一线治疗的基石。在此框架下,PD-(L)1单药治疗可能适用于精心挑选的PD- l1高表达患者,而化学免疫治疗可以将益处扩展到更广泛的亚组;抗vegf或抗ctla -4药物的升级治疗在临床上很有前景,值得生物标志物驱动的前瞻性评估。KRAS G12C抑制剂在后期治疗中有效,而非G12C疾病的治疗选择仍然有限。
{"title":"KRAS-mutant advanced NSCLC: efficacy and clinical outcomes from network meta-analysis and real-world evidence","authors":"Xiaoyu Gang ,&nbsp;Yige Sun ,&nbsp;Junli Hao ,&nbsp;Suya Zhao ,&nbsp;Yizheng Wang ,&nbsp;Xinrui Yang ,&nbsp;Heming Li ,&nbsp;Mingfang Zhao","doi":"10.1016/j.lungcan.2026.108930","DOIUrl":"10.1016/j.lungcan.2026.108930","url":null,"abstract":"<div><h3>Background</h3><div><em>KRAS</em> is a common driver gene in non-small cell lung cancer (NSCLC). Owing to the absence of universally effective targeted agents and marked heterogeneity, optimal treatment selection for <em>KRAS</em>-mutant NSCLC remains uncertain. This study combined network meta-analysis (NMA) with real-world evidence to inform precision treatment strategies.</div></div><div><h3>Methods</h3><div>Thirteen randomized controlled trials were included in a Bayesian NMA to compare efficacy outcomes across regimens in <em>KRAS</em>-mutant and <em>KRAS</em> G12C-mutant NSCLC. In parallel, real-world data from advanced <em>KRAS</em>-mutant NSCLC patients treated at our center were analyzed.</div></div><div><h3>Results</h3><div>Across <em>KRAS</em> and G12C NMAs, immunotherapy-based regimens generally outperformed chemotherapy-based regimens. PD-(L)1 inhibitors monotherapy ranked highest for overall survival (OS), while chemotherapy plus PD-(L)1 inhibitors and anti-angiogenic therapy (anti-VEGF) ranked highest for progression-free survival (PFS). Chemotherapy plus dual immune checkpoint blockade (PD-(L)1 and CTLA-4) yielded a greater improvement in OS than in PFS. In our real-world cohort, first-line PD-(L)1 monotherapy achieved the best outcomes (objective response rate: 88.9%; median PFS: 22.2 months), followed by chemotherapy plus PD-(L)1 ± anti-VEGF. On multivariable analysis, ECOG performance status 0–1, PD-L1 TPS ≥ 50%, TMB ≥ 10 mut/Mb, and chemotherapy plus PD-(L)1 ± anti-VEGF were independently associated with longer first-line PFS. In subsequent lines, G12C inhibitors significantly improved outcomes versus other therapies, whereas non-G12C disease derived limited benefit from available strategies.</div></div><div><h3>Conclusions</h3><div>Immunotherapy constitutes the cornerstone of first-line therapy for <em>KRAS</em>-mutant NSCLC. Within this framework, PD-(L)1 monotherapy may be appropriate for carefully selected patients with high PD-L1 expression, whereas chemoimmunotherapy can extend benefit to broader subgroups; escalation with anti-VEGF or anti-CTLA-4 agents appears clinically promising and merits biomarker-driven prospective evaluation. KRAS G12C inhibitors are effective in later lines, while treatment options for non-G12C disease remain limited.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"213 ","pages":"Article 108930"},"PeriodicalIF":4.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981781","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
Combined intrathecal therapy via Ommaya reservoir and whole-brain radiotherapy improves survival in EGFR-mutant NSCLC patients with leptomeningeal metastases: a real-world cohort study 一项真实世界队列研究:通过Ommaya储液池和全脑放疗联合鞘内治疗可提高egfr突变的脑膜轻转移NSCLC患者的生存率
IF 4.4 2区 医学 Q1 ONCOLOGY Pub Date : 2026-01-12 DOI: 10.1016/j.lungcan.2026.108918
Meifang Li , Haibo Wang , Wei Zhang , Dong Lin , Chongting Gao , Ying Chen , Cheng Lin , Zongyang Yu

Objective

This study aimed to evaluate the survival benefit of combined intrathecal treatment (IT) via Ommaya reservoir and whole-brain radiotherapy (WBRT) in EGFR-mutant non-small cell lung cancer (NSCLC) patients with leptomeningeal metastases (LM).

Methods

We retrospectively analyzed EGFR-mutant NSCLC patients with LM diagnosed between January 2019 and September 2024. Patients were included if they had cytologically or radiologically confirmed LM and prior EGFR-TKI exposure. Clinical data, cerebrospinal fluid (CSF) profiles (cytology, biochemistry, molecular features), and treatment details were collected. Local therapies included WBRT (30–37.5 Gy in 10–15 fractions) and IT pemetrexed via Ommaya reservoir (10–20 mg weekly for 4 weeks, then bi-weekly for 2 months, followed by monthly maintenance). Overall survival (OS) was analyzed using Kaplan-Meier method and Cox regression. A prognostic nomogram was developed and validated.

Results

Among 200 included patients, the median OS was 12.3 months (95% CI: 10.8–13.8). Patients receiving local therapy (n = 149) had longer OS than those without (n = 51) (13.1 vs. 8.8 months; HR = 0.78, p = 0.001). The combination of IT and WBRT was associated with the best survival outcome (median OS 18.5 months). In CSF analysis, the initial cytology positivity rate was 74.4% (128/172), and normal lactate dehydrogenase (LDH) and chloride levels were associated with longer OS (p < 0.05). Multivariate analysis identified ECOG score, prior third-generation TKI, third-generation TKI plus anti-angiogenic therapy, and local therapy as independent prognostic factors.

Conclusion

The combination of IT via Ommaya reservoir and WBRT may result in better survival in EGFR-mutant NSCLC patients with LM and represents a promising treatment strategy for this patient population.
目的本研究旨在评估经Ommaya储液池和全脑放疗(WBRT)联合鞘内治疗(IT)对egfr突变的非小细胞肺癌(NSCLC)轻脑膜转移(LM)患者的生存获益。方法回顾性分析2019年1月至2024年9月期间诊断为LM的egfr突变型NSCLC患者。如果患者有细胞学或放射学证实的LM和先前的EGFR-TKI暴露,则纳入患者。收集临床资料、脑脊液(CSF)资料(细胞学、生物化学、分子特征)和治疗细节。局部治疗包括WBRT (30-37.5 Gy, 10-15份)和IT培美曲塞通过Ommaya水库(每周10-20 mg,持续4周,然后每两周,持续2个月,然后每月维持)。采用Kaplan-Meier法和Cox回归分析总生存期(OS)。开发并验证了预后图。结果在纳入的200例患者中,中位OS为12.3个月(95% CI: 10.8-13.8)。接受局部治疗的患者(n = 149)比未接受局部治疗的患者(n = 51)有更长的OS (13.1 vs 8.8个月;HR = 0.78, p = 0.001)。IT和WBRT的结合与最佳生存结果(中位OS 18.5个月)相关。在CSF分析中,初始细胞学阳性率为74.4%(128/172),正常乳酸脱氢酶(LDH)和氯化物水平与较长的生存期相关(p < 0.05)。多因素分析发现ECOG评分、既往第三代TKI、第三代TKI联合抗血管生成治疗和局部治疗是独立的预后因素。结论经Ommaya水库的IT和WBRT联合治疗egfr突变的非小细胞肺癌LM患者可能提高生存率,是一种很有前景的治疗策略。
{"title":"Combined intrathecal therapy via Ommaya reservoir and whole-brain radiotherapy improves survival in EGFR-mutant NSCLC patients with leptomeningeal metastases: a real-world cohort study","authors":"Meifang Li ,&nbsp;Haibo Wang ,&nbsp;Wei Zhang ,&nbsp;Dong Lin ,&nbsp;Chongting Gao ,&nbsp;Ying Chen ,&nbsp;Cheng Lin ,&nbsp;Zongyang Yu","doi":"10.1016/j.lungcan.2026.108918","DOIUrl":"10.1016/j.lungcan.2026.108918","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the survival benefit of combined intrathecal treatment (IT) via Ommaya reservoir and whole-brain radiotherapy (WBRT) in EGFR-mutant non-small cell lung cancer (NSCLC) patients with leptomeningeal metastases (LM).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed EGFR-mutant NSCLC patients with LM diagnosed between January 2019 and September 2024. Patients were included if they had cytologically or radiologically confirmed LM and prior EGFR-TKI exposure. Clinical data, cerebrospinal fluid (CSF) profiles (cytology, biochemistry, molecular features), and treatment details were collected. Local therapies included WBRT (30–37.5 Gy in 10–15 fractions) and IT pemetrexed via Ommaya reservoir (10–20 mg weekly for 4 weeks, then bi-weekly for 2 months, followed by monthly maintenance). Overall survival (OS) was analyzed using Kaplan-Meier method and Cox regression. A prognostic nomogram was developed and validated.</div></div><div><h3>Results</h3><div>Among 200 included patients, the median OS was 12.3 months (95% CI: 10.8–13.8). Patients receiving local therapy (n = 149) had longer OS than those without (n = 51) (13.1 vs. 8.8 months; HR = 0.78, p = 0.001). The combination of IT and WBRT was associated with the best survival outcome (median OS 18.5 months). In CSF analysis, the initial cytology positivity rate was 74.4% (128/172), and normal lactate dehydrogenase (LDH) and chloride levels were associated with longer OS (p &lt; 0.05). Multivariate analysis identified ECOG score, prior third-generation TKI, third-generation TKI plus anti-angiogenic therapy, and local therapy as independent prognostic factors.</div></div><div><h3>Conclusion</h3><div>The combination of IT via Ommaya reservoir and WBRT may result in better survival in EGFR-mutant NSCLC patients with LM and represents a promising treatment strategy for this patient population.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"213 ","pages":"Article 108918"},"PeriodicalIF":4.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981118","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
Corrigendum to “Global trends in lung cancer incidence and mortality by age, gender and morphology and forecast: A bootstrap-based analysis”. [Lung Cancer 205 (2025) 108626] “按年龄、性别和形态划分的肺癌发病率和死亡率的全球趋势和预测:基于自助的分析”的勘误表。[肺癌205(2025)108626]。
IF 4.4 2区 医学 Q1 ONCOLOGY Pub Date : 2026-01-11 DOI: 10.1016/j.lungcan.2026.108909
Jinto Edakkalathoor George , Preethi Sara George , Jagathnath K.M. Krishna , Aleyamma Mathew
{"title":"Corrigendum to “Global trends in lung cancer incidence and mortality by age, gender and morphology and forecast: A bootstrap-based analysis”. [Lung Cancer 205 (2025) 108626]","authors":"Jinto Edakkalathoor George ,&nbsp;Preethi Sara George ,&nbsp;Jagathnath K.M. Krishna ,&nbsp;Aleyamma Mathew","doi":"10.1016/j.lungcan.2026.108909","DOIUrl":"10.1016/j.lungcan.2026.108909","url":null,"abstract":"","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"212 ","pages":"Article 108909"},"PeriodicalIF":4.4,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959584","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
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Lung Cancer
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