Lung Cancer最新文献

{"title":"Clinical benefit evaluation of drug treatment regimens for advanced lung cancer:based on ASCO-VF and ESMO-MCBS","authors":"Jingdan Pang ,&nbsp;Yiruo Zhang ,&nbsp;Xuan Wang ,&nbsp;Wentian Wu ,&nbsp;Chang Wan ,&nbsp;Ziming Li ,&nbsp;Yingying Du","doi":"10.1016/j.lungcan.2024.108001","DOIUrl":"10.1016/j.lungcan.2024.108001","url":null,"abstract":"<div><h3>Background</h3><div>With the increasing use of novel targeted drugs and immune checkpoint inhibitors (ICIs) for lung cancer (LC), the life expectancy of patients with LC has notably increased. In China, many drugs with the same mechanism of action have been approved by the National Medical Products Administration (NMPA) through phase III randomized controlled trials (RCTs). However, differences occur in these drugs’ efficacy and adverse effects, all of which have been compared with standard treatments, and data from head-to-head studies are lacking.</div></div><div><h3>Methods</h3><div>The key RCTs of EGFR tyrosine kinase inhibitors (EGFR-TKIs), ALK-TKIs, and ICIs approved by NMPA in advanced LC in China were searched and divided into five groups. The American Society of Clinical Oncology Value Framework (ASCO-VF v2) and European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS v1.1) were used to evaluate the net health benefits (NHB) of RCTs, including efficacy, adverse reactions, and patient-reported outcomes (PROs), etc. The consistency of the ASCO-VF and ESMO-MCBS was compared.</div></div><div><h3>Results</h3><div>As of September 2024, 37 RCTs have been included in the ASCO-VF and ESMO-MCBS. NHB scores ranged from 12.30 to 93.25. Nineteen trials met the ASCO-VF “substantial benefit”, and 28 trials achieved the ESMO-MCBS “substantial benefit”. Except for icotinib, dacomitinib, and befotertinib, all EGFR-TKIs and ALK-TKIs met the threshold of two frameworks. In the ICI regimens, eight regimens met the threshold of “ substantial benefit ” as defined by the two frameworks and nine studies showed conflicting results. The correlation coefficient of the 37 pairs of scores in the advanced LC study was estimated to be 0.473(Spearman), and the consistency analysis showed fair agreement.(κ = 0.265, p = 0.001).</div></div><div><h3>Conclusions</h3><div>ASCO-VF and ESMO-MCBS focus on clinical efficacy and consider the adverse effects of drugs and PROs. We look forward to head-to-head studies on the different treatment options and advocate refining the ESMO-MCBS.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"197 ","pages":"Article 108001"},"PeriodicalIF":4.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546277","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}

{"title":"Corrigendum to “Real-world treatment sequencing and effectiveness of second- and third-generation ALK tyrosine kinase inhibitors for ALK -positive advanced non-small cell lung cancer” [Lung Cancer 195 (2024) 107919]","authors":"Jessica R. Bauman ,&nbsp;Geoffrey Liu ,&nbsp;Isabel Preeshagul ,&nbsp;Stephen V. Liu ,&nbsp;Barbara Melosky ,&nbsp;Devin Abrahami ,&nbsp;Benjamin Li ,&nbsp;Despina Thomaidou ,&nbsp;Kirsten Duncan ,&nbsp;Stan Krulewicz ,&nbsp;Martin Rupp ,&nbsp;Jessica J. Lin","doi":"10.1016/j.lungcan.2024.108000","DOIUrl":"10.1016/j.lungcan.2024.108000","url":null,"abstract":"","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"197 ","pages":"Article 108000"},"PeriodicalIF":4.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world comparison of the efficacy and safety of atezolizumab versus durvalumab in extensive-stage small cell lung cancer","authors":"Megan Vince ,&nbsp;Syeda Mahrukh Hussnain Naqvi ,&nbsp;Bruna Pellini ,&nbsp;Michael Verbosky ,&nbsp;Dan Melzer","doi":"10.1016/j.lungcan.2024.107999","DOIUrl":"10.1016/j.lungcan.2024.107999","url":null,"abstract":"<div><h3>Background</h3><div>Small cell lung cancer (SCLC) is an aggressive disease associated with high relapse rates and limited treatment options. Current standard of care treatment for extensive-stage disease includes combination chemotherapy plus immunotherapy. Programmed death ligand-1 (PD-L1) immune checkpoint inhibitors (ICIs) are preferred first-line treatments in combination with chemotherapy with both atezolizumab and durvalumab being equivalent options. Although both ICIs are listed as front-line options in clinical guidelines, there have been no head-to-head trials comparing durvalumab to atezolizumab. Therefore, it is unknown if either agent is superior with regards to efficacy or safety.</div></div><div><h3>Methods</h3><div>This retrospective, single-institution study examined patients with extensive-stage small cell lung cancer presenting to Moffitt Cancer Center between October 1st, 2018 to May 31st, 2023 who received either atezolizumab or durvalumab in combination with a platinum-doublet in the first-line setting. To be included in this analysis patients must have received at least two cycles of induction chemotherapy and ICI and one cycle of maintenance ICI. The primary outcome of this study was overall survival. The secondary outcomes include progression-free survival, immune-related adverse events, hospitalizations due to ICIs, and progression-free survival on second-line therapy (PFS2).</div></div><div><h3>Results</h3><div>Of the 101 patients included, 55 received durvalumab (54.5 %) and 46 received atezolizumab (45.5 %). The median overall survival in the durvalumab and atezolizumab arms were 14.7 versus 11.6 months, respectively (HR 0.59; 95 % CI, 0.38–0.92; <em>P</em> = 0.020). There was not a statistically significant difference in median progression-free survival between the two arms (6.3 versus 5.9 months, <em>P</em> = 0.344). Atezolizumab was associated with a numerically higher incidence of immune-related adverse events (47.8 % versus 32.7 %, <em>P</em> = 0.157) and hospitalization rates for those with an immune-related adverse event (36.4 % versus 16.7 %, <em>P</em> = 0.204). PFS2 was 2.3 months in the atezolizumab arm and 3.4 months in the durvalumab arm (HR 1.24; 95 % CI, 0.69–2.23; <em>P</em> = 0.466).</div></div><div><h3>Conclusions</h3><div>In this real-world retrospective study, durvalumab was associated with improved overall survival in patients with extensive-stage small cell lung cancer consistent with previous findings from a similar study in a Chinese patient population. Although not statistically significant, there was a lower incidence of immune-related adverse events in the durvalumab arm as well as ICI-related hospitalizations. PFS2 was not statistically significant different between arms.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 107999"},"PeriodicalIF":4.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578898","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}

{"title":"The relevance of the reference range for EGFR testing in non-small cell lung cancer patients","authors":"Pasquale Pisapia ,&nbsp;Alessandro Russo ,&nbsp;Caterina De Luca ,&nbsp;Francesco Pepe ,&nbsp;Francesco Drago ,&nbsp;Christian Rolfo ,&nbsp;Giancarlo Troncone ,&nbsp;Umberto Malapelle","doi":"10.1016/j.lungcan.2024.108002","DOIUrl":"10.1016/j.lungcan.2024.108002","url":null,"abstract":"<div><h3>Introduction</h3><div>Identifying mutations in the epidermal growth factor receptor (<em>EGFR</em>) gene is crucial for individualized treatment of non-small cell lung cancer (NSCLC) patients. Accordingly, several methodologies and instruments are now commercially available to detect these alterations. The aim of this study was to examine the performance of next generation sequencing (NGS) in detecting both common and uncommon <em>EGFR</em> gene mutations in advanced NSCLC patients.</div></div><div><h3>Methods</h3><div>We retrospectively retrieved molecular data from n = 1312 advanced stage NSCLC patients tested by our NGS DNA-based panel (namely SiRe® panel) from January 2018 to December 2022. We subsequently compared the NGS results with the reference ranges of the most popular real time PCR (RT-qPCR) assays (cobas® <em>EGFR</em> Mutation Test v2, EasyPGX® ready <em>EGFR</em>, Idylla™ <em>EGFR</em> mutation test, and therascreen® <em>EGFR</em> Plus RGQ).</div></div><div><h3>Results</h3><div>Overall, NGS detected n = 234 mutations in n = 192 (15.9 %) patients. Conversely, when these results were compared with the reference ranges of the four most common commercially available RT-qPCR assays, far fewer mutations were identified: n = 18 (9.4 %), n = 17 (8.9 %), n = 17 (8.9 %), and n = 18 (9.4 %) mutations. These results suggest that if patients were tested solely using RT-qPCR assays, a substantial proportion would have been ineligible for targeted therapies.</div></div><div><h3>Conclusions</h3><div>Our study highlights that NGS is able to identify a much higher number of actionable <em>EGFR</em> mutations than RT-qPCR approaches, thereby providing many more patients the opportunity to receive targeted EGFR treatments.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 108002"},"PeriodicalIF":4.5,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Putative mechanisms of primary resistance to EGFR-targeted therapies: A retrospective study","authors":"Xueliang Tu ,&nbsp;Zhongyu Lu ,&nbsp;Fengrong Hei ,&nbsp;Tong Zhang ,&nbsp;Xiaoxuan Wang ,&nbsp;Dongsheng Chen ,&nbsp;Fengjuan Fan ,&nbsp;Jing Xu ,&nbsp;Xing Zhang ,&nbsp;Kefeng Guo","doi":"10.1016/j.lungcan.2024.107998","DOIUrl":"10.1016/j.lungcan.2024.107998","url":null,"abstract":"<div><h3>Backgrounds</h3><div>Advanced lung adenocarcinoma (LUAD) patient with <em>EGFR</em> mutations often experience resistance to first-line epidermal growth factor tyrosine kinase inhibitors (EGFR-TKIs) therapy. Nonetheless, the mechanism and biomarkers of primary resistance remain unclear. Further exploration of independent prognostic factors will help clinicians identify patients who may not respond to EGFR-TKIs and select appropriate treatment strategies.</div></div><div><h3>Methods</h3><div>A retrospective study involving 124 patients with stage IV LUAD harboring a common sensitizing <em>EGFR</em> mutation (exon 19 deletion or L858R mutation) who received EGFR-TKIs as first-line therapy was performed. All participants were tested by DNA-targeted sequencing in baseline samples, and there were 19 patients with progression-free survival (PFS) ≤ 3 months (cohort 1, C1, primary resistance), 22 patients with 3 &lt; PFS &lt; 8 months (cohort 2, C2, poor response) without known mutations associated with resistance, and 83 patients with PFS ≥ 8 months (cohort 3, C3, normal).</div></div><div><h3>Results</h3><div>The most commonly mutated genes at baseline in patients prior to treatment within the entire study population. were <em>TP53</em> (65 %), <em>MYC</em> (19 %), <em>CDKN2A</em> (12 %), <em>MUC16</em> (12 %) and <em>RBM10</em> (12 %). The baseline characteristics, except for the proportions of patients with <em>EGFR</em> L858R mutation and exon 19 deletion in C1 plus C2 compared to C3 (<em>p</em> = 0.036), were not significantly different among the cohorts. The frequencies of <em>PIK3C2G</em>, <em>STK11</em>, <em>EPAS1</em>, <em>RARA</em> and <em>BTG2</em> variation were significantly higher in C1, the primary resistance group. Multivariate Cox analysis revealed that <em>PIK3C2G</em> (HR 15.70 95 % CI 3.24–76.05, <em>p</em> &lt; 0.001), <em>STK11</em> (HR 17.04, 95 % CI 3.68–78.92, <em>p</em> &lt; 0.001), <em>EPAS1</em> (HR 11.99, 95 % CI 2.57–56.03, <em>p</em> = 0.002), and <em>BTG2</em> amplification (HR 9.53, 95 % CI 1.67–54.28, <em>p</em> = 0.011) were significantly associated with shorter PFS.</div></div><div><h3>Conclusions</h3><div>The genomic landscape varies significantly among patients with LUAD, which should be considered when making personalized treatment decisions. This information could provide insights into molecular changes and their effects on clinical treatment in diverse patients with LUAD harboring sensitizing <em>EGFR</em> mutations.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"197 ","pages":"Article 107998"},"PeriodicalIF":4.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neoadjuvant therapy in early-stage non-small cell lung cancer: A real-world analysis","authors":"Leyla Ay ,&nbsp;Daniel Steiner ,&nbsp;Hannah Fabikan ,&nbsp;Oliver Illini ,&nbsp;Dagmar Krenbek ,&nbsp;Thomas Klikovits ,&nbsp;Michal Benej ,&nbsp;Klaus Kirchbacher ,&nbsp;Stefan Watzka ,&nbsp;Arschang Valipour ,&nbsp;Maximilian Hochmair","doi":"10.1016/j.lungcan.2024.107997","DOIUrl":"10.1016/j.lungcan.2024.107997","url":null,"abstract":"<div><h3>Background</h3><div>Phase 3 trials of neoadjuvant immunotherapy-based regimens have shown promising outcomes in patients with resectable non-small cell lung cancer (NSCLC). However, real-world data on treatment regimens with combined chemoimmunotherapy, patient profiles, and clinical outcomes in those patients are limited.</div></div><div><h3>Methods</h3><div>This dual-center registry-based study describes clinical patterns and outcomes of using neoadjuvant platinum-based chemoimmunotherapy in patients with resectable NSCLC. The main objective was to evaluate the proportion of patients receiving local therapy after chemoimmunotherapy. Further objectives include pathological outcome, disease-free survival (DFS), and overall survival (OS). Histological samples underwent next-generation sequencing (NGS).</div></div><div><h3>Results</h3><div>Seventy-two patients (median age 64.5 years (interquartile range (IQR), 59–69); 40.3 % women) were included. Prior to initiation of therapy, NGS was available in 90.3 %. Median follow-up time from date of diagnosis was 374 days (IQR, 241–605). After neoadjuvant therapy, 46 patients underwent surgery and 23 radiotherapy, resulting in 69 patients receiving local therapy. Out of 46 patients who underwent surgery, 22 had pathological complete remission (PR), 11 major PR, and 12 minor PR.</div><div>DFS (95 % confidence interval (CI)) in 43 (out of 46) surgical patients with R0 resection was 98 % (93–100), 98 % (93–100) and 81 % (57–100) after 180, 360 and 720 days, respectively. OS (95 % CI) was 97 % (94–100), 90 % (82–99) and 90 % (82–99), after 180, 360 and 720 days, respectively.</div></div><div><h3>Conclusion</h3><div>Following neoadjuvant chemoimmunotherapy, the majority of resectable early-stage NSCLC patients could undergo local therapy in routine clinical practice. This was associated with favorable DFS and OS.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 107997"},"PeriodicalIF":4.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment with trimetazidine dihydrochloride and lung cancer survival: Implications on metabolic re-programming","authors":"Yap-Hang Chan ,&nbsp;Cheng Yuen-Ting ,&nbsp;Chun-Fung Sin ,&nbsp;Edmond S.K. Ma ,&nbsp;Stephen T.S. Lam ,&nbsp;Shiu-Lun Au Yeung ,&nbsp;Bernard M.Y. Cheung ,&nbsp;Chung-Man Ho ,&nbsp;Kai-Hang Yiu ,&nbsp;Hung-Fat Tse","doi":"10.1016/j.lungcan.2024.107996","DOIUrl":"10.1016/j.lungcan.2024.107996","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic re-wiring with preferential fatty acid oxidation has been observed in lung cancer cells. Whether the use of trimetazidine, an anti-anginal agent that inhibits fatty acid oxidation, alters clinical outcomes in ischemic heart disease (IHD) patients with lung cancers is unknown.</div></div><div><h3>Methods</h3><div>We carried out this territory-wide, retrospective cohort study of 279,894 IHD patients prescribed with trimetazidine or long-acting oral nitrates in Hong Kong (population coverage of 7.5 millions, January 1999 − December 2020). A total of 6561 patients with pre-existing or <em>de novo</em> lung cancers were identified. Clinical outcomes of all-cause mortality were longitudinally compared between lung cancer patients who received trimetazidine (n = 547) versus non-users (control, n = 6014).</div></div><div><h3>Results</h3><div>Over 902.9 ± 1410.6 days, lower incidence of deaths occurred in the trimetazidine group (79.0 %, n = 432/547) compared to controls (90.5 %, n = 5442/6014, <em>P &lt; 0.001</em>). Kaplan-Meier analyses showed that trimetazidine use was associated with significantly higher survival from all-cause mortality in IHD patients (trimetazidine: mean survival = 1840.6 [95 %CI 1596.0–2085.3], versus control: 1056.7 [95 %CI 1011.3–1102.0] days, Log Rank = 69.4, <em>P &lt; 0.001</em>). Cox regression showed that trimetazidine use was significantly associated with reduced risk of all-cause mortality in crude (HR = 0.60 [95 %CI: 0.53 to 0.68], <em>P &lt; 0.001</em>) and multivariable models (HR = 0.65 [95 % CI: 0.57 to 0.74], <em>P &lt; 0.001</em>). Pre-specified analyses amongst patients with pre-existing lung cancers yielded similar findings (HR = 0.49 [95 %CI: 0.35 to 0.67], <em>P &lt; 0.001</em>). Survival benefits related to trimetazidine use was predominantly restricted to non-cardiovascular mortality (<em>P &lt; 0.001</em>).</div></div><div><h3>Conclusions</h3><div>Trimetazidine use is associated with higher overall survival in IHD patients with lung cancers, particularly from non-cardiovascular death. These findings need to be confirmed by randomized controlled trials.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"197 ","pages":"Article 107996"},"PeriodicalIF":4.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529137","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}

{"title":"PRIMALung (EORTC-1901): PRophylactic cerebral irradiation (PCI) or active brain MAgnetic resonance imaging (MRI) surveillance in small-cell lung cancer (SCLC) patients","authors":"Antonin Levy ,&nbsp;Thierry Berghmans ,&nbsp;Michael Koller ,&nbsp;Beatrice Fournier ,&nbsp;Murielle Mauer ,&nbsp;Nicolaus Andratschke ,&nbsp;Corinne Faivre-Finn","doi":"10.1016/j.lungcan.2024.107993","DOIUrl":"10.1016/j.lungcan.2024.107993","url":null,"abstract":"<div><div>The PRIMALung EORTC-1901 trial investigates brain MRI ± PCI in all-stages of SCLC, aiming for non-inferior survival, improve cognition in the era of immunotherapy.</div><div>@finn_corinne</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"198 ","pages":"Article 107993"},"PeriodicalIF":4.5,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621737","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}

{"title":"Confronting synchronous multiple primary lung cancers: Navigating the intersection of challenges and opportunities","authors":"Xue He ,&nbsp;Zhihui Yang ,&nbsp;Fang Wu ,&nbsp;Qingchun Liang ,&nbsp;Wenliang Liu ,&nbsp;Fenglei Yu ,&nbsp;Chen Chen","doi":"10.1016/j.lungcan.2024.107994","DOIUrl":"10.1016/j.lungcan.2024.107994","url":null,"abstract":"<div><div>The increased detection of synchronous multiple primary lung cancers (sMPLC) through advanced computed tomography underscores the necessity for innovative therapeutic approaches. sMPLC typically manifests as ground-glass opacities, mixed ground-glass opacities, and/or solid nodules, predominantly in early-stage, non-smoking female patients, with a majority being adenocarcinomas. The high prevalence of EGFR mutations and considerable heterogeneity among lesions pose distinct diagnostic and therapeutic challenges for sMPLC. This study provides a comprehensive review and analysis of recent clinical and radiological studies, genomic profiling, and the efficacy of the “Surgery + X” treatment model for sMPLC. Additionally, the article discusses several intricate and complex sMPLC cases, shedding light on the disease’s complexities and identifying existing gaps and potential breakthroughs in clinical diagnosis, treatment, and research. It underscores the critical role of a multidisciplinary approach and advocates for targeted research on sMPLC, highlighting its potential to impact lung cancer research significantly.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"197 ","pages":"Article 107994"},"PeriodicalIF":4.5,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Segmentectomy vs. Lobectomy in stage IA non-small cell lung cancer: A systematic review and meta-analysis of perioperative and survival outcomes","authors":"Luca Bertolaccini ,&nbsp;Antonino Carmelo Tralongo ,&nbsp;Marzia Del Re ,&nbsp;Francesco Facchinetti ,&nbsp;Roberto Ferrara ,&nbsp;Tindara Franchina ,&nbsp;Paolo Graziano ,&nbsp;Umberto Malapelle ,&nbsp;Jessica Menis ,&nbsp;Antonio Passaro ,&nbsp;Sara Pilotto ,&nbsp;Sara Ramella ,&nbsp;Giulio Rossi ,&nbsp;Rocco Trisolini ,&nbsp;Michela Cinquini ,&nbsp;Francesco Passiglia ,&nbsp;Silvia Novello","doi":"10.1016/j.lungcan.2024.107990","DOIUrl":"10.1016/j.lungcan.2024.107990","url":null,"abstract":"<div><div>While recent randomized controlled trials (RCT) have suggested superior overall survival (OS) outcomes with segmentectomy over lobectomy, questions remain regarding the comparability of these surgical procedures for treating early-stage non-small cell lung cancer (NSCLC). This systematic review and meta-analysis aimed to synthetize existing evidence and to compare the survival outcomes observed for stage IA NSCLC following segmentectomy or lobectomy.</div><div>40 studies (38 observational, 2 RCTs) encompassing 103,926 patients were analyzed. Primary outcomes included overall survival (OS), disease-free survival (DFS), local recurrences, harvested lymph nodes, postoperative morbidity, and length of hospital stay. Risk of bias was assessed using established tools, and evidence certainty was evaluated using GRADE.</div><div>Non-RCTs showed an OS HR of 1.10 (95 % CI: 0.94–1.30, p = 0.24) with low certainty, contrasting with RCTs’ HR of 0.82 (95 % CI: 0.66–1.02, p = 0.7) with moderate certainty. Local recurrences exhibited OR 1.40 (95 % CI: 0.94–2.08, p = 0.09) in non-RCTs with low certainty, and RR 1.61 (95 % CI: 1.12–2.31, p = 0.01) in RCTs with low certainty. Non-RCTs showed DFS HR 1.13 (95 % CI: 0.95–1.34, p = 0.18) with low certainty, while RCTs yielded HR 1.00 (95 % CI: 0.85–1.18, p = 0.97) with moderate certainty. Lobectomy resulted in more harvested lymph nodes. Postoperative morbidity and length of hospital stay did not differ significantly.</div><div>While definitive evidence for OS, DFS, and postoperative outcomes differences was inconclusive, a potential increase in local recurrences following lobectomy was noted. Further well-designed studies are warranted to enhance evidence and inform clinical practice in stage I lung cancer surgery.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"197 ","pages":"Article 107990"},"PeriodicalIF":4.5,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503193","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}