Lung Cancer最新文献

{"title":"Durvalumab-containing treatment for recurrent or metastatic pulmonary sarcomatoid carcinoma: A pooled post hoc analysis of two KCSG phase II trials","authors":"Dong Hyun Kim ,&nbsp;Miso Kim ,&nbsp;Jeonghwan Youk ,&nbsp;Tae Min Kim ,&nbsp;Gyeong-Won Lee ,&nbsp;Se Hyun Kim ,&nbsp;Yu Jung Kim ,&nbsp;Jin-Soo Kim ,&nbsp;Sook-Hee Hong ,&nbsp;Mi Sun Ahn ,&nbsp;Seong Hoon Shin ,&nbsp;Dong-Wan Kim ,&nbsp;Joo-Hang Kim ,&nbsp;Bhumsuk Keam","doi":"10.1016/j.lungcan.2026.108916","DOIUrl":"10.1016/j.lungcan.2026.108916","url":null,"abstract":"<div><h3>Introduction</h3><div>Pulmonary sarcomatoid carcinoma (PSC) is a rare cancer characterized by a high programmed death-ligand 1 (PD-L1) expression, suggesting a potential therapeutic benefit from immune checkpoint inhibitors. We investigated the efficacy of durvalumab-containing combination therapy and explored potential predictive biomarkers in patients with recurrent or metastatic (R/M) PSC.</div></div><div><h3>Method</h3><div>In this pooled <em>post hoc</em> analysis, data were integrated from two prospective phase II trials (NCT03022500 and NCT04224337) wherein durvalumab-containing combination therapies were evaluated in patients with R/M PSC. PD-L1 expression was assessed using 22C3 or SP263 assays, and circulating lymphocyte subsets were analyzed using flow cytometry.</div></div><div><h3>Results</h3><div>Overall, 33 patients were included, of whom 66.7 % had a PD-L1 tumor proportion score (TPS) ≥ 1 % and 45.5 % had a TPS ≥ 50 %. The overall response rate was 33.3 % (95 % confidence interval [CI], 18.0 %–51.8 %), and the disease control rate was 72.7 % (95 % CI, 54.5 %–86.7 %). The median progression-free survival and overall survival were 5.4 (95 % CI, 2.8–9.4) and 15.7 (95 % CI, 11.3–not estimated) months, respectively. PD-L1 expression was not associated with the response or survival outcomes. Patients who achieved disease control exhibited a higher proportion of circulating CD8⁺ T cells (mean, 28.5 % vs. 20.3 %, <em>P</em> = 0.083) and a lower CD4⁺/CD8⁺ ratio (median, 1.4 vs. 1.7, <em>P</em> = 0.048) than did those with progressive disease.</div></div><div><h3>Conclusion</h3><div>Durvalumab-containing combination therapy showed promising efficacy in patients with R/M PSC, irrespective of PD-L1 expression. A lower CD4⁺/CD8⁺ ratio may be associated with favorable disease control.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"213 ","pages":"Article 108916"},"PeriodicalIF":4.4,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145950220","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":"Diagnostic performance of monarch robotic bronchoscopy with and without mobile cone-beam CT support","authors":"Jingjing Chen,&nbsp;Dakota McNierney,&nbsp;Joe G. Zein,&nbsp;Laszlo T. Vaszar,&nbsp;Karen L. Swanson,&nbsp;Natalya Azadeh,&nbsp;Kenneth K. Sakata","doi":"10.1016/j.lungcan.2026.108910","DOIUrl":"10.1016/j.lungcan.2026.108910","url":null,"abstract":"<div><h3>Background</h3><div>Robotic-assisted bronchoscopy (RAB) is limited by CT-to-body divergence. Cone-beam CT (CBCT) may enhance tool-to-lesion alignment and diagnostic yield (DY), but the benefit of integrating mobile CBCT (mCBCT) into the Monarch^TM RAB remains understudied. This is the first study to evaluate diagnostic performance between Monarch alone versus Monarch plus mCBCT for peripheral pulmonary lesion (PPL) biopsy, hypothesizing improved DY with the combined approach.</div></div><div><h3>Methods</h3><div>This single-center retrospective study examined adults undergoing RAB biopsy for PPLs (May 2019—March 2023), applying a strict DY definition. Clinical characteristics and outcomes were evaluated in Monarch and Monarch plus mCBCT groups.</div></div><div><h3>Results</h3><div>Of 331 cases, 179 used Monarch and 152 used Monarch plus mCBCT. There was no significant difference in baseline characteristics. DY was not different (70.9 % in Monarch vs 71.7 % in Monarch plus mCBCT, p = 0.976) nor were complication rates (7.3 % in Monarch vs. 3.9 % in Monarch plus mCBCT, p = 0.291). In the Monarch group, the procedure duration was longer (77 min in Monarch vs. 69 min in Monarch plus mCBCT, p = 0.002) and the radiation dose was lower (7.4 mGy in Monarch vs. 285.9 mGy in Monarch plus mCBCT, p &lt; 0.001). Adjusted analysis demonstrated that mCBCT was not associated with improved DY (OR [95 % CI]: 1.33[0.78–2.28]) or reduced risk for complications (OR [95 % CI]: 0.41 [0.13; 1.14]). DY increased with larger nodule size but not with lesion location.</div></div><div><h3>Conclusions</h3><div>Evaluating outcomes across two sequential practice eras, the addition of mCBCT to Monarch RAB did not significantly improve DY or reduce complications but reduced procedure duration at the cost of increased radiation exposure.</div></div><div><h3>Summary</h3><div>- Evaluated diagnostic performance of Monarch™ vs. Monarch™ + mobile Cone-beam CT (mCBCT).</div><div>- Diagnostic yield and complication rates were similar.</div><div>- The mCBCT group had shorter procedure times and about 40-fold higher radiation doses.</div></div><div><h3>Conference presentation</h3><div>The study findings have been presented in American Association for Bronchology and Interventional Pulmonology Annual Conference in 2024.</div><div>The institutional review board approved all protocols (IRB 23–005284).</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"213 ","pages":"Article 108910"},"PeriodicalIF":4.4,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146009919","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":"SEZ6 expression and lineage plasticity in small cell lung cancer and transformed non-small cell lung cancer","authors":"Jennifer A. Marks ,&nbsp;Kieran Sweeney ,&nbsp;Andrew Elliott ,&nbsp;Brinda Gupta ,&nbsp;Ari VanderWalde ,&nbsp;Sonam Puri ,&nbsp;Misty Dawn Shields ,&nbsp;Jorge J. Nieva ,&nbsp;Heloisa P. Soares ,&nbsp;Patrick C. Ma ,&nbsp;Balazs Halmos ,&nbsp;Stephen V. Liu","doi":"10.1016/j.lungcan.2026.108913","DOIUrl":"10.1016/j.lungcan.2026.108913","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Small cell lung cancer (SCLC) and extrapulmonary neuroendocrine (NE) tumors are aggressive malignancies with limited treatment options. Seizure-related homolog 6 (SEZ6) is a potential therapeutic target, but its expression in these tumors remains poorly understood. Lineage plasticity contributes to resistance in non-small cell lung cancer (NSCLC), where some cases can undergo SCLC-transformation after targeted therapy. We aimed to characterize &lt;em&gt;SEZ6&lt;/em&gt; expression across NE tumors and presumed NSCLC-to-SCLC transformations.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;DNA and RNA sequencing were performed for SCLC, NSCLC, and NE samples. Samples were stratified by SEZ6 RNA expression quartiles and classified into subtypes based on ASCL1, NEUROD1, and POU2F3 expression. Significance was tested using the Mann-Whitney &lt;em&gt;U&lt;/em&gt; test. Real-world overall survival was obtained from insurance claims data, with p-values calculated using the log-rank test. Paired samples for NSCLC-to-SCLC transformation were identified by sequential biopsies classified as NSCLC followed by SCLC.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;RNA sequencing was performed on 1318 SCLC and 2218 NE samples. Median SEZ6&lt;!--&gt; &lt;!--&gt;expression was higher in SCLC (39.7 transcripts per million (TPM)) than in NE tumors (20.8 TPM, p&lt;0.0001) and NSCLC (1.34 TPM, p&lt;0.001). Among NE tumors, median SEZ6 expression was highest in prostate (52.0 TPM, p=0.0016 vs SCLC) and lowest in adrenal gland tumors (1.2 TPM, p&lt;0.0001 vs SCLC). In SCLC,&lt;!--&gt; &lt;!--&gt;SEZ6&lt;!--&gt; &lt;!--&gt;expression was positively correlated with ASCL1&lt;!--&gt; &lt;!--&gt;(p=0.44, p&lt;0.0001) and&lt;!--&gt; &lt;!--&gt;NEUROD1&lt;!--&gt; &lt;!--&gt;(p=0.16, p&lt;0.0001) expression but not&lt;!--&gt; &lt;!--&gt;POU2F3&lt;!--&gt; &lt;!--&gt;(p=-0.04, p=0.1253). Median survival was longest in SEZ6-Q2 for both SCLC and NE (13.0 mos. and 33.7 mos., respectively). NSCLC-to-SCLC transformation samples showed numerically higher SEZ6 expression post-transformation (median: 86.2 vs 2.4 TPM).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;SEZ6&lt;!--&gt; &lt;!--&gt;expression is higher in SCLC than in NE tumors, with notable heterogeneity by subtype, warranting consideration of expanded use of SEZ6-directed therapy.&lt;/div&gt;&lt;div&gt;Translational Relevance Statement:&lt;/div&gt;&lt;div&gt;This study establishes SEZ6 as a promising therapeutic target in small cell lung cancer (SCLC) and transformed non-small cell lung cancer (NSCLC), demonstrating its significantly elevated expression compared to neuroendocrine (NE) tumors and NSCLC. The positive correlation of &lt;em&gt;SEZ6&lt;/em&gt; expression with NE lineage markers, particularly in &lt;em&gt;ASCL1&lt;/em&gt; and &lt;em&gt;NEUROD1&lt;/em&gt; subtypes, highlights its role as a lineage-specific marker, guiding the development of SEZ6-targeted antibody-drug conjugates (ADCs). Additionally, the increased &lt;em&gt;SEZ6&lt;/em&gt; expression following NSCLC-to-SCLC transformation suggests that SEZ6-targeted therapies could address resistance mechanisms in transformed tumors. Importantly, the association be","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"213 ","pages":"Article 108913"},"PeriodicalIF":4.4,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981115","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":"Nintedanib as switch maintenance treatment in malignant pleural mesothelioma (NEMO): A double-blind randomized phase II trial (EORTC-08112-LCG)","authors":"Omar Abdel-Rahman ,&nbsp;Paul Taylor ,&nbsp;Mary O’Brien ,&nbsp;Jo Raskin ,&nbsp;Claudio Dazzi ,&nbsp;Veerle Surmont ,&nbsp;Sabrina Zonato ,&nbsp;Robin Young ,&nbsp;Anne-Claire Toffart ,&nbsp;Petra Jankowska ,&nbsp;Adam Hassani ,&nbsp;Sandrine Marreaud ,&nbsp;Luc Boone ,&nbsp;Sanjay Popat","doi":"10.1016/j.lungcan.2026.108906","DOIUrl":"10.1016/j.lungcan.2026.108906","url":null,"abstract":"<div><h3>Introduction</h3><div>Pleural mesothelioma (PM) is a lethal malignancy in which angiogenesis and progressive fibrosis drives disease. We evaluated angiogenesis inhibition using nintedanib monotherapy as switch maintenance in patients with PM that completed 4–6 cycles of prior platinum-pemetrexed chemotherapy. The trial was performed in parallel to the LUME-Meso trial in an era prior to routine immune checkpoint inhibitor use, when platinum-pemetrexed was standard of care.</div></div><div><h3>Methods</h3><div>This is a triple-blind, placebo-controlled, multicentric, randomized, phase II study. Patients with inoperable PM (all histologies) that completed 4–6 cycles of platinum-pemetrexed chemotherapy were randomized to nintedanib or placebo. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS) and safety.</div></div><div><h3>Results</h3><div>The trial was prematurely closed due to poor accrual after LUME-meso reported. 37 patients were randomized (18 to nintedanib, 19 to placebo). All analyses performed were descriptive. The median PFS was 3.4 months (95% CI: 2.83–5.82) and 4.6 months (95% CI: 3.65–13.17) for nintedanib and placebo arms, respectively (HR = 2.25, 95% CI: 1.07–4.73) with corresponding median OS of 13.1 months (95% CI: 10.22–26.02) and 38.9 months (95% CI: 18.66-NE) for nintedanib and placebo arms, respectively (HR = 2.38, 95% CI: 1.05–5.43). Two patients (11.1%) in the nintedanib arm experienced ≥ grade 3 treatment-related adverse events. Post progression treatment was balanced between arms but more patients in the placebo arm received immunotherapy (87% vs 54%).</div></div><div><h3>Conclusions</h3><div>Descriptive analyses suggest switch maintenance nintedanib does not improve PFS nor OS compared to placebo. Efficacy of the placebo arm may be related to imbalanced immunotherapy usage.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"213 ","pages":"Article 108906"},"PeriodicalIF":4.4,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981117","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":"Comparative efficacy and safety of post-TKI treatments for advanced EGFR-mutant non-small-cell lung cancer: a systematic review and network meta-analysis","authors":"Yuanyuan Wang ,&nbsp;Lin Zhang ,&nbsp;Jianhua Zhan ,&nbsp;Ling Wen ,&nbsp;Xinyuan Zhao ,&nbsp;Haishuang Sun ,&nbsp;Xueyuan Chen ,&nbsp;Yaxiong Zhang ,&nbsp;Gang Chen ,&nbsp;Yuanyuan Zhao ,&nbsp;Yan Huang ,&nbsp;Wenfeng Fang ,&nbsp;Li Zhang ,&nbsp;Dongchen Sun ,&nbsp;Yunpeng Yang","doi":"10.1016/j.lungcan.2026.108914","DOIUrl":"10.1016/j.lungcan.2026.108914","url":null,"abstract":"<div><h3>Background</h3><div>Despite the availability of several validated therapies, the optimal second-line regimen for <em>EGFR</em>-mutant non-small cell lung cancer (NSCLC) after tyrosine kinase inhibitor (TKI) failure remains uncertain.</div></div><div><h3>Methods</h3><div>The protocol was registered in PROSPERO (CRD420251157131). We systematically searched MEDLINE, Embase, CENTRAL, and conference proceedings (to Oct 20, 2025) for phase III randomized controlled trials (RCTs). A Bayesian network <em>meta</em>-analysis was performed. The primary outcome was progression-free survival (PFS). Secondary outcomes included overall survival (OS) and the incidence of grade ≥3 treatment-related adverse events (TRAEs).</div></div><div><h3>Results</h3><div>Eleven RCTs (3,650 patients, seven regimens) were included. Compared to chemotherapy, sacituzumab tirumotecan (SacTMT), amivantamab plus chemotherapy (Chemo-Ami), and chemo-immunotherapy plus anti-angiogenic agent (Chemo-IO-anti-VEGF) demonstrated superior PFS (HR 0.49, 0.48, 0.53, respectively) and OS (HR 0.60, 0.73, 0.83, respectively). SacTMT also significantly improved OS over chemo-immunotherapy (HR 0.68, 95 % CrI 0.48 to 0.95). Regarding safety, Chemo-Ami carried higher grade ≥3 TRAEs risk (OR 2.83, 95 % CrI 1.01 to 7.90) versus chemotherapy, while SacTMT and Chemo-IO-anti-VEGF demonstrated toxicity comparable to chemotherapy.</div></div><div><h3>Conclusions</h3><div>SacTMT, Chemo-Ami, and Chemo-IO-anti-VEGF offer superior efficacy over chemotherapy for <em>EGFR</em>-mutant NSCLC after TKI progression. SacTMT and Chemo-IO-anti-VEGF may have more favorable safety profiles than Chemo-Ami. This comparative evidence helps to inform clinical decision-making.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"212 ","pages":"Article 108914"},"PeriodicalIF":4.4,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927316","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":"Letter to the editor: treatment sequencing in synchronous oligometastatic NSCLC − the need for standardized patient selection Criteria","authors":"Peng Bai ,&nbsp;Jun Zhang","doi":"10.1016/j.lungcan.2026.108911","DOIUrl":"10.1016/j.lungcan.2026.108911","url":null,"abstract":"","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"212 ","pages":"Article 108911"},"PeriodicalIF":4.4,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927315","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":"Proteomic profiling of early-stage non-small cell lung cancer identifies a high-performance protein signature associated with postoperative recurrence","authors":"Ying Huang ,&nbsp;Qiuhua Deng ,&nbsp;Jie Li ,&nbsp;Runchen Wang ,&nbsp;Zhen Li ,&nbsp;Liping Liu ,&nbsp;Lei Song ,&nbsp;Xiaohong Zhao ,&nbsp;Liyan Huang ,&nbsp;Haihong Yang ,&nbsp;Weiqiang Yin","doi":"10.1016/j.lungcan.2026.108907","DOIUrl":"10.1016/j.lungcan.2026.108907","url":null,"abstract":"<div><h3>Background</h3><div>The 5-year recurrence rate remains significantly high (∼30 %) in patients with early-stage Non-Small Cell Lung Cancer (NSCLC), even after complete tumor resection. Recurrence prediction primarily relies on pathological assessment and genomic abnormalities. However, proteins — the functional executors of genetic information — may offer additional prognostic value. In this study, we aimed to develop a model integrating proteomic and clinical features to improve recurrence prediction in early-stage NSCLC.</div></div><div><h3>Methods</h3><div>We recruited 351 stage Ⅰ NSCLC patients who underwent radical surgery in discovery corhort. An additional 103 participants from external prospective cohort were used for validation. Clinical data and follow-up outcomes were retrospectively collected. Tumor proteomics profiling was performed using liquid chromatography-mass spectrometry (LC-MS/MS). The proteomics data were acquired using a data-independent acquisition mode with a 150-minute gradient method and analyzed against the human UniProt database using DIA-NN (v1.8.1). We assessed the association between proteomic and clinicopathologic factors and disease-free survival (DFS) using Cox proportional hazards regression. A receiver operating characteristic (ROC) curve analysis was used to construct the predictive model.</div></div><div><h3>Results</h3><div>Of the 351 patients analyzed, 4260 differentially expressed proteins (DEPs) were identified as being associated with tumor recurrence. A nine-protein prediction model outperformed the clinicopathologic-based model (AUC, 0.898 vs. 0.742; <em>P</em> &lt; 0.001) in predicting DFS. A combined model incorporating nine proteins and clinicopathological features demonstrated excellent predictive value for 5-year recurrence in the discovery cohort (AUC = 0.896). Nine proteins combined with clinicopathological features showed an AUC of 0.810 in the external validation cohort and an AUC of 0.844 in the combined cohort.</div></div><div><h3>Conclusion</h3><div>Integrating tumor proteomics with clinicopathologic features enhances risk stratification and improves recurrence prediction after surgical resection of early-stage NSCLC. This approach may enable more personalized postoperative management through refined surveillance intervals and potential adjuvant therapies.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"213 ","pages":"Article 108907"},"PeriodicalIF":4.4,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046900","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":"Survival outcomes of patients with uncommon EGFR mutations in surgically resected lung adenocarcinoma: A multi-institutional real-world database study (CReGYT-01 EGFR study)","authors":"Kazuki Hayasaka ,&nbsp;Mototsugu Shimokawa ,&nbsp;Naoki Haratake ,&nbsp;Hirotsugu Notsuda ,&nbsp;Shinya Katsumata ,&nbsp;Akira Hamada ,&nbsp;Kotaro Nomura ,&nbsp;Kosuke Fujino ,&nbsp;Mao Yoshikawa ,&nbsp;Ken Suzawa ,&nbsp;Kazuhiko Shien ,&nbsp;Kenichi Suda ,&nbsp;Shuta Ohara ,&nbsp;Shota Fukuda ,&nbsp;Ikuhiko Kinoshita ,&nbsp;Shinkichi Takamori ,&nbsp;Satoshi Muto ,&nbsp;Yusuke Takanashi ,&nbsp;Kiyomichi Mizuno ,&nbsp;Takamitsu Hayakawa ,&nbsp;Yoshinori Okada","doi":"10.1016/j.lungcan.2026.108908","DOIUrl":"10.1016/j.lungcan.2026.108908","url":null,"abstract":"<div><h3>Introduction</h3><div>Uncommon epidermal growth factor receptor (EGFR) mutations (UCM) account for approximately 10% of EGFR-mutant lung adenocarcinoma (LUAD) cases; however, their prognostic impact remains unclear. This study aimed to evaluate postoperative outcomes in patients with UCM compared to those with common mutations (CM) using a large multicenter database.</div></div><div><h3>Materials and methods</h3><div>This retrospective study included 1,636 patients with EGFR-mutant LUAD who underwent complete resection between 2015 and 2018 at 21 Japanese institutions. Patients were classified into the CM and UCM groups. Recurrence-free survival (RFS), overall survival (OS), lung cancer-specific survival (LCSS), and survival after recurrence (SAR) were analyzed using univariable and multivariable analyses and the inverse probability of treatment weighting (IPTW) method.</div></div><div><h3>Results</h3><div>Among the patients, 1,441 (88.1%) had CM and 195 (11.9%) had UCM. RFS was comparable between the groups. However, patients with UCM showed significantly shorter OS and LCSS than those with CM (OS: multivariable hazard ratio [HR] 1.538, 95% confidence interval [CI] 1.003–2.359; LCSS: multivariable HR 1.803, 95% CI 1.064–3.056). This trend was consistently validated using IPTW methods. SAR was also significantly shorter in patients with UCM. Subtype-specific analyses revealed that patients with exon 20 insertions (Ex20ins) had a significantly worse prognosis than those with other UCMs.</div></div><div><h3>Conclusion</h3><div>Patients with UCM had significantly worse OS, LCSS, and SAR than those with CM despite similar RFS. These survival disadvantages in UCM were strongly associated with the Ex20ins subtype. These findings highlight the urgent need for novel perioperative treatments for patients with UCM, especially Ex20ins.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"212 ","pages":"Article 108908"},"PeriodicalIF":4.4,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927806","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":"Lung cancer in women: current evidence and future research priorities","authors":"Monireh Sadat Seyyedsalehi ,&nbsp;Massimiliano Cani ,&nbsp;Qian Wang ,&nbsp;Chitra Thakur ,&nbsp;Umberto Malapelle ,&nbsp;Chung Yin Kong ,&nbsp;Silvia Novello ,&nbsp;Paolo Boffetta","doi":"10.1016/j.lungcan.2025.108905","DOIUrl":"10.1016/j.lungcan.2025.108905","url":null,"abstract":"<div><div>Lung cancer (LC) remains the leading cause of cancer-related mortality among women worldwide. Compared to men, LC in women presents distinct epidemiologic, biological, and clinical characteristics. A large proportion of LC cases in women occur in never-smokers, underscoring the important roles of environmental exposures, genetic susceptibility, and hormonal influences in disease pathogenesis. LC in women also displays unique molecular profiles, with a higher prevalence of actionable alterations such as epidermal growth factor receptor (<em>EGFR</em>) mutations and anaplastic lymphoma kinase (<em>ALK</em>) rearrangements, which inform targeted therapy selection. Despite advances in chemotherapy, targeted agents, and immunotherapy, sex-based differences in treatment efficacy, toxicity, and survivorship persist and remain incompletely understood. Additional barriers, including limited access to LC screening and the underrepresentation of women in clinical trials, further constrain the application of evidence-based interventions for women. This review synthesizes latest evidence on epidemiology, risk factors, molecular features, screening, treatment outcomes, and survivorship challenges in women with LC with a deep focus on novel approaches to overcome current barriers and disparities to improve prevention, early detection, treatment, and long-term survivorship care.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"213 ","pages":"Article 108905"},"PeriodicalIF":4.4,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010182","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":"Multi-omic screening for pleural mesothelioma in Asbestos-Exposed Populations: A literature review and Recommendations","authors":"Kathleen Zwijsen ,&nbsp;Ellen Heirwegh ,&nbsp;Eline Schillebeeckx ,&nbsp;Elly Marcq ,&nbsp;Adrian Covaci ,&nbsp;Ken Op de Beeck ,&nbsp;Jan P. van Meerbeeck ,&nbsp;Jo Raskin ,&nbsp;Annelies Janssens ,&nbsp;Annemiek Snoeckx ,&nbsp;Kevin Lamote","doi":"10.1016/j.lungcan.2025.108893","DOIUrl":"10.1016/j.lungcan.2025.108893","url":null,"abstract":"<div><h3>Objectives</h3><div>Pleural mesothelioma (PM) is an aggressive thoracic cancer related to historical exposure to asbestos fibres. Symptoms often appear at an advanced stage, leading to delayed diagnosis and dismal prognosis. Early diagnosis is thus crucial in improving patient outcome. Current biomarker research for early detection focuses on different −omics research fields (genomics, proteomics, transcriptomics, metabolomics and volatomics), however with no clinically useful result. Moreover, currently no screening program is advocated for asymptomatic individuals with an established asbestos exposure. The aim of this review is to summarise the advances in different −omics fields and to pinpoint state-of-the art biomarkers with the highest potential to serve as primary targets in clinical trials for early PM detection or screening.</div></div><div><h3>Methods</h3><div>A literature search was performed in the databases MEDLINE and Web Of Science. Research articles published before 1 August 2025 were eligible.</div></div><div><h3>Results</h3><div>In total, 63 articles were included in this review, with specific focus on radiomics, genomics, transcriptomics, epigenomics, proteomics, metabolomics, and volatomics. Several research groups have focused on investigating biomarkers or screening techniques for pleural mesothelioma among individuals with a history of asbestos exposure. Notable approaches include using low-dose Computed Tomography, and determining mesothelin levels and micro-RNAs in blood, and volatile organic compounds in exhaled breath.</div></div><div><h3>Discussion</h3><div>Single biomarkers like miRNAs, mesothelin, and VOCs show promise, but further validation is needed in larger cohorts with correct control groups. A multi-omics approach, which integrates biomarker panels from various −omics areas, has the potential to enhance diagnostic accuracy.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"212 ","pages":"Article 108893"},"PeriodicalIF":4.4,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927314","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}