Lung Cancer最新文献

{"title":"Prognostic significance of consolidation-to-tumor ratio in stage IA solid predominant non-mucinous adenocarcinoma: a paradigm for risk stratification","authors":"Yura Ahn ,&nbsp;Geun Dong Lee ,&nbsp;SeHoon Choi ,&nbsp;Hyeong Ryul Kim ,&nbsp;Yong-Hee Kim ,&nbsp;Dong Kwan Kim ,&nbsp;Seung-Il Park ,&nbsp;Jooae Choe ,&nbsp;Jae Kwang Yun","doi":"10.1016/j.lungcan.2026.108934","DOIUrl":"10.1016/j.lungcan.2026.108934","url":null,"abstract":"<div><h3>Objective</h3><div>The optimal consolidation-to-tumor ratio (CTR) cutoff for survival stratification in radiologically solid-predominant adenocarcinoma (CTR &gt; 0.5) remains unclear. This study aimed to evaluate the prognostic significance of CTR in clinical-stage IA non-mucinous lung adenocarcinoma with CTR &gt; 0.5.</div></div><div><h3>Materials and methods</h3><div>We retrospectively analyzed patients who underwent curative resection for clinical stage IA non-mucinous adenocarcinoma with CTR &gt; 0.5 between 2011 and 2021. Optimal cutoffs for overall survival (OS) and freedom from recurrence (FFR) were determined using maximized log-rank statistics. Patients were stratified according to the derived CTR cutoff values, and OS and FFR were compared among the CTR groups before and after propensity score matching (PSM).</div></div><div><h3>Results</h3><div>Among 2,789 patients included, the optimal CTR cutoffs for OS and FFR were 0.84 and 0.85, respectively. Based on the 0.85 cutoff, patients were categorized into three groups: 0.5 &lt; CTR ≤ 0.85 (n = 672), 0.85 &lt; CTR &lt; 1 (n = 229), and CTR = 1 (n = 1,888). OS and FFR were significantly worse in the 0.85 &lt; CTR &lt; 1 group compared to the 0.5 &lt; CTR ≤ 0.85 group (p &lt; 0.05) but not significantly different from the CTR = 1 group (p &gt; 0.05). These trends persisted after PSM. The 0.85 &lt; CTR &lt; 1 group exhibited a higher proportion of pathological risk factors (high-grade patterns, lymphovascular invasion, and nodal metastasis) than the 0.5 &lt; CTR ≤ 0.85 group (all p &lt; 0.05) and was comparable to the CTR = 1 group, except for lymphovascular invasion (p = 0.045). Dichotomization into 0.5 &lt; CTR ≤ 0.85 and 0.85 &lt; CTR ≤ 1 revealed significantly worse OS and FFR in the 0.85 &lt; CTR ≤ 1 group across PSM cohorts for both lobectomy and sublobar resection.</div></div><div><h3>Conclusion</h3><div>A CTR cutoff of 0.85 effectively distinguishes survival outcomes in patients with clinical stage IA adenocarcinoma and CTR &gt; 0.5 and may inform risk stratification and postoperative surveillance.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"213 ","pages":"Article 108934"},"PeriodicalIF":4.4,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146078925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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}

{"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}

{"title":"FAM83A promotes the progression of lung squamous cell carcinoma by inducing the epithelial–mesenchymal transition and inhibiting apoptosis via ERK pathway","authors":"Xiang Fei ,&nbsp;Hao Wu ,&nbsp;Mengxing Li ,&nbsp;Jianmang Yu ,&nbsp;Junyi Huang ,&nbsp;Siqi Cao ,&nbsp;Shiyou Wei ,&nbsp;Qiuyun Wang ,&nbsp;Wei Zhu ,&nbsp;Zhize Yuan","doi":"10.1016/j.lungcan.2026.108917","DOIUrl":"10.1016/j.lungcan.2026.108917","url":null,"abstract":"<div><h3>Background</h3><div>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).</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"213 ","pages":"Article 108917"},"PeriodicalIF":4.4,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145981116","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":"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}

{"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}

{"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}

{"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}