Lung Cancer最新文献

{"title":"A pathomics model for predicting response to chemo-immunotherapy in lung squamous cell carcinoma: A multicenter study","authors":"Dongying Wang ,&nbsp;Shuai Mu ,&nbsp;Minghui Zhang ,&nbsp;Guangyu Tao ,&nbsp;Shuyuan Wang ,&nbsp;Yinchen Shen ,&nbsp;Guanxi Xiao ,&nbsp;Xueyan Zhang ,&nbsp;Baohui Han ,&nbsp;Lei Cheng ,&nbsp;Hua Zhong ,&nbsp;Wei Nie","doi":"10.1016/j.lungcan.2025.108881","DOIUrl":"10.1016/j.lungcan.2025.108881","url":null,"abstract":"<div><h3>Background</h3><div>The identification of lung squamous cell carcinoma (LUSC) patients who may benefit from first-line chemo-immunotherapy (CIT) remains a challenge. This study aimed to develop a pathomics model to predict the T cell-inflamed gene-expression profile (GEP) status and validate its utility in identifying patients who derive survival benefit from CIT.</div></div><div><h3>Methods</h3><div>The pathomics model was developed using whole-slide images and RNA-sequencing data from The Cancer Genome Atlas (TCGA) LUSC cohort (n = 334) to predict the GEP status and generate a pathomics score (PS). The predictive value of PS was validated in a prospective, multicenter trial (AK105-302, n = 267) by assessing its interaction with treatment (CIT vs. chemotherapy) for progression-free survival (PFS) and overall survival (OS). Two additional independent cohorts (n = 82 and n = 50) were used for external validation.</div></div><div><h3>Results</h3><div>The pathomics model accurately predicted GEP status, achieving area under the curve (AUC) values of 0.80 and 0.71 in the TCGA training and validation sets, respectively. In the AK105-302 cohort, significant interactions were identified between PS and treatment modalities for both PFS (interaction <em>p</em> = 0.011) and OS (interaction <em>p</em> &lt; 0.001). Patients with high PS who received CIT exhibited significantly prolonged PFS (hazard ratio [HR]: 0.31, 95 % confidence interval [CI]: 0.21–0.48, <em>p</em> &lt; 0.001) and OS (HR: 0.30, 95 % CI: 0.18–0.50, <em>p</em> &lt; 0.001) compared to high PS patients receiving chemotherapy. However, this survival benefit was not observed in the low-PS patients. These findings were corroborated in two independent clinical cohorts. Furthermore, biological assessments revealed a significant association between high PS and an immune-hot tumor microenvironment.</div></div><div><h3>Conclusion</h3><div>We developed a GEP-based pathomics model that provides a practical, cost-effective strategy to identify patients most likely to derive superior survival benefit from first-line CIT over chemotherapy alone.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"211 ","pages":"Article 108881"},"PeriodicalIF":4.4,"publicationDate":"2025-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145797367","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":"Identifying eligible patients for the Australian national lung cancer screening program in primary care: A cross-sectional study using clinical decision support systems and evaluating PLCOm2012 data quality","authors":"Lucas De Mendonça ,&nbsp;Shakira Onwuka ,&nbsp;Sarah York ,&nbsp;Javiera Martinez-Gutierrez ,&nbsp;Jon Emery ,&nbsp;Christine Paul ,&nbsp;Jo-Anne Manski-Nankervis ,&nbsp;Nicole M. Rankin","doi":"10.1016/j.lungcan.2025.108880","DOIUrl":"10.1016/j.lungcan.2025.108880","url":null,"abstract":"<div><div>Primary care is pivotal in identifying eligible participants for Australia’s National Lung Cancer Screening Program (NLCSP). Clinical Decision Support Systems (CDSS) can assist by flagging potentially eligible individuals using Electronic Medical Record (EMR) data. We developed a CDSS to identify people aged 50–70 who currently or formerly smoked cigarettes (with an unknown quit date or cessation within the past 10 years) for use in Australian general practice EMRs. This study aimed to: (1) assess the algorithm’s accuracy in identifying eligible patients, (2) estimate NLCSP eligibility based on audited EMR smoking data, and (3) evaluate EMR data quality for applying the PLCO_m2012 risk prediction tool.</div><div>A cross-sectional EMR audit was conducted across five Victorian general practices. Of 4,186 records flagged by the CDSS, 1,315 (31.4 %) were manually audited. The algorithm correctly identified all patients according to its rules (age and smoking status). Pack-year could be calculated for 226 patients (17.2 %), with 91 (6.9 %) meeting NLCSP eligibility. Eligibility was higher among people who currently smoke (9.2 %) than those who formerly smoked (3.6 %). A subset of 933 records was assessed for PLCOm2012 variables, revealing substantial data gaps (% missing): education level (100 %), ethnicity (58 %), BMI (57 %), and daily cigarette consumption (33 %).</div><div>CDSS algorithms can identify potential NLCSP participants, but confirmation of smoking history remains essential due to sub-optimal smoking data quality. Significant data limitations currently hinder PLCO_m2012 implementation via CDSS in general practice EMRs.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"211 ","pages":"Article 108880"},"PeriodicalIF":4.4,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145797368","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":"Multiomic analysis of treatment-naïve NSCLC before the era of neoadjuvant immunotherapy reveals contrasting immune phenotypes in stage IIIA: node-dominant (T1N2) exhibiting hot versus tumor-dominant (T4N0) cold features","authors":"Duk Ki Kim ,&nbsp;Yooyoung Chong ,&nbsp;Min-Kyung Yeo ,&nbsp;Da Hyun Kang ,&nbsp;Joo-Eun Lee ,&nbsp;Hyun-Yi Kim ,&nbsp;Min-Woong Kang ,&nbsp;Chaeuk Chung","doi":"10.1016/j.lungcan.2025.108879","DOIUrl":"10.1016/j.lungcan.2025.108879","url":null,"abstract":"<div><h3>Background</h3><div>Non-small cell lung cancer (NSCLC) exhibits substantial heterogeneity in its tumor immune microenvironment, which critically influences therapeutic outcomes. Recently, immune checkpoint inhibitors (ICIs) have been increasingly incorporated not only in metastatic settings but also into neoadjuvant, adjuvant, and perioperative treatments. Pathologic complete remission (pCR) following neoadjuvant immunotherapy is strongly associated with reduced recurrence and favorable survival outcomes. However, reliable biomarkers for predicting preoperative immunotherapy response remain limited. The dichotomy between “hot” and “cold” tumors provides a useful framework to explain differential immunotherapy responsiveness, yet how these immune phenotypes manifest across specific tumor stages remains poorly defined.</div></div><div><h3>Methods</h3><div>We performed integrative analyses combining bulk RNA sequencing and immunohistochemistry (IHC) on tumor specimens from patients with stage T1N2 and T4N0 NSCLC. Frozen samples were used for RNA sequencing and formalin-fixed paraffin-embedded (FFPE) tissues for IHC, obtained from surgeries performed between 2009 and 2018—prior to the widespread introduction of immunotherapy. Differentially expressed genes (DEGs) were identified, and Gene Ontology (GO) enrichment analyses were conducted to characterize biological pathways. Immune cell infiltration and spatial distribution were assessed by IHC staining for CD3⁺, CD4⁺, CD8⁺, CD56⁺, FOXP3⁺, CD68⁺, and CD163⁺ markers. Statistical analyses were performed using the Mann–Whitney <em>U</em> test.</div></div><div><h3>Results</h3><div>Transcriptomic and histologic analyses revealed distinct molecular and immune profiles between T1N2 and T4N0 tumors. T1N2 tumors were enriched for immune activation pathways and displayed dense, evenly distributed infiltration of CD3⁺, CD4⁺, and CD8⁺ T cells. In contrast, T4N0 tumors showed upregulation of extracellular matrix organization and adhesion-related pathways, accompanied by reduced intratumoral CD4⁺ and CD8⁺ T-cell density, accumulation of FOXP3⁺ regulatory T cells, and increased CD163⁺ M2 macrophages, consistent with an immune-excluded phenotype.</div></div><div><h3>Conclusion</h3><div>Our integrative multiomic analysis delineates node-dominant (T1N2) NSCLC as “hot” tumors with active immune engagement, whereas tumor-dominant (T4N0) NSCLC exhibit “cold” features characterized by stromal remodeling, immune exclusion, and immunosuppression. These findings suggest that the balance between tumor invasiveness and nodal spread may shape immune contexture and potentially modulate responsiveness to neoadjuvant immunotherapy, highlighting the clinical value of immune landscape profiling in personalized NSCLC treatment.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"211 ","pages":"Article 108879"},"PeriodicalIF":4.4,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145797437","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":"Prognostic comparison of lymph node metastasis subtypes in lung adenocarcinoma: clinical implications of intranodal metastasis versus extranodal extension for optimizing R classification","authors":"Jia-Yong Wu ,&nbsp;Guo-Zhong Liang ,&nbsp;Tian-Qing Chen ,&nbsp;Hai-Ping Qiu ,&nbsp;Cai-Biao Huang ,&nbsp;Xiao-Ping Xie","doi":"10.1016/j.lungcan.2025.108876","DOIUrl":"10.1016/j.lungcan.2025.108876","url":null,"abstract":"<div><h3>Background</h3><div>Lung adenocarcinoma (LUAD) prognosis is strongly influenced by lymph node (LN) status. While extranodal extension (ENE) is a recognized negative prognostic factor, the International Association for the Study of Lung Cancer (IASLC) has proposed reclassifying ENE from R0 (complete resection) to R1 (incomplete resection). The prognostic significance of intranodal metastasis (INM) remains less defined. This study aims to compare the prognosis of LUAD patients with INM versus ENE to inform potential refinements to the R classification system.</div></div><div><h3>Methods</h3><div>This retrospective study enrolled 357 patients with pT1-3N0-1M0 LUAD who underwent lobectomy with systematic lymph node dissection between 2015 and 2021. Patients were stratified into three groups based on postoperative pathology: no LN metastasis (N0, n = 180), INM (n = 124), and ENE (n = 53). Overall survival (OS) and disease-free survival (DFS) were compared using Kaplan-Meier and Cox regression analyses.</div></div><div><h3>Results</h3><div>Among 177N1-stage patients, no significant difference in OS or DFS was observed between the INM and ENE groups (p &gt; 0.05). However, both the INM and ENE groups showed significantly worse OS and DFS compared to the N0 group (p &lt; 0.05). Multivariate analysis confirmed LN metastasis as an independent adverse prognostic factor for both DFS (HR = 2.95, 95 % CI: 1.32–6.61, P = 0.008) and OS (HR = 3.11, 95 % CI: 1.52–6.38, P = 0.002). Patients with nodal metastasis also had a significantly higher risk of recurrence.</div></div><div><h3>Conclusion</h3><div>In N1-stage LUAD, the prognosis of patients with INM is comparable to that of patients with ENE, with both groups exhibiting significantly poorer outcomes than node-negative patients. These findings suggest that the presence of nodal metastasis, regardless of extracapsular extension, may represent occult residual disease. We propose that INM, alongside ENE, should be considered for classification as incomplete resection (R1) to better guide adjuvant therapy strategies.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"211 ","pages":"Article 108876"},"PeriodicalIF":4.4,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757013","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":"Global patterns and trends in mesothelioma incidence: A retrospective cross-sectional study","authors":"Leiwen Fu ,&nbsp;Ke Liu ,&nbsp;Yang Liu ,&nbsp;Yanxiao Gao ,&nbsp;Bingyi Wang ,&nbsp;Yuxian Sun ,&nbsp;Wei Shu ,&nbsp;Yujia Ning ,&nbsp;Minyi Zhang ,&nbsp;Jian Du ,&nbsp;Liang Li","doi":"10.1016/j.lungcan.2025.108878","DOIUrl":"10.1016/j.lungcan.2025.108878","url":null,"abstract":"<div><h3>Background</h3><div>Mesothelioma is a rare and aggressive malignancy primarily caused by asbestos exposure; it predominantly affects older adults with a history of occupational contact.</div></div><div><h3>Methods</h3><div>This population-based study used the GLOBOCAN 2022 database to estimate mesothelioma incidence and mortality across 185 countries in 2022. Long-term trends were assessed using the Cancer Incidence in Five Continents (CI5) Volume XII and CI5 <em>plus</em> databases. Age-standardised incidence rates (ASIRs) were calculated, and Joinpoint regression analysis was employed to assess trends in mesothelioma ASIRs by estimating the average annual percentage change (AAPC).</div></div><div><h3>Results</h3><div>In 2022, there were an estimated 30,633 new mesothelioma cases globally, with an ASIR of 0.28 per 100,000. Europe bore the highest burden, accounting for 48.1% of global cases and 48.4% of deaths. A significant positive correlation was observed between the ASIR or age-standardised mortality rate (ASMR) and the Human Development Index. From 2003 to 2017, while mesothelioma incidence decreased in many regions, significant increases were observed among male in Croatia (AAPC: 2.5, 95% CI: 0.3 to 4.8), the Republic of Korea (2.5, 1.2 to 3.7), and Slovenia (1.2, 0.1 to 2.2), as well as in female in Canada (4.5, 1.3 to 7.9). Mesothelioma incidence declined significantly in males in Australia, Belarus, Germany, Israel, the Netherlands, New Zealand, Norway, Turkey, the UK, and in the White population of the USA, as well as in females in Belarus, Germany, and Turkey.</div></div><div><h3>Conclusion</h3><div>Mesothelioma remains a significant global health challenge, characterised by notable geographic and socioeconomic disparities. Sustained public health efforts are required to eliminate asbestos exposure and reduce disease burden, particularly in regions with rising incidence.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"211 ","pages":"Article 108878"},"PeriodicalIF":4.4,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757063","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":"Reply to letter to the editor “The effectiveness of pembrolizumab maintenance with or without pemetrexed after induction treatment for advanced non-squamous Non-Small-Cell lung cancer”","authors":"Bas J.M. Peters ,&nbsp;Stefan Böhringer ,&nbsp;Esmee van Geffen","doi":"10.1016/j.lungcan.2025.108872","DOIUrl":"10.1016/j.lungcan.2025.108872","url":null,"abstract":"","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"211 ","pages":"Article 108872"},"PeriodicalIF":4.4,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743101","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":"Informed choice for lung cancer screening: A randomised trial of three decision support tools","authors":"Rachael H Dodd ,&nbsp;Marianne Weber ,&nbsp;Kathleen McFadden ,&nbsp;Nicole M Rankin","doi":"10.1016/j.lungcan.2025.108874","DOIUrl":"10.1016/j.lungcan.2025.108874","url":null,"abstract":"<div><div>Shared decision-making in the Australian National Lung Cancer Screening Program (NLCSP) involves consultation between healthcare provider and individual to ensure participants make an informed choice about screening. Three decision support tools were co-designed: a 16-page A5 booklet (booklet), 2-page A4 leaflet (leaflet) and a 3-minute animated video (video). This randomised trial evaluated the tools’ ability to support informed choice, attitudes/intentions towards lung cancer screening, acceptability, comprehension, ease of understanding and balance of information of the tool. An online survey was conducted with people eligible for the Australian NLCSP. Participants were randomised to view one of the tools and completed a questionnaire. The primary outcome was informed choice (defined as adequate knowledge and congruency between attitudes and screening intentions). 715 participants completed the survey: booklet (n = 221), leaflet (n = 252) and video (n = 242). There was no statistically significant difference in informed choice between tools; informed choice was made by 148 (67 %) people who viewed the booklet, 167 (66.3 %) for the leaflet and 153 (63.2 %) for the video. Across all the tools, over 90 % found the information clear and easy to understand, around 85 % found the tool they viewed as helpful in deciding about screening, and around 80 % would recommend the viewed tool to others. Almost 80 % in each group intended to participate in lung cancer screening. Attitudes towards screening were significantly less positive for those viewing the leaflet than the booklet or video (p = 0.006). Each decision support tool was acceptable, supported informed choice, and could be adapted for use in the Australian NLCSP.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"211 ","pages":"Article 108874"},"PeriodicalIF":4.4,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145724446","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":"A multi-institutional perspective on tarlatamab administration and management of CRS/ICANS","authors":"Bingnan Zhang ,&nbsp;Laura Alder ,&nbsp;Samuel Rosner ,&nbsp;Aakash Desai ,&nbsp;Alissa J. Cooper ,&nbsp;Habte Yimer ,&nbsp;Wiktoria Bogdanska ,&nbsp;Abdul Rafeh Naqash ,&nbsp;Ashtin Taylor ,&nbsp;Utsav Joshi ,&nbsp;Jennifer Carlisle ,&nbsp;Stephane Champiat ,&nbsp;Mehmet Altan ,&nbsp;Maria Franco Vega ,&nbsp;Josiah Halm ,&nbsp;Joanna-Grace Manzano ,&nbsp;Graeme Fenton ,&nbsp;Yunan Nie ,&nbsp;Kaiwen Wang ,&nbsp;Mitchell Parma ,&nbsp;Sonam Puri","doi":"10.1016/j.lungcan.2025.108870","DOIUrl":"10.1016/j.lungcan.2025.108870","url":null,"abstract":"<div><h3>Background</h3><div>Tarlatamab, a bispecific T-cell engager, is the first treatment in many years to significantly improve overall survival in relapsed extensive stage small cell lung cancer (ES-SCLC). However, implementation of this therapy has been challenging due to unique toxicities such as cytokine release syndrome (CRS) and immune effector cell‐associated neurotoxicity syndrome (ICANS) requiring prolonged observation following administration.</div></div><div><h3>Methods</h3><div>We conducted a U.S. based multi-institutional survey through the ONWARD-SCLC consortium, compromised of 15 academic and 1 community centers actively administrating tarlatamab.</div></div><div><h3>Results</h3><div>We received responses from 9 U.S. academic centers and 1 community-based practice, detailing their standard operating procedures and management of toxicities. While each had unique practices, common strategies included risk stratification, multidisciplinary coordination, communication and education, and well-defined workflows. We highlighted the similarities and differences in the approaches and proposed a list of best practice considerations for tarlatamab administration and toxicity management.</div></div><div><h3>Conclusions</h3><div>This perspective highlights current best practices and suggests future directions to improve on our current approaches for tarlatamab administration and CRS/ICANS management.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"211 ","pages":"Article 108870"},"PeriodicalIF":4.4,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145724467","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":"Treatment response after induction therapy in advanced thymic tumors: results from the Italian nationwide TYME database","authors":"Giovanni Leuzzi ,&nbsp;Federica Sabia ,&nbsp;Claudia Proto ,&nbsp;Giuseppe Lo Russo ,&nbsp;Monica Ganzinelli ,&nbsp;Michele Ferrari ,&nbsp;Matteo Perrino ,&nbsp;Nadia Cordua ,&nbsp;Luigi Checchi ,&nbsp;Fabio De Vincenzo ,&nbsp;Antonio Federico ,&nbsp;Paolo Zucali ,&nbsp;Marco Lucchi ,&nbsp;Marcello Carlo Ambrogi ,&nbsp;Vittorio Aprile ,&nbsp;Paolo Mendogni ,&nbsp;Lorenzo Rosso ,&nbsp;Fabiana Letizia Cecere ,&nbsp;Giovanni Comacchio ,&nbsp;Roberto Bianco ,&nbsp;Calabrese Fiorella","doi":"10.1016/j.lungcan.2025.108871","DOIUrl":"10.1016/j.lungcan.2025.108871","url":null,"abstract":"<div><h3>Background</h3><div>Induction therapy (IT) prior to surgery is a key strategy to improve resectability in advanced thymic tumors (ATTs). This study aimed to assess prognostic factors and the impact of IT on clinical outcomes.</div></div><div><h3>Material and methods</h3><div>We retrospectively analyzed 64 patients with TNM-stage II–IV ATTs treated with IT and surgery between January 2002 and December 2024, using data from the TYME multicenter Italian database. Radiological response (RR) was defined by RECIST v1.1. Statistical comparisons were performed using Chi-square, <em>t</em>-test, or Wilcoxon rank-sum test. Univariate and multivariate logistic models evaluated associations between variables and outcomes.</div></div><div><h3>Results</h3><div>Mean age was 52 years; 58 % were male. Most tumors (83.4 %) were stage III–IV, with thymoma as the predominant histology (79.7 %). Radiological signs of mediastinal or vascular invasion and tumor diameter &gt; 5 cm were present in over 86 % of cases. Platinum-based chemotherapy was administered in 96.9 %, with CAP regimen used in 62.5 %. Partial response was achieved in 69 % (Responders, RE), while 31 % had stable/progressive disease (Non-responders, NRE). Extended surgery was performed in 84.4 %, with R0 resection in 76.3 %. Adjuvant therapy was administered in 66.7 % of cases. Relapse occurred in 78.6 % (local) and 21.4 % (distant). No significant differences were found between RE and NRE in clinical, radiological, or pathological features. Five-year OS (88 % vs 93 %) and RFS (45 % vs 43 %) were similar between groups. ECOG performance status was the strongest independent predictor of better RFS (OR 7.18), while ASA score was associated with RR (OR 0.20).</div></div><div><h3>Conclusion</h3><div>The TYME database analyses revealed no significant outcome differences between RE and NRE following IT in ATTs, underscoring the complexity of predicting long-term outcomes based on RR alone. This study also suggests the prognostic value of physical status via ASA score and ECOG PS. Further studies with varied chemo regimens are needed to improve response rates in multimodal ATT therapy.</div><div>Accepted as poster presentation at ESMO Congress 2025, October 17-21, 2025 – Berlin.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"211 ","pages":"Article 108871"},"PeriodicalIF":4.4,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145722884","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":"Radiotherapy outcomes in patients with interstitial lung disease and interstitial lung abnormalities: Adverse events and survival from a UK tertiary centre","authors":"Sarah Bowen Jones ,&nbsp;Conal Hayton ,&nbsp;Ahmed Lodhi ,&nbsp;Aqeel Umar ,&nbsp;Corinne Faivre-Finn","doi":"10.1016/j.lungcan.2025.108873","DOIUrl":"10.1016/j.lungcan.2025.108873","url":null,"abstract":"<div><h3>Background</h3><div>Interstitial lung disease (ILD) encompasses a spectrum of inflammatory and fibrotic lung conditions. Interstitial lung abnormalities (ILA) are incidental radiological findings with the potential to progress to clinical ILD. Evidence guiding radiotherapy in patients with ILD and ILA is very limited.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included patients receiving curative-intent radiotherapy with or without chemotherapy at a UK tertiary oncology centre over a seven- year period. Patients with a prior ILD diagnosis or computer tomography (CT) features suggestive of ILA were identified and reviewed by specialist ILD radiologists. Patients were classified into 3 groups: ILD, ILA, or no radiological evidence of ILD/ILA. Clinical outcomes and adverse events were analysed.</div></div><div><h3>Results</h3><div>Of 1693 patients referred for radiotherapy, 163 underwent specialist radiological review: 53 ILD, 53 ILA, and 57 with no ILD/ILA features. Survival outcomes differed significantly between groups. Median overall survival (OS) was 9.4 months (ILD), 14.7 months (ILA), and 22.5 months (no ILD/ILA) (p = 0.001). On multivariable analysis, ILD was independently associated with worse OS (HR 2.88). Grade 5 pneumonitis occurred in 13 % of ILD patients, 6 % with ILA, and 0 % with no ILD/ILA features. Conventional radiotherapy was associated with higher treatment-related adverse events compared to hypofractionated regimens.</div></div><div><h3>Conclusions</h3><div>Patients with ILD experience significantly worse survival and higher risk of adverse events, including fatal pneumonitis, following radiotherapy. ILA represents an intermediate-risk group. These findings highlight the need for improved pre-treatment identification and risk stratification using radiological and clinical tools, and highlights the importance of prospective validation in future studies.</div></div>","PeriodicalId":18129,"journal":{"name":"Lung Cancer","volume":"211 ","pages":"Article 108873"},"PeriodicalIF":4.4,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701283","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}