Editors Choice
Robotic Esophagectomy Compared With Open Esophagectomy Reduces Sarcopenia within the First Postoperative Year: A Propensity Score-Matched Analysis
Sarcopenia is a known risk factor for adverse outcomes after esophageal cancer (EC) surgery. Robot-assisted minimally invasive esophagectomy (RAMIE) offers numerous advantages, including reduced morbidity and mortality. However, no evidence exists to date comparing the development of sarcopenia after RAMIE and open esophagectomy (OE). The objective was to evaluate whether the development of sarcopenia within the first postoperative year after esophagectomy is associated with the surgical approach: RAMIE versus OE.Treatment Characteristics and Real-World Progression-Free Survival in Patients With Unresectable Stage III NSCLC Who Received Durvalumab After Chemoradiotherapy: Findings From the PACIFIC-R Study
The phase 3 PACIFIC trial established consolidation therapy with durvalumab as standard of care for patients with unresectable, stage III NSCLC and no disease progression after definitive chemoradiotherapy (CRT). The observational PACIFIC-R study assesses the real-world effectiveness of durvalumab in patients from an early access program. Here, we report treatment characteristics and a preplanned analysis of real-world progression-free survival (rwPFS).UNcommon EGFR Mutations: International Case Series on Efficacy of Osimertinib in Real-Life Practice in First-LiNe Setting (UNICORN)
Approximately 10% of EGFR mutations (EGFRmuts) are uncommon (ucEGFRmuts). We aimed to collect real-world data about osimertinib for patients with ucEGFRmuts.A Phase 2 Study of Palbociclib for Recurrent or Refractory Advanced Thymic Epithelial Tumors (KCSG LU17-21)
Thymic epithelial tumors (TETs) are rare but are the most common tumors of the anterior mediastinum. Platinum-based combination chemotherapy is the standard of care for such tumors and is associated with a 50% to 90% objective response rate (ORR) in metastatic disease. Nevertheless, there is no standard chemotherapeutic option after failure of platinum-based combination chemotherapy. Genetic alterations associated with the cell cycle, including pRB, p16INK4A, and cyclin D1, are most often observed in TETs.Lung Cancer in Turkey
Turkey stretches from the Balkans to the Middle East and is among the larger countries in terms of land area and population (Fig. 1). Turkey’s population of approximately 85 million people encompasses a diverse genomic, ethnic, and cultural heritage with roots from several empires and civilizations dating back to the Paleolithic age. According to the GLOBOCAN 20201 registry, lung cancer (LC) comprises 17.6% of all cancer types. It ranks highest in Turkey, with 41,000 new cases in 2020 and an age-adjusted incidence rate of 41.7 and 8.7 per 100,000 for men and women, respectively.Lung Cancer in Rwanda
Rwanda is a landlocked country in East Africa with an estimated population of approximately 12.5 million in 2018, making it the second most densely populated country in Africa.1,2 Rwanda is counted among low-income countries, with a little more than 80% of Rwandans living in rural areas. Women represent approximately a half of the population.3 Figure 1 is the map of Rwanda in relation to its neighboring countries.Antiangiogenesis May Not Be a Universal Booster of EGFR Tyrosine Kinase Inhibitors
Since the concept of antiangiogenesis was introduced in oncology, various types of systemic anticancer treatment, from cytotoxic chemotherapy, molecular targeted therapy, to immunotherapy, had been attempted to be combined with antiangiogenic agents. At around 2010, cytotoxic chemotherapy and EGFR tyrosine kinase inhibitors (TKIs) were two pillars of systemic treatments for NSCLC, and the combination of antiangiogenic agents and EGFR TKIs was thus naturally to be explored.Determining Whether YAP1 and POU2F3 Are Antineuroendocrine Factors
Rudin et al.1 reported that SCLCs can be subtyped into four groups (SCLC-A, SCLC-N, SCLC-Y, and SCLC-P) according to four molecules—ASCL1, NEUROD1, POU2F3, and YAP1—based on gene expression data of primary SCLC samples and cell lines. Initially, both YAP1 and POU2F3 were identified as markers of the non-neuroendocrine (non-NE) phenotype of SCLC; however, subsequent studies have gradually revealed that YAP1 and POU2F3 have different significance.EGFR Tyrosine Kinase Inhibitor Sequencing Revisited: From the Revival of Old Tools to the Integration of New Agents
In this issue of the Journal of Thoracic Oncology, Piccirillo et al.1 report the results of the BEVERLY trial, a randomized phase 3 study that reveals the progression-free survival (PFS) benefit of bevacizumab to erlotinib as first-line treatment for Italian patients with metastatic NSCLC with common EGFR mutations. In this large study, after a median follow-up of 36.3 months, median investigator-assessed PFS was 15.4 months with erlotinib plus bevacizumab and 9.6 months with erlotinib alone (hazard ratio = 0.66, 95% confidence interval: 0.47–0.92).Assessment of Updated Commission on Cancer Guidelines for Intraoperative Lymph Node Sampling in Early Stage NSCLC
The American College of Surgeons Commission on Cancer recently updated its sampling recommendations for early stage NSCLC from at least 10 lymph nodes to at least one N1 (hilar) and three N2 (mediastinal) lymph node stations. Nevertheless, intraoperative lymph node sampling minimums remain subject to debate. We sought to evaluate these guidelines in patients with early stage NSCLC.Surgical, Radiation, and Systemic Treatments of Patients With Thymic Epithelial Tumors: A Clinical Practice Guideline
The aim of this guideline was to provide recommendations for the most effective therapy for patients with thymic epithelial tumors, including thymoma, thymic carcinoma, and thymic neuroendocrine tumors (NETs). This guideline is intended to be used by all health care professionals managing patients with thymic epithelial tumors.Cytisine Therapy Improved Smoking Cessation in the Randomized Screening and Multiple Intervention on Lung Epidemics Lung Cancer Screening Trial
Cytisine, a partial agonist-binding nicotine acetylcholine receptor, is a promising cessation intervention. We conducted a single-center, randomized, controlled trial (RCT) in Italy to assess the efficacy and tolerability of cytisine as a smoking cessation therapy among lung cancer screening participants.Efficacy and Safety of SH-1028 in Patients With EGFR T790M-Positive NSCLC: A Multicenter, Single-Arm, Open-Label, Phase 2 Trial
As a novel third-generation EGFR tyrosine kinase inhibitor (TKI), SH-1028 (formerly oritinib) is developed to inhibit both sensitizing EGFR mutations and EGFR T790M mutation.Efficacy and Safety of Befotertinib (D-0316) in Patients With EGFR T790M-Mutated NSCLC That Had Progressed After Prior EGFR Tyrosine Kinase Inhibitor Therapy: A Phase 2, Multicenter, Single-Arm, Open-Label Study
Befotertinib (D-0316) is a novel, third-generation EGFR tyrosine kinase inhibitor (TKI). This study evaluated befotertinib in patients with locally advanced or metastatic NSCLC who developed an EGFR T790M mutation after progression on first- or second-generation EGFR TKI therapy.Lung Cancer in Colombia
Colombia is a country on the northwest of South America, and it is divided into 32 departments, a capital district, 1121 municipalities, and indigenous territories. Population growth in the period 1990 to 2016 was 42.0%, during which time population structure became regressive and older, with most living in urban areas (82%) (Fig. 1A–C). The Colombian health system is made up of a social security sector and a private sector. The system's backbone is the General Social Security Health System, with a coverage near to 100%.Lung Cancer in Germany
Since the reunification of the Federal Republic of Germany with the German Democratic Republic in 1990, Germany, situated in middle Europe, has become the most populous country in Europe with 83.5 million inhabitants. With a gross domestic product of 3.8 trillion U.S. dollars (2020), it is the largest national economy in the European Union and the fourth worldwide. As a result of the political reorganization after World War II, a federal organization has been adopted, delegating a large number of tasks to each of the 16 federal states, thereby, enabling a more regionalized approach (e.g., education or the health system).Asbestos Lung Burden Does Not Predict Survival in Malignant Pleural Mesothelioma: A Necropsy-Based Study of 185 Cases
Malignant pleural mesothelioma is an asbestos-related disease with poor survival. The prognostic role of histologic subtype is well established. Some studies (without a biological hypothesis) suggested that higher asbestos lung burden is associated with reduced survival.Efficacy and Safety of Limertinib (ASK120067) in Patients With Locally Advanced or Metastatic EGFR Thr790Met-Mutated NSCLC: A Multicenter, Single-Arm, Phase 2b Study
Limertinib (ASK120067) is a newly developed third-generation EGFR tyrosine kinase inhibitor targeting both sensitizing EGFR and EGFR Thr790Met (T790M) mutations. This study aimed to evaluate the efficacy and safety of limertinib in patients with locally advanced or metastatic EGFR T790M-mutated NSCLC.Lung Cancer in Pakistan
Pakistan is the fifth most populous country in the world with an estimated population of more than 207 million located in South Central Asia between the Himalayas and Arabian Gulf. It has a population density of 260 per km2 with 10 major metropolitan cities. Although each of these 10 cities has a population of more than 10 million, only 36.4% of the total population lives in urban areas. Administratively, it consists of four provinces and federal capital territory as illustrated in Figure 1.1 Pakistan ranks as a low- to middle-income country with a gross national income per capita of USD 1410 according to the World Bank 2020 data.A Large-Scale Genome-Wide Gene-Gene Interaction Study of Lung Cancer Susceptibility in Europeans With a Trans-Ethnic Validation in Asians
Although genome-wide association studies have been conducted to investigate genetic variation of lung tumorigenesis, little is known about gene-gene (G × G) interactions that may influence the risk of non-small cell lung cancer (NSCLC).Lung Cancer in Sudan
Sudan, with an area of 1,886,068 km2, is the third-largest country in Africa. This African Arab country is surrounded by North Africa, Sub-Saharan Africa, and the Middle East. In 2020, the population of Sudan was about 43.8 million.1 The population structure is young, with approximately 40% under 15 years of age, as illustrated in Figure 1. Sudan is a low-income country despite its abundant natural resources, with approximately half of the population living below the poverty line. In 2011, with the independence of South Sudan under the term of Comprehensive Peace Agreement,2 Sudan lost almost half of its revenue, as South Sudan took with it approximately 75% of all oil production and reserves.Pulmonary Asbestos Fiber Burden Is Related to Patient Survival in Malignant Pleural Mesothelioma
Malignant pleural mesothelioma (MPM) is associated with poor prognosis and is strongly associated with occupational asbestos exposure. Given the importance of asbestos exposure in MPM pathogenesis, we retrospectively analyzed the types and concentrations of asbestos fibers within the lung tissues of patients with MPM and investigated their effects on all-cause mortality.KEAP1-Mutant NSCLC: The Catastrophic Failure of a Cell-Protecting Hub
Mutations in the KEAP1-NRF2 pathway are common in NSCLC, albeit with a prevalence of KEAP1 mutations in lung adenocarcinoma and an equal representation of KEAP1 and NFE2L2 (the gene encoding for NRF2) alterations in lung squamous cell carcinoma. The KEAP1-NRF2 axis is a crucial modulator of cellular homeostasis, enabling cells to tolerate oxidative and metabolic stresses, and xenobiotics. The complex cytoprotective response orchestrated by NRF2-mediated gene transcription embraces detoxification mechanisms, ferroptosis protection, and metabolic reprogramming.Lung Cancer in Japan
Japan is located in East Asia and consists of five large islands and numerous smaller islands, with a total of 6852 islands (Fig. 1). Mountainous areas cover 75% of the country, and the population is concentrated in the plains along the coast. Because it is an island nation and because of the policy of seclusion that lasted for more than 300 years during the Edo period, it is almost ethnically homogeneous. The total population is 125.36 million, ranking 11th in the world. The average life expectancy of men is 81 years, and that of women is 87 years, making Japan a country with one of the highest life expectancies in the world.Efficacy of Atezolizumab in Patients With Advanced NSCLC Receiving Concomitant Antibiotic or Proton Pump Inhibitor Treatment: Pooled Analysis of Five Randomized Control Trials
Gut dysbiosis may reduce immune checkpoint inhibitor (ICI) efficacy. Antibiotics and proton pump inhibitors (PPIs) are commonly used drugs causing gut dysbiosis. There is limited randomized controlled trial (RCT) evidence on whether antibiotics or PPIs impact ICI benefit versus comparator treatments.
