Cancer Research and Treatment

Original Articles

Lung and Thoracic cancer

The Real-World Outcome of First Line Atezolizumab in Extensive-Stage Small Cell Lung Cancer: A Multicenter Prospective Cohort Study: Myeong Geun Choi, Yeon Joo Kim, Jae Cheol Lee, Wonjun Ji, In-Jae Oh, Sung Yong Lee, Seong Hoon Yoon, Shin Yup Lee, Jeong Eun Lee, Eun Young Kim, Chang-Min Choi; Cancer Res Treat. 2024;56(2):422-429. Published online October 23, 2023; DOI: https://doi.org/10.4143/crt.2023.913

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Purpose
The addition of immune checkpoint inhibitors to chemotherapy has improved survival outcomes in patients with extensive-stage small cell lung cancer (ES-SCLC). However, their real-world effectiveness remains unknown. Therefore, we investigated the effectiveness of atezolizumab plus chemotherapy in ES-SCLC in actual clinical settings.
Materials and Methods
In this multicenter prospective cohort study, patients with ES-SCLC receiving or scheduled to receive atezolizumab in combination with etoposide and carboplatin were enrolled between June 2021 and August 2022. The primary outcomes were progression-free survival (PFS) and the 1-year overall survival (OS) rate.
Results
A total of 100 patients with ES-SCLC were enrolled from seven centers. Median age was 69 years, and 6% had an Eastern Cooperative Oncology Group performance status (ECOG PS) ≥ 2. The median PFS was 6.0 months, the 1-year OS rate was 62.2%, and the median OS was 13.5 months. An ECOG PS of 2-3 and progressive disease as the best response were poor prognostic factors for PFS, while an ECOG PS of 2-3 and brain metastasis were associated with poor prognosis for OS. In addition, consolidative thoracic radiotherapy was found to be an independent favorable prognostic factor for OS (hazard ratio, 0.336; p=0.021). Grade ≥ 3 treatment-related adverse events were observed in 7% of patients, with treatment-related deaths occurring in 2% of patients.
Conclusion
We provided evidence of the favorable real-world effectiveness and safety of atezolizumab plus chemotherapy in ES-SCLC patients, including in the elderly and those with poor ECOG PS. Additional consolidative thoracic radiotherapy may also benefit ES-SCLC patients.

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Real-World Treatment Patterns and Clinical Outcomes in Patients With Extensive-Stage Small Cell Lung Cancer Treated With First-Line Platinum-Based Chemotherapy and ≥ 2 Subsequent Lines of Therapy in the United States
Kamya Sankar, Sudhir Unni, Marian Eberl, Hoa Le, Tara Herrmann, Boris Gorsh, Mei Tang, Friso Coerts, Sajid Ahmed
Advances in Therapy.2026; 43(1): 214. CrossRef
Atezolizumab in the first-line treatment of small cell lung cancer: Toxicity and safety in real-world clinical practice
Ju. S. Mansurova, M. A. Lyadova, E. A. Denisova, E. S. Kuzmina, V. К. Lyadov
Meditsinskiy sovet = Medical Council.2026; (21): 20. CrossRef
Atezolizumab plus platinum-based chemotherapy and etoposide as first-line treatment for metastatic small cell lung cancer: a retrospective multicenter observational study
Laura Moñino Domínguez, Laura Amaro Álvarez, Alicia Aguado Paredes, Isabel María Carrión Madroñal
Farmacia Hospitalaria.2026;[Epub] CrossRef
Real-World Evidence of Atezolizumab Efficacy as Part of First-Line Treatment for Extensive-Stage SCLC in Bulgaria
Manoela Manova, Boryana Ivanova, Rositsa Krasteva, Nikolay Conev, Tanya Zlatanova, Jeliazko Arabadjiev, Natalia Chilingirova, Mila Petrova, Assen Dudov, Bozhil Robev, Velko Minchev, Ivan Tonev, Krassimir Koynov, Daniel Penchev, Todor Georgiev, Antoan Rang
Cancers.2026; 18(7): 1129. CrossRef
[Artículo traducido] Atezolizumab más quimioterapia con platino y etopósido como tratamiento de primera línea en cáncer de pulmón microcítico metastásico: estudio multicéntrico observacional retrospectivo
Laura Moñino Domínguez, Laura Amaro Álvarez, Alicia Aguado Paredes, Isabel María Carrión Madroñal
Farmacia Hospitalaria.2026;[Epub] CrossRef
First-Line Serplulimab in Extensive-Stage Small Cell Lung Cancer
Jingjing Liu, Liang Han, Lin Wu, Jun Chen, Hongmei Sun, Guilan Wen, Yinghua Ji, Jianhua Shi, Zhijie Pan, Jinsheng Shi, Xicheng Wang, Yuansong Bai, Yueyin Pan, Xuhong Min, Maksym Viguro, Xingya Li, Yanqiu Zhao, Junquan Yang, Tamta Makharadze, Ekaterine Ark
JAMA Oncology.2026;[Epub] CrossRef
Significance of Platinum‐Based Chemotherapy With Programmed Death‐1 Blockade in Limited Disease Small Cell Lung Cancer: A Retrospective Study
Ayako Shiono, Hisao Imai, Kyoichi Kaira, Takanori Abe, Yuki Sato, Ken Yamamoto, Hiroki Watanabe, Yuko Tsuchiya‐Kawano, Akihiro Tamiya, Takashi Osaki, Noriko Yanagitani, Shigeru Tanzawa, Toshiyuki Sumi, Kohei Yoshimine, Yohei Matsui, Satoshi Endo, Kazuhiko
Thoracic Cancer.2025;[Epub] CrossRef
Impact of Treatment Duration in First-Line Atezolizumab Plus Chemotherapy in Extensive-Stage Small-Cell Lung Cancer: A Multicenter Real-World Retrospective Study
Mehmet Nuri Baser, Bilgin Demir, Gamze Serin Ozel, Gamze Gokoz Dogu, Serdar Karakaya, Mucahit Ugar, Naziye Ak, Ahmet Ozveren, Ufuk Camanlı, Olcun Umit Unal, Merve Turan, Esin Oktay
Medicina.2025; 61(7): 1230. CrossRef
Extended Follow‐Up Analysis of First‐Line Atezolizumab in Extensive‐Stage Small Cell Lung Cancer: A Real‐World Multicenter Prospective Cohort Study
Yechan Song, Myeong Geun Choi, Yeon Joo Kim, Jae Cheol Lee, Wonjun Ji, In‐Jae Oh, Sung Yong Lee, Seong Hoon Yoon, Shin Yup Lee, Jeong Eun Lee, Eun Young Kim, Ho Young Kim, Chang‐Min Choi
Thoracic Cancer.2025;[Epub] CrossRef

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Clinical Outcome of Stereotactic Body Radiotherapy in Patients with Early-Stage Lung Cancer with Ground-Glass Opacity Predominant Lesions: A Single Institution Experience: Jeong Yun Jang, Su Ssan Kim, Si Yeol Song, Young Seob Shin, Sei Won Lee, Wonjun Ji, Chang-Min Choi, Eun Kyung Choi; Cancer Res Treat. 2023;55(4):1181-1189. Published online March 21, 2023; DOI: https://doi.org/10.4143/crt.2022.1656

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Purpose
The detection rate of early-stage lung cancer with ground-glass opacity (GGO) has increased, and stereotactic body radiotherapy (SBRT) has been suggested as an alternative to surgery in inoperable patients. However, reports on treatment results are limited. Therefore, we performed a retrospective study to investigate the clinical outcome after SBRT in patients with early-stage lung cancer with GGO-predominant tumor lesions at a single institution.
Materials and Methods
This study included 89 patients with 99 lesions who were treated with SBRT for lung cancer with GGO-predominant lesions that had a consolidation-to-tumor ratio of ≤0.5 at Asan Medical Center between July 2016 and July 2021. A median total dose of 56.0 Gy (range, 48.0–60.0) was delivered using 10.0–15.0 Gy per fraction.
Results
The overall follow-up period for the study was median 33.0 months (range, 9.9 to 65.9 months). There was 100% local control with no recurrences in any of the 99 treated lesions. Three patients had regional recurrences outside of the radiation field, and three had distant metastasis. The 1-year, 3-year, and 5-year overall survival rates were 100.0%, 91.6%, and 82.8%, respectively. Univariate analysis revealed that advanced age and a low level of diffusing capacity of the lungs for carbon monoxide were significantly associated with overall survival. There were no patients with grade ≥3 toxicity.
Conclusion
SBRT is a safe and effective treatment for patients with GGO-predominant lung cancer lesions and is likely to be considered as an alternative to surgery.

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Prognostic analysis of helical tomotherapy stereotactic body radiotherapy in multiple primary or second primary lung cancers
Jintao Ma, Xiaohong Xu, Wenhan Huang, Yong Hu, Gang Chen, Jian He
BMC Cancer.2025;[Epub] CrossRef
Place de la radiothérapie en conditions stéréotaxiques dans les cancers bronchiques non à petites cellules localisés
Catherine Durdux, Aurélia Alati
Bulletin du Cancer.2025; 112(3): 3S31. CrossRef
Prognostic Impact of Tumor Solid Components in Stereotactic Body Radiotherapy for Clinical Stage Tis–1N0M0 Lung Cancer
Junki Fukuda, Hiroshi Doi, Atsushi Kono, Takaya Inagaki, Naoko Ishida Hamazawa, Saori Tatsuno Imamura, Takuya Uehara, Masahiro Inada, Kiyoshi Nakamatsu, Makoto Hosono, Kazunari Ishii, Yukinori Matsuo
Thoracic Cancer.2025;[Epub] CrossRef
Management of possible idiopathic inferior vena cava compression during stereotactic body radiation therapy for lung cancer
Shinya Neri, Yuma Ichikawa
BMJ Case Reports.2025; 18(8): e263832. CrossRef
European Respiratory Society and European Society of Thoracic Surgeons clinical practice guideline on fitness for curative intent treatment of lung cancer
Alessandro Brunelli, Georgia Hardavella, Rudolf M. Huber, Thierry Berghmans, Armin Frille, Maria Rodriguez, Ilona Tietzova, Lieven Depypere, Riccardo Asteggiano, Tim Batchelor, Adrien Costantini, Dirk De Ruysscher, Valerie Durieux, Corinne Faivre-Finn, Ma
European Respiratory Journal.2025; 66(5): 2500156. CrossRef
European Respiratory Society and European Society of Thoracic Surgeons clinical practice guideline on fitness for curative intent treatment of lung cancer
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European Journal of Cardio-Thoracic Surgery.2025;[Epub] CrossRef
Recent Advancements in Minimally Invasive Surgery for Early Stage Non-Small Cell Lung Cancer: A Narrative Review
Jibran Ahmad Khan, Ibrahem Albalkhi, Sarah Garatli, Marcello Migliore
Journal of Clinical Medicine.2024; 13(11): 3354. CrossRef
The clinical effect of thoracoscopic segmentectomy in the treatment of lung malignancies less than 2CM in diameter
Yafeng Zhang, Renzhong Shi, Xiaoming Xia, Kaiyao Zhang
Journal of Cardiothoracic Surgery.2024;[Epub] CrossRef
Impact of ground-glass component on prognosis in early-stage lung cancer treated with stereotactic body radiotherapy via Helical Tomotherapy
Jintao Ma, Shaonan Fan, Wenhan Huang, Xiaohong Xu, Yong Hu, Jian He
Radiation Oncology.2024;[Epub] CrossRef

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Optimal Definition of Oligometastasis Showing Survival Benefits of Local Therapies during Tyrosine Kinase Inhibitor Treatment: Yoon Jung Jang, Dong-gon Hyun, Wonjun Ji, Chang-Min Choi, Shinkyo Yoon, Dae Ho Lee, Sang-We Kim, Jae Cheol Lee; Cancer Res Treat. 2023;55(2):468-478. Published online November 28, 2022; DOI: https://doi.org/10.4143/crt.2022.1342

Abstract PDF Supplementary Material PubReader ePub

Purpose
We aimed to investigate the feasibility of four criteria on oligometastasis (OM) concerning clear survival benefits of local therapy (LT) during tyrosine kinase inhibitor (TKI) treatment in non–small cell lung cancer (NSCLC).
Materials and Methods
This single-center, retrospective study included patients with advanced NSCLC who received LT because of OM during TKI treatment at Asan Medical Center from January 2011 to December 2020. At the application of LT OM was classified according to four criteria: TNM, European Organization for Research and Treatment of Cancer Lung Cancer Group (EORTC-LCG), National Comprehensive Network (NCCN), and ORGAN. We compared survival outcomes between patients with and without OM.
Results
The median overall survival of the 117 patients included in the analysis was 70.8 months (95% confidence interval [CI], 56.6 to 85.1). The patients with OM meeting all four criteria (hazard ratio [HR] with 95% CI of TNM criteria 0.24 with 0.10-0.57; p=0.001, EORTC-LCG criteria 0.34 with 0.17-0.67; p=0.002, NCCN criteria 0.41 with 0.20-0.86; p=0.018 and ORGAN criteria 0.33 with 0.18-0.60; p < 0.001) had significantly longer survival compared with patients who did not after adjusting for confounding factors. Furthermore, increasing the number of extra-thoracic metastatic organs to two or more were independent predictive factors for worse survival outcomes (2 organs: HR, 3.51; 95% CI, 1.01 to 12.14; p=0.048; 3 organs: HR, 4.31; 95% CI, 0.94 to 19.73; p=0.060; 4 organs: HR, 24.47; 95% CI, 5.08 to 117.80; p < 0.001).
Conclusion
Patients with OM defined by all four criteria showed prognostic benefits from LT during TKI therapy.

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The patterns of systemic metastasis in major salivary gland cancer and therapeutic implications
Subi Oh, Younghac Kim, Hyojun Kim, Eunhye Kim, Sook-young Woo, Nayeon Choi, Junhun Cho, Dongryul Oh, Yong-Chan Ahn, Sehhoon Park, Myung-Ju Ahn, Han-Sin Jeong
Oral Oncology.2025; 164: 107258. CrossRef
Surgery for Stage IV Disease—Is It Prime Time Yet?
Marianna V. Papageorge, Mara B. Antonoff
Surgical Oncology Clinics of North America.2025; 34(4): 489. CrossRef

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A Phase I/IIa Randomized Trial Evaluating the Safety and Efficacy of SNK01 Plus Pembrolizumab in Patients with Stage IV Non-Small Cell Lung Cancer: Eo Jin Kim, Yong-Hee Cho, Dong Ha Kim, Dae-Hyun Ko, Eun-Ju Do, Sang-Yeob Kim, Yong Man Kim, Jae Seob Jung, Yoonmi Kang, Wonjun Ji, Myeong Geun Choi, Jae Cheol Lee, Jin Kyung Rho, Chang-Min Choi; Cancer Res Treat. 2022;54(4):1005-1016. Published online December 3, 2021; DOI: https://doi.org/10.4143/crt.2021.986

Abstract PDF Supplementary Material PubReader ePub

Purpose
The aim of this study is to evaluate the safety and efficacy of ex vivo activated and expanded natural killer (NK) cell therapy (SNK01) plus pembrolizumab in a randomized phase I/IIa clinical trial.
Materials and Methods
Overall, 18 patients with advanced non–small cell lung cancer (NSCLC) and a programmed death ligand 1 tumor proportion score of 1% or greater who had a history of failed frontline platinum-based therapy were randomized (2:1) to receive pembrolizumab every 3 weeks +/– 6 weekly infusions of SNK01 at either 2×10⁹ or 4×10⁹ cells per infusion (pembrolizumab monotherapy vs. SNK01 combination). The primary endpoint was safety, whereas the secondary endpoints were the objective response rate (ORR), progression-free survival (PFS), overall survival, and quality of life.
Results
Since no dose-limiting toxicity was observed, the maximum tolerated dose was determined as SNK01 4×10⁹ cells/dose. The safety data did not show any new safety signals when SNK01 was combined with pembrolizumab. The ORR and the 1-year survival rate in the NK combination group were higher than those in patients who underwent pembrolizumab monotherapy (ORR, 41.7% vs. 0%; 1-year survival rate, 66.7% vs. 50.0%). Furthermore, the median PFS was higher in the SNK01 combination group (6.2 months vs. 1.6 months, p=0.001).
Conclusion
Based on the findings of this study, the NK cell combination therapy may consider as a safe treatment method for stage IV NSCLC patients who had a history of failed platinum-based therapy without an increase in adverse events.

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Lung Cancer

Prognostic Factor and Clinical Outcome in Stage III Non-Small Cell Lung Cancer: A Study Based on Real-World Clinical Data in the Korean Population: Ho Cheol Kim, Wonjun Ji, Jae Cheol Lee, Hyeong Ryul Kim, Si Yeol Song, Chang-Min Choi, Korean Association for Lung Cancer, Korea Central Cancer Registry; Cancer Res Treat. 2021;53(4):1033-1041. Published online February 16, 2021; DOI: https://doi.org/10.4143/crt.2020.1350

Abstract PDF Supplementary Material PubReader ePub

Purpose
The optimal treatment for patients with stage III non-small cell lung cancer (NSCLC) remains controversial. This study aimed to investigate prognostic factors and clinical outcome in stage III NSCLC using real-world clinical data in the Korean population.
Materials and Methods
Among 8,110 patients with lung cancer selected from 52 hospitals in Korea during 2014-2016, only patients with stage III NSCLC were recruited and analyzed. A standardized protocol was used to collect clinical information and cox proportional hazards models were used to identify risk factors for mortality.
Results
A total of 1,383 patients (46.5% had squamous cell carcinoma and 40.9% had adenocarcinoma) with stage III NSCLC were enrolled, and their median age was 70 years. Regarding clinical stage, 548 patients (39.6%) had stage IIIA, 517 (37.4%) had stage IIIB, and 318 (23.0%) had stage IIIC. Pertaining to the initial treatment method, the surgery group (median survival period: 36 months) showed better survival outcomes than the non-surgical treatment group (median survival period: 18 months, p=0.001) in patients with stage IIIA. Moreover, among patients with stage IIIB and stage IIIC, those who received concurrent chemotherapy and radiation therapy (CCRT, median survival period: 24 months) showed better survival outcomes than those who received chemotherapy (median survival period: 11 months), or radiation therapy (median survival period: 10 months, p<0.001).
Conclusion
While surgery might be feasible as the initial treatment option in patients with stage IIIA NSCLC, CCRT showed a beneficial role in patients with stage IIIB and IIIC NSCLC.

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Lung cancer

Active Treatment Improves Overall Survival in Extremely Older Non–Small Cell Lung Cancer Patients: A Multicenter Retrospective Cohort Study: Su Yeon Lee, Yoon-Ki Hong, Wonjun Ji, Jae Cheol Lee, Chang Min Choi, Korean Association for Lung Cancer, Korea Central Cancer Registry; Cancer Res Treat. 2021;53(1):104-111. Published online October 5, 2020; DOI: https://doi.org/10.4143/crt.2020.894

Abstract PDF Supplementary Material PubReader ePub

Purpose
As the aging of society progresses, the proportion of extremely older lung cancer patients has also increased; However, studies of these patients with non–small cell lung cancer are limited. Therefore, we investigated the initial treatment modalities and survival outcomes for patients aged 80 years or over.
Materials and Methods
We included a multicenter retrospective cohort from the Korean Association for Lung Cancer Registry, which surveys 10% of the newly diagnosed lung cancer patients across 52 hospitals in Korea. We analyzed and compared the 2014–2016 data of the non–small cell lung cancer patients aged ≥ 80 years and those aged < 80 years.
Results
Of the 6,576 patients reviewed, 780 patients were aged ≥ 80 years, and 5,796 patients were aged < 80 years. In the patients aged ≥ 80 years, surgery and radiation therapy resulted in longer patient survival among those with a resectable tumor (stage I–II) than the best supportive care (median survival, not reached [surgery] vs. 32.2 months [radiation therapy] vs. 11.43 months [best supportive care]). The duration of survival in patients with advanced-stage (IV) lung cancers was higher after chemotherapy than after the best supportive care (median survival, 8.63 months vs. 2.5 months). Patients with stage IV adenocarcinoma who received targeted therapy had better survival than those who did not (median survival, 9.0 months vs. 4.3 months).
Conclusion
Even in extremely older patients, active treatments, such as surgery, radiation therapy, and chemotherapy, can result in better survival outcomes than the best supportive care.

Citations

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