Therapy for Stage IV Non–Small Cell Lung Cancer With Driver Alterations: ASCO Living Guideline, Version 2024.3

Journal of Clinical Oncology, Год журнала: 2025, Номер unknown

Опубликована: Фев. 27, 2025

Living guidelines are developed for selected topic areas with rapidly evolving evidence that drives frequent change in recommended clinical practice. updated on a regular schedule by standing expert panel systematically reviews the health literature continuous basis, as described ASCO Guidelines Methodology Manual . follow Conflict of Interest Policy Implementation Clinical Practice and updates not intended to substitute independent professional judgment treating clinician do account individual variation among patients. See appendix disclaimers other important information ( Appendix 1 2 ). Updates published regularly can be found at https://ascopubs.org/nsclc-da-living-guideline

Язык: Английский

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Therapy for Stage IV Non–Small Cell Lung Cancer Without Driver Alterations: ASCO Living Guideline, Version 2024.3

Journal of Clinical Oncology, Год журнала: 2025, Номер unknown

Опубликована: Фев. 27, 2025

Living guidelines are developed for selected topic areas with rapidly evolving evidence that drives frequent change in recommended clinical practice. updated on a regular schedule by standing expert panel systematically reviews the health literature continuous basis, as described ASCO Guidelines Methodology Manual . follow Conflict of Interest Policy Implementation Clinical Practice and updates not intended to substitute independent professional judgment treating clinician do account individual variation among patients. See appendix disclaimers other important information ( Appendix 1 2 ). Updates published regularly can be found at https://ascopubs.org/nsclc-non-da-living-guideline

Язык: Английский

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Implications of EGFR expression on EGFR signaling dependency and adaptive immunity against EGFR-mutated lung adenocarcinoma

Lung Cancer, Год журнала: 2025, Номер 202, С. 108494 - 108494

Опубликована: Март 12, 2025

Язык: Английский

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Precision Oncology in Non-small Cell Lung Cancer: A Comparative Study of Contextualized ChatGPT Models

Cureus, Год журнала: 2025, Номер unknown

Опубликована: Март 24, 2025

Objectives: The growing adoption of Large Language Models (LLMs) in medicine has raised important questions about their potential utility for clinical decision support within oncology. This study aimed to evaluate the effects various contextualization methods on ChatGPT's ability provide National Comprehensive Cancer Network (NCCN) guideline-aligned recommendations managing non-small cell lung cancer (NSCLC). Methodology: GPT-4o, base GPT-4, and GPT-4 models contextualized with prompts PDF documents were asked identify preferred chemotherapies twelve advanced cancers given molecular profiles derived from 2024 NCCN Clinical Practice Guidelines Oncology NSCLC. GPT responses subsequently compared guidelines using readability scores qualitative reviewer assessments (1) recommendation specific targeted therapy, (2) agreement NCCN-guideline-preferred therapies, (3) guideline non-concordant (4) provision supplementary information. Results: PDF+Prompt model demonstrated elevated 23/24 versus 17/24 (P = 0.040) 18/24 GPT-4o 0.089). No contained therapies contrast 4/12 GPT4 0.093) 5/12 GPT4o 0.037). Comparison response between or showed a lower mean word count (both P < 0.001), Simple Measure Gobbledygook (SMOG) score Gunning Fog 0.001 0.002 GPT-4o). Prompting alone did not significantly improve reduce rate therapy recommendations. Conclusions: performance gains observed following suggest that broader applications LLMs oncology may exist than current literature indicates. provides proof concept use showcases accessibility. Future studies validating this application additional types real-life patient encounters could an bridge eventual adoption.

Язык: Английский

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Plasma-First Testing in Advanced Lung Cancer: Evidence and Implications

Journal of Thoracic Oncology, Год журнала: 2025, Номер 20(4), С. 411 - 414

Опубликована: Апрель 1, 2025

Язык: Английский

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Oncogenic Fusions in NSCLC: From Mechanisms to Clinical Applications

International Journal of Molecular Sciences, Год журнала: 2025, Номер 26(8), С. 3802 - 3802

Опубликована: Апрель 17, 2025

Non-small cell lung cancer (NSCLC) is operated commonly by diverse genetic alterations, and oncogenic fusions represent a significant therapeutic role. Common include ALK, ROS1, RET, NTRK, signaling pathways in tumorigenesis. Recent advances investigating tumor molecular biology underlying fusions, including chromosomal rearrangements, highlighting their role as drivers. The development of targeted therapies, such tyrosine kinase inhibitors (TKIs), has impacted most patients’ NSCLC treatment. Despite the greater profiles, remarkable efficiency tolerable side effects compared to traditional chemotherapy, challenges, acquired mutations, lead more ongoing research-optimized future therapies.

Язык: Английский

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Driving Best Practices Throughout the Treatment Journey for Patients with NSCLC with Actionable Alterations: A Podcast Discussion

Advances in Therapy, Год журнала: 2025, Номер unknown

Опубликована: Май 22, 2025

Non-small cell lung cancer (NSCLC) treatment has been revolutionized by the advent of targeted therapies for tumors harboring specific actionable alterations. Targeted agents are now approved use in patients with advanced NSCLC various drivers including ALK rearrangements, BRAF V600E mutations, EGFR ERBB2 KRAS G12C MET exon 14 skipping alterations, NTRK fusions, RET and ROS1 rearrangements. Importantly, availability these raised clinical question how to optimally sequence their alongside chemotherapy and/or immunotherapy strategies, which indicated broader populations. Key considerations include (i) evidence better outcomes when first-line is initiated following molecular profiling data; (ii) decreasing proportion able receive therapy each successive line; (iii) efficacy demonstrated either single-arm trials or head-to-head comparisons immunotherapy, as compared poor modest drivers; (iv) real-world data showing alterations who received those did not; (v) generally favorable safety profile therapies, well potential increased toxicity precedes certain agents; (vi) patient-centric factors greater ease administration oral over intravenous strategies. In line considerations, guidelines typically recommend most initial immunotherapy. this podcast, authors discuss current therapeutic landscape provide perspectives on algorithms, using patient cases illustrate key principles.

Язык: Английский

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Intrathecal pemetrexed efficacy and cerebrospinal fluid tumor marker response in refractory leptomeningeal metastasis of non-small-cell lung cancer: a single-arm phase II trial

BMC Medicine, Год журнала: 2025, Номер 23(1)

Опубликована: Май 28, 2025

The treatments for refractory leptomeningeal metastasis (RLM) of non-small cell lung cancer (NSCLC) are limited, and response assessment is complex challenging. This clinical trial aimed to evaluate the efficacy intrathecal pemetrexed (IP) using cerebrospinal fluid (CSF) tumor marker in RLM. was a single-center, single-arm, phase II adaptive trial. Patients with RLM NSCLC were eligible inclusion. assigned receive 30 mg IP every 3 weeks total 6 cycles. primary endpoint overall survival (OS). secondary endpoints included progression-free (PFS) evaluated according EANO-ESMO assessment, disease control rate, concordance CSF safety. A 29 patients enrolled median PFS 10.03 months (95% CI, 6.42-13.64), OS 20.37 14.86-25.88), respectively. ± 35% threshold level change (TML) yielded optimal predictive performance, AUCs 0.890 0.833-0.947), 0.911 0.870-0.951), 0.784 0.717-0.850) response, progression, stable, Most (93.1%) experienced grade 1-2 treatment-related adverse events. Our therapeutic regimen provided practical, survival-extending, tolerant option patients. correlated offering an effective tool monitoring Chinese Clinical Trial Register (ChiCTR) ChiCTR2200057235. Registered on March 1, 2022. Date first patient enrollment: April 29,

Язык: Английский

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Functions of CAFs in microenvironment of non-small cell lung cancer: based on updated hallmarks of cancer

ONCOLOGIE, Год журнала: 2024, Номер 26(5), С. 701 - 709

Опубликована: Сен. 1, 2024

Abstract Non-small cell lung cancer (NSCLC) is the most common subtype of cancer, which ranks as first malignant tumor in mortality. The occurrence and development NSCLC are closely related to microenvironment (TME). Cancer-associated fibroblasts (CAFs) considered be critical regulators NSCLC, have essential effects on multiple biological characteristics NSCLC. hallmarks biology been updated recently, however, there no reviews revisiting function CAFs microenvironment. This article origin, markers, classification CAFs, their impacts potential therapeutic targets help develop individualized treatment plans for

Язык: Английский

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Proteolysis Targeting Chimera Agents (PROTACs): New Hope for Overcoming the Resistance Mechanisms in Oncogene-Addicted Non-Small Cell Lung Cancer

International Journal of Molecular Sciences, Год журнала: 2024, Номер 25(20), С. 11214 - 11214

Опубликована: Окт. 18, 2024

Non-small cell lung cancer (NSCLC) remains a disease with poor prognosis despite the advances in therapies. NSCLC actionable oncogenic alterations represent subgroup of diseases for which tyrosine kinase inhibitors (TKIs) have shown relevant and robust impact on prognosis, both early advanced stages. While introduction powerful TKIs increases ratio potentially curable patients, does develop resistance over time through either secondary mutations or bypass activating tracks. Therefore, new treatment strategies are being developed to overcome this inevitable prevent it, proteolysis targeting chimera agents (PROTACs) among them. They consist two linked molecules that bind target protein an E3 ubiquitin ligase causes ubiquitination degradation proteins interest. In paper, we review rationale PROTAC therapy current development PROTACs oncogene-addicted cancer. Moreover, critically analyze strengths limitations promising technique may help pave way future perspectives.

Язык: Английский

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