Background: While video-assisted thoracoscopic surgery (VATS) has emerged as the standard surgical approach for non-small cell lung cancer, its role in managing resectable small cell lung cancer (SCLC) remains controversial. Methods: We conducted a retrospective analysis of patients with SCLC undergoing lobectomy at our institution between November 2005 and November 2021. Prospectively maintained clinical data were analyzed using 1:1 propensity score matching to balance baseline characteristics. Survival outcomes were evaluated through Kaplan-Meier estimates and multivariable Cox regression analyses. Results: Among 178 eligible patients (VATS: 93, open: 85), 43 matched pairs demonstrated effective covariate balance. VATS was associated with significantly reduced intraoperative blood loss (66.97 f 32.74 mL vs. 158.48 f 158.25 mL, P = 0.002) and higher lymph node station yield (6.00 f 1.72 vs. 5.07 f 2.16, P = 0.035). The median follow-up time was 51.9 months. Survival analysis revealed no statistically significant differences in overall survival (hazards ratio [HR], 0.916, 95 % confidence interval [CI], 0.492-1.707; P = 0.783) and disease-free survival (HR, 0.836, 95 % CI, 0.460-1.519; P = 0.556) between the VATS and open lobectomy groups. Subgroup analysis suggested a non-significant trend toward improved overall survival with VATS compared to open lobectomy in patients with pT1-stage SCLC (HR, 0.292, 95 % CI, 0.061-1.387; P = 0.122). Conclusions: Compared to open lobectomy, VATS demonstrated superior perioperative outcomes and achieved comparable long-term oncological outcomes in patients with resectable limited-stage SCLC. Prospective multi-center studies with larger cohorts are warranted to validate these findings. (c) 2026 Asian Surgical Association and Taiwan Society of Coloproctology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/).

Importance Perioperative immunotherapy has improved clinical outcomes for patients with early-stage non–small cell lung cancer (NSCLC). The influence of immune checkpoint inhibitor in combination with chemotherapy on surgical outcomes remains to be explored. Objective To evaluate perioperative toripalimab in combination with chemotherapy on surgical outcomes. Design, Setting, and Participants This multicenter, double-blind, placebo-controlled phase 3 randomized clinical trial (Neotorch study) enrolled patients with resectable stage III NSCLC and took place at 50 centers in China. Patients who had histologically confirmed resectable stage IIIA or IIIB NSCLC were eligible. These data were analyzed from July 2024 to March 2026. Interventions Patients were randomized (1:1) to receive toripalimab (240 mg) plus platinum-based chemotherapy or placebo plus platinum-based chemotherapy for 3 cycles before surgery and 1 cycle after surgery, followed by maintenance with toripalimab or placebo alone for 13 cycles. Main Outcomes and Measures Surgical outcomes, including perioperative complications, tumor downstaging, and lymph node downstaging, and their association with event-free survival (EFS), were studied in this post hoc analysis. Results Among 404 patients enrolled, 314 patients (median [SD] age 60 [6.82] years; 90% of patients were male and 10% were female) underwent surgery (166 in toripalimab group and 148 in placebo group). Percentage of patients canceling surgery (17.8% vs 26.7%; P = .03) was significantly lower in the toripalimab group. Proportions of minimally invasive surgery, R0 resection, and lobectomy were slightly higher in the toripalimab group. Surgical complications were similar between the 2 groups. Rates of postsurgery tumor (80.7% vs 50.7%; P < .001) and lymph node downstaging (67.5% vs 48.6%; P = .001) were both significantly higher with toripalimab than placebo. With a median follow-up of 18.3 months, a better EFS was noticed in the toripalimab group. Tumor and lymph node downstaging in the toripalimab group were both associated with better EFS than nondownstaging (median EFS, not estimable [NE] vs 17.5 months; P = .004 and NE vs 19.2 months; P = .001, respectively), and were also associated with even better EFS than tumor and lymph node downstaging in the placebo group (median EFS, NE vs 22.0 months; P = .002 and NE vs NE; P = .009, respectively). Conclusions and Relevance In this study, perioperative toripalimab plus chemotherapy showed comparable perioperative outcomes, as with chemotherapy alone without new safety signals, and could help improve survival through effective tumor downstaging in patients with resectable stage III NSCLC. Trial Registration ClinicalTrials. gov Identifier: NCT04158440

The evolution of drug-tolerant persister (DTP) cells into resistant clones remains a major clinical obstacle to targeted therapies. Transcriptomic profiling across melanoma (A375, SK-MEL-28), non-small cell lung cancer (NSCLC; HCC827, PC-9), and colorectal cancer (CRC; SW480) models revealed a conserved biphasic telomerase regulation during DTP evolution. Combining targeted therapies with the telomere dysfunction-inducing agent 6-thio-dG effectively suppressed DTP outgrowth and resistance in vitro and in vivo. Mechanistically, 6-thio-dG induces telomere dysfunction-driven chromatin remodeling, which reduces the accessibility of the SUCLG2 locus to transcription factors. The subsequent downregulation of this mitochondrial enzyme severely disrupts the metabolic stability required for DTP survival. Consistently, SUCLG2 knockdown recapitulated these therapeutic effects. Furthermore, bulk RNA sequencing (RNA-seq) of HCC827 xenograft-derived samples confirmed that this combination therapy coordinately suppresses mitochondrial metabolism, telomere maintenance, and persister transcriptional programs. Collectively, preemptively combining 6-thio-dG with targeted therapies offers a potent strategy to disrupt DTP evolution and overcome adaptive resistance across diverse malignancies.

SMARCA4-deficient thoracic undifferentiated tumor is a rare and highly aggressive subtype of lung cancer defined in the 2021 World Health Organization classification. Its scarcity and highly undifferentiated histology limit the availability of representative in vitro models and hinder therapeutic development. In this study, we established a novel cell line, TRI-LC21, from the primary tumor of a patient with lung cancer showing pathological features consistent with this entity. TRI-LC21 exhibited stable proliferation, strong colony-forming ability, and robust tumorigenicity in subcutaneous xenograft models. Xenograft tumors recapitulated the histological features and immunophenotype of the original tumor. Cell line authenticity was confirmed by short tandem repeat profiling, and mycoplasma contamination was excluded. Whole-exome sequencing revealed SMARCA4 loss accompanied by co-mutations in TP53, STK11, RBM10, and ARHGAP35. Transcriptome analysis demonstrated decreased expression of epithelial-associated genes and increased expression of stemness- and plasticity-related programs, consistent with an undifferentiated phenotype. Collectively, TRI-LC21 faithfully recapitulates the histological, immunophenotypic, and molecular characteristics of this tumor type and provides a valuable in vitro model for mechanistic investigation and preclinical studies.

Background:The prognostic value of lepidic pattern in small stage I lung adenocarcinoma (LUAD) with pathological high-risk features remains unclear. This study evaluated whether lepidic pattern was associated with improved survival outcomes in this pathologically high-risk population. Methods:Consecutive patients with surgically resected stage I invasive LUAD measuring ≤3 cm at West China Hospital, Sichuan University, between January 2018 and April 2025 were retrospectively reviewed. Patients with at least one pathological high-risk feature were included and stratified according to the presence or absence of lepidic pattern. Recurrence-free survival (RFS) and overall survival (OS) were compared before and after propensity score matching. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results:A total of 1,233 patients were included, including 412 without lepidic pattern and 821 with lepidic pattern. After 1:1 propensity score matching, 315 matched pairs were generated. The median follow-up duration was 44 months. In the overall cohort, patients with lepidic pattern had better RFS than those without lepidic pattern, with 3-year RFS rates of 96.8% and 87.0%, respectively, and estimated 5-year RFS rates of 94.0% and 81.9%, respectively (HR, 0.42; 95% CI: 0.25-0.70; P<0.001). This association persisted after matching, with 3-year RFS rates of 96.3% and 86.6%, respectively, and estimated 5-year RFS rates of 92.2% and 81.2%, respectively (HR, 0.37; 95% CI: 0.20-0.69; P=0.001). In multivariable analysis, lepidic pattern remained independently associated with improved RFS (adjusted HR, 0.42; 95% CI: 0.25-0.70; P=0.001). OS was not significantly associated with lepidic pattern after matching or multivariable adjustment. Conclusions:Lepidic pattern was independently associated with improved RFS, but not OS, in patients with pathologically high-risk small stage I LUAD. Lepidic pattern may serve as a complementary histologic marker for postoperative recurrence risk stratification.

Background:The optimal volume for pleural lavage during lung cancer surgery remains controversial, despite its recognized importance in thoracic cavity decontamination, tumor cell clearance, and prevention of postoperative complications. This study assessed the impact of varying lavage volumes on perioperative outcomes in non-small cell lung cancer (NSCLC) patients, with the objective of establishing evidence-based procedural guidelines. Methods:Participants underwent lobectomy for NSCLC were randomly assigned to receive either 1,000 or 250 mL of pleural lavage before chest closure. The primary outcome was overall fever rates, and secondary outcomes included complication rates, drainage parameters, and length of hospital stay. Results:A total of 415 patients were screened, and 406 were randomized to either the 1,000 mL (n=206) or 250 mL (n=200) groups. Postoperative fever (≥37.3 ℃) occurred in 23.08% of the 1,000 mL group and 17.01% of the 250 mL group (P=0.17). The fever rates at ≥38 ℃ were similar between groups (5.13% vs. 4.12%, P=0.82). A temporal difference in fever progression was observed, with the 1,000 mL group peaking 24 hours earlier on postoperative day 1 (POD1) evening, while the 250 mL group peaked on POD2 evening. Postoperative pneumonias were comparable (1.54% vs. 1.55%, P>0.99) between groups. Surgery duration, drainage volume, and cost were slightly more favorable in the 250 mL group, though not statistically significant. Conclusions:A volume of 250 mL pleural lavage demonstrated comparable efficacy to 1,000 mL in controlling postoperative fever and complications, while showing trends toward reduced resource utilization (shorter surgery duration, lower drainage volume and cost). Trial Registration:The trial protocol was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR1900021950) before patient enrollment.

The molecular heterogeneity of brain metastases hampers therapeutic development for cures. To address this unmet and urgent need, we construct a comprehensive multi-omic, single cell, and spatially resolved atlas of 1,032 pan-cancer brain metastases, identifying four robust molecular subtypes with distinct biological programs and clinical associations. These brain metastases subtypes (BrMS) are defined by unique biological states: neural-like (BrMS1), metabolic (BrMS3), highly proliferative/immune-excluded (BrMS4), and an immune-infiltrated (BrMS2) state featuring a coordinated epithelial-mesenchymal transition program. Patient-derived organoids coupled with targeted drug screening indicate subtype-specific molecular dependencies and putative targets, notably mTOR signaling activation in BrMS3 and CDK4/6 axis activation in BrMS4, while BrMS1 and BrMS2 display distinct radiobiologic and immunologic signatures. This atlas provides a rigorous classification framework of BrMs and offers insights into subtype-specific molecular vulnerabilities. The molecular heterogeneity of brain metastases (BrMs) poses challenges for their treatment. Here, the authors generate a multi-omic, single cell, and spatially resolved atlas of 1,032 pan-cancer BrMs and identify four molecular subtypes with distinct biological and clinical features.

Background: In China, lung cancer remains a major public health concern and accounts for a substantial proportion of cancer-related deaths nationwide. However, limited research has examined public perceptions of lung cancer in the digital sphere, where health-related information is increasingly disseminated and accessed. Objective: This study aims to systematically examine patterns of public attention and perceptions toward lung cancer in China by integrating search engine query data and social media content, thereby enhancing current understanding of web-based health information dynamics related to lung cancer. Methods: Data were collected from Baidu Index (BI) (2011-2025) and Sina Weibo (2010-2025) to represent web-based search behavior and social media discourse on lung cancer, respectively. Spatiotemporal patterns of BI, per capita Baidu Index (PBI), and Weibo posts were examined to capture temporal trends and spatial variations. Additionally, the spatial autocorrelation of PBI was assessed using global and local Moran I statistics. PBI-related explanatory variables were assessed using a spatial panel Durbin model. Topic modeling and lexicon-based sentiment analysis were applied to Weibo content to uncover thematic evolution and emotional polarity across years, sex/organization groups, and user types. Results: Public attention toward lung cancer, as reflected by BI, increased initially, peaked in 2019, and subsequently declined, whereas Weibo discussions demonstrated a fluctuating but generally upward trend before stabilizing after 2022. Similar temporal patterns were observed across most provinces. Significant spatial heterogeneity was identified, with higher BI levels concentrated in eastern coastal regions and persistently lower levels in western and southwestern provinces. Spatial autocorrelation analysis revealed stable positive clustering over time, with low-low clusters particularly concentrated in southwestern regions such as Guangxi, and no significant high-high clusters were detected. Panel spatial regression analyses indicated that the provincial PBI was positively associated with gross domestic product (GDP) per capita and average years of education per capita, but negatively associated with the urbanization rate. Moreover, significant spatial spillover effects were observed, suggesting that socioeconomic factors were associated not only with local public attention but also with that of neighboring regions. Topic modeling revealed a clear thematic evolution over time. Although personal experiences initially dominated web-based discourse, discussions progressively shifted toward health care service-related issues, which became the most prominent theme by 2025. Sentiment analysis indicated an overall positive emotional tone throughout the study period, with "Good" and "Disgust" representing the predominant positive and negative emotions, respectively. Emotional expression varied across demographic groups and user types, with noticeable differences in both intensity and temporal trends. Conclusions: This study offers a comprehensive overview of public attention and discourse on lung cancer in China's digital landscape, providing valuable evidence to inform targeted health communication and policy interventions.

Importance:Perioperative immunotherapy has improved clinical outcomes for patients with early-stage non-small cell lung cancer (NSCLC). The influence of immune checkpoint inhibitor in combination with chemotherapy on surgical outcomes remains to be explored. Objective:To evaluate perioperative toripalimab in combination with chemotherapy on surgical outcomes. Design, Setting, and Participants:This multicenter, double-blind, placebo-controlled phase 3 randomized clinical trial (Neotorch study) enrolled patients with resectable stage III NSCLC and took place at 50 centers in China. Patients who had histologically confirmed resectable stage IIIA or IIIB NSCLC were eligible. These data were analyzed from July 2024 to March 2026. Interventions:Patients were randomized (1:1) to receive toripalimab (240 mg) plus platinum-based chemotherapy or placebo plus platinum-based chemotherapy for 3 cycles before surgery and 1 cycle after surgery, followed by maintenance with toripalimab or placebo alone for 13 cycles. Main Outcomes and Measures:Surgical outcomes, including perioperative complications, tumor downstaging, and lymph node downstaging, and their association with event-free survival (EFS), were studied in this post hoc analysis. Results:Among 404 patients enrolled, 314 patients (median [SD] age 60 [6.82] years; 90% of patients were male and 10% were female) underwent surgery (166 in toripalimab group and 148 in placebo group). Percentage of patients canceling surgery (17.8% vs 26.7%; P = .03) was significantly lower in the toripalimab group. Proportions of minimally invasive surgery, R0 resection, and lobectomy were slightly higher in the toripalimab group. Surgical complications were similar between the 2 groups. Rates of postsurgery tumor (80.7% vs 50.7%; P < .001) and lymph node downstaging (67.5% vs 48.6%; P = .001) were both significantly higher with toripalimab than placebo. With a median follow-up of 18.3 months, a better EFS was noticed in the toripalimab group. Tumor and lymph node downstaging in the toripalimab group were both associated with better EFS than nondownstaging (median EFS, not estimable [NE] vs 17.5 months; P = .004 and NE vs 19.2 months; P = .001, respectively), and were also associated with even better EFS than tumor and lymph node downstaging in the placebo group (median EFS, NE vs 22.0 months; P = .002 and NE vs NE; P = .009, respectively). Conclusions and Relevance:In this study, perioperative toripalimab plus chemotherapy showed comparable perioperative outcomes, as with chemotherapy alone without new safety signals, and could help improve survival through effective tumor downstaging in patients with resectable stage III NSCLC. Trial Registration:ClinicalTrials. gov Identifier: NCT04158440.

With the accelerating population aging, the number of older adult patients with lung cancer continues to increase. These patients often present with multiple chronic diseases and geriatric syndromes, resulting in more complex perioperative management and significantly increased surgical risks. This guideline was developed and reported on the basis of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system and the Reporting Items for Practice Guidelines in Healthcare (RIGHT) checklist. Focusing on 28 key clinical issues commonly encountered among older adults with lung cancer, such as frailty, malnutrition, and falls, a total of 55 recommendations were formulated. This guideline aims to provide standardized perioperative management strategies through comprehensive geriatric assessment, comorbidity management, and early identification and intervention for complications to reduce the incidence of postoperative complications and improve patients' quality of life.

OBJECTIVES:Non-small cell lung cancer (NSCLC) with pleural dissemination is categorized as stage IV (M1a) and traditionally deemed a contraindication for surgical intervention. This study aimed to explore the potential role of surgery in NSCLC patients with isolated pleural dissemination. METHODS:Patients who either underwent primary tumour resection (PTR) or received only pleural nodules biopsy were included for analysis from the Western China Lung Cancer (WCLC) database (2005-2021) and Surveillance, Epidemiology, and End Results (SEER) database (2010-2015). Survival curves were generated using the Kaplan-Meier method, with significance assessed by the log-rank test. RESULTS:A total of 289 patients (261 PTR and 28 biopsy only) from the WCLC cohort and 2232 patients (278 PTR and 1954 biopsy only) from the SEER cohort were identified for analysis. In both cohorts, patients who underwent PTR showed significantly better outcomes compared to those who received only pleural nodules biopsy, with the 5-year survival rates of 28.3% versus 5.0% in the WCLC cohort (P < .0001) and 30.5% versus 7.4% in the SEER cohort (P < .0001). Subgroup analysis indicated that PTR significantly improved survival in patients without malignant pleural effusion, regardless of tumour size and T stage. Furthermore, anatomic lobectomy with systematic lymph node dissection was associated with better overall survival than partial resection or lobectomy plus lymph node sampling (P = .008). CONCLUSIONS:NSCLC patients with isolated pleural dissemination may represent an M1a subgroup in whom PTR is associated with longer survival, particularly in the absence of malignant pleural effusion.

The health effects of climate change are increasingly recognized, but its role in cancer remains insufficiently explored. We aimed to conduct a systematic spatiotemporal analysis to investigate the association between climatic indicators and cancer incidence of all neoplasms as well as major cancer subtypes. We assessed associations between 17 climatic indicators and incidence of all neoplasms and 34 specific cancer subtypes across 204 countries and territories from 1990 to 2021. Region-level data were analyzed using cross-correlation functions (CCF) and Granger causality analysis (GCA) to identify potential directional and lagged associations, with uncertainty addressed through meta-analytic pooling, multiple-testing correction, evaluation across multiple lag structures, and sex-stratified analyses. Global Moran’s I index with Monte Carlo permutation testing was applied to evaluate spatial clustering of significant GCA results. Our analyses revealed complex and dynamic global trends of climatic indicators and cancer incidence rates, with pronounced spatial variability. The CCF and GCA analyses demonstrated mild-to-moderate lagged associations between climatic indicators and cancer incidence, with an average predominant lag of four to five years. Among 595 climate-cancer pairs, GCA identified 105 significant associations, with air pollution (nitrogen dioxide [NO2], fine particulate matter [PM2.5], and ambient ozone pollution) emerging as the category most frequently associated with cancer incidence, while additional associations were found for vapor pressure deficit (VPD), wind speed, and other indicators. Moreover, sex-specific differences and spatial clustering of significant regions were observed. This study provided a panoramic overview of climate–cancer linkages across all neoplasms and 34 cancer subtypes, offering valuable insights into the delayed associations between climate-related indicators and cancer incidence and highlighting the need for sustained attention and climate-informed policy action.

Background:The detection of multiple pulmonary nodules (MPNs) has increased significantly, yet evidence regarding the safety of simultaneous resection using video-assisted thoracoscopic surgery (VATS) remains limited. This study evaluated treatment-requiring postoperative pulmonary complications (PPCs) and procedure-specific risk factors after VATS-based simultaneous resection for MPNs, with particular attention to combined anatomical resections and segmentectomy-related anatomy. Methods:Lung cancer patients with a dominant tumor ≤3 cm who underwent synchronous thoracoscopic resection between December 2008 and October 2020 were retrospectively reviewed. The primary endpoint was treatment-requiring PPCs, defined as Clavien-Dindo grade ≥II. Multivariable logistic regression was used to identify factors associated with treatment-requiring PPCs. Subgroup and supplementary analyses evaluated resection combinations, basal segment involvement, segmentectomy complexity, surgery period, and complication severity. Results:Among 1,052 patients, treatment-requiring PPCs occurred in 14.0% of patients, with no perioperative mortality. Impaired pulmonary function [forced expiratory volume in 1 second (FEV1%) less than 80%; adjusted odds ratio (aOR) =2.76, P=0.002], larger dominant tumor size (aOR =1.35, P=0.03), and the resection of more than two nodules (aOR =1.75, P=0.02) independently increased baseline risks. In the comprehensive analysis, advanced age (≥70 years) (aOR =1.72, P=0.046) and lobectomy involvement (aOR =1.84, P=0.02) were independently associated with treatment-requiring PPCs. For two-nodule cases, combining a lobectomy with a segmentectomy carried the highest risk of treatment-requiring PPCs (aOR =3.19, P=0.007). Basal segment involvement was associated with treatment-requiring PPCs in the segmentectomy cohort (aOR =2.14, P=0.02) and remained associated after additional adjustment for complex segmentectomy. Conclusions:Video-assisted thoracoscopic simultaneous resection of MPNs appears feasible in selected patients, with a low severe PPC rate and no perioperative mortality. Preoperative pulmonary reserve, nodule burden, advanced age, lobectomy involvement, and basal segment involvement in segmentectomy-related procedures should be considered when planning individualized surgical strategies.

Abstract Background: Perioperative A (IgG4 anti-PD-L1 antibody) + chemo showed promising efficacy and favorable safety in resectable NSCLC in the phase 1 part of a phase 1b/3 study (NCT04316364). We now report EFS IA and exploratory MRD results from the double-blind, randomized, phase 3 part. Methods: Patients (pts) with untreated, resectable stage II-III (IIIA/T3N2M0 IIIB) NSCLC per AJCC v8 and without EGFR/ALK alterations were randomized 1:1 to receive 3 cycles of A 20 mg/kg or placebo (PBO) with histology-based platinum-doublet chemo (Q3W), followed by surgery (Sx) and 16 cycles of adjuvant A 20 mg/kg or PBO (Q3W). Primary endpoints were EFS per BICR and MPR per BIPR. MRD was based on tumor-informed assays. A prespecified IA was done at 158 (69.0% of total expected) EFS events. Results: 501 pts were randomized and treated. At data cutoff, median follow-up was 23.6 mo. Perioperative A + chemo significantly improved EFS and MPR vs PBO + chemo (Table 1). Definitive surgery (88.8% vs 83.2%) and pCR (31.1% vs 7.6%) rates also favored A arm. Grade ≥3 AEs related to any study agent occurred in 52.6% in A arm vs 53.6% in PBO arm; of these, all reported in ≥2% with A were hematologic. Among 316 MRD+ pts at baseline (detectable ctDNA), those with pre-Sx ctDNA clearance (CL) in A arm were more likely to achieve MPR (PPV 83.1% vs 48.5%) and pCR (PPV 57.6% vs 21.2%) vs PBO arm. Pre-Sx ctDNA CL was associated with improved EFS in both arms, with a trend toward longer EFS with A vs PBO irrespective of CL (CL: HR 0.85 [95% CI 0.28-2.59]; no CL: HR 0.64 [0.40-1.02]). Pts without post-Sx ctDNA CL (adjuvant C1D1) had poor EFS, with a trend favoring A vs PBO (HR 0.25 [0.08-0.82]). Conclusions: Perioperative A + chemo significantly improved EFS and MPR with manageable safety in resectable stage II-III NSCLC. ctDNA dynamics were prognostic of clinical outcomes, providing a potential tool for refined perioperative risk stratification. Citation Format: Yi-Long Wu, Wen-Zhao Zhong, Li-Xu Yan, Keneng Chen, Wanpu Yan, Yongzhong Luo, Wenxiang Wang, Wenqun Xing, Xiaolong Yan, Lin Wu, Feng Yao, Dongsheng Yue, Naiquan Mao, Yu Qi, Bentong Yu, Jianji Guo, Jindan Kai, Yuejun Chen, Hui Wang, Qin Zhang, Lunxu Liu, Honghai Wang, Yuanyuan Ji, Yongtao Han, Yongxiang Song, Jianjun Xu, Wei Guo, Hongxu Liu, Di Ge, Hecheng Li, XiuJuan Qu, Jifang Yao, Junfeng Liu, Tingyan Zhong, Yanhua Huang, Li Song, Wei Shi. Perioperative adebrelimab (A) plus chemotherapy (chemo) in resectable stage II-III NSCLC: Phase 3 EFS interim analysis (IA) and molecular residual disease (MRD) analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(8_Suppl):Abstract nr CT014.

Background and Objective:Lung transplantation (LTx) remains the only definitive treatment for end-stage lung disease. Throughout 2025, the global transplant community has made notable progress in addressing persistent challenges in the field, ranging from policy-level improvements in graft allocation to deeper biological insights into post-transplant complications. This review aims to synthesize the pivotal literature published in 2025 across four core areas: optimizing allocation, advancing perioperative care, defining the mechanisms of graft injury, and exploring translational frontiers. Methods:We conducted a structured literature search focused primarily on studies published in 2025 that highlight major advancements in LTx. In addition, the search was supplemented with key society guidelines, consensus statements, and relevant early 2026 publications. Selected articles were critically analyzed and categorized into clinical advancements, and basic/translational findings. Key Content and Findings:In clinical research, the refinement of allocation strategies and the expansion of donor criteria, have effectively broadened access. Perioperative management has evolved with the integration of artificial intelligence to predict complications such as primary graft dysfunction (PGD) and chronic lung allograft dysfunction (CLAD). In basic and translational research, studies have dissected the molecular basis of complications. Additionally, new insights into the evolution of drug-resistant pathogens and macrophage plasticity have deepened our understanding of infection and rejection. Conclusions:In 2025, significant progress has been achieved in the field of LTx research. Strategies for clinical donor allocation and perioperative management, along with the understanding of molecular mechanisms underlying complications, have also been greatly improved. These advancements are essential to further optimize outcomes and address the complex challenges in LTx.

Background: Occupational physical workload has been recognized as a potential, yet understudied, determinant of lung cancer and chronic respiratory diseases (CRDs). However, large-scale prospective evidence remains scarce. This study aimed to evaluate the association between occupational physical workload and the incidence of lung cancer, chronic obstructive pulmonary disease (COPD), asthma, and idiopathic pulmonary fibrosis (IPF) in a population-based cohort. Methods: We analyzed data from 221,845 participants in the UK Biobank with complete baseline information on occupational physical workload. Occupational physical workload was derived from three questionnaire items-weekly working hours, standing or walking frequency, and heavy manual work- combined into a composite workload score (range, 0-6) and categorized into low (0-2), medium (3-4), and high (5-6) exposure groups. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for disease incidence, with progressive adjustment for demographic, socioeconomic, and lifestyle factors. Stratified and sensitivity analyses were further conducted. Results: Compared with the low workload group, the high workload group showed significantly increased risks of lung cancer (HR =1.54; 95% CI: 1.23-1.93), COPD (HR =1.45; 95% CI: 1.32-1.58), asthma (HR =1.15; 95% CI: 1.08-1.21), and IPF (HR =1.40; 95% CI: 1.11-1.76). Each one-point increase in workload score was associated with 10%, 11%, 4%, and 11% higher risks, respectively. Conclusions: Occupational physical workload was associated with increased risks of lung cancer and major CRDs in this large prospective cohort. Reducing excessive occupational workload may represent a feasible strategy for preventing respiratory morbidity.