OBJECTIVES:While treatment strategies for non-small cell lung cancer (NSCLC) continue to evolve, the prognostic implications of lymph node metastasis patterns in upper lobe tumours remain inadequately defined. This study investigated whether tumour laterality and specific nodal stations involved in N2a disease correlate with long-term survival in patients undergoing surgical resection for upper lobe NSCLC. METHODS:This retrospective single-centre study included patients with stage I-IIIB upper lobe NSCLC who underwent anatomical resection with systematic lymph node dissection from January 2010 to December 2022. Patients were stratified by tumour laterality and nodal involvement, with specific analysis of N2a subgroups based on lymph node station. Propensity score matching, Kaplan-Meier survival analysis, and log-rank testing were used to compare survival outcomes. RESULTS:Of 3313 patients considered, 2028 met the prespecified inclusion criteria (right: n = 1212; left: n = 816). Mean age was 65.7 ± 9.4 years; 61.7% were male. Median overall survival (OS) was similar for right- and left-sided N0 and N1 tumours. Significant differences emerged among N2a subgroups: Patients with left-sided skip metastases to LN5/6 had markedly improved OS (66.2 ± 14.9 months) versus right-sided LN2/4 (35.3 ± 8.5 months; P = .047). Outcomes of left-sided N2a1 LN5/6 were also more favourable than LN7-9 (37.7 ± 15.2 months; P = .023) and showed better OS than left-sided N1 disease (47.6 ± 4.2 months; P = .284). CONCLUSIONS:Positive nodal station and tumour laterality significantly impact survival in upper lobe NSCLC. Skip metastases to LN5/6 in left-sided tumours were linked to more favourable prognosis and may warrant inclusion in future TNM classification refinements.

INTRODUCTION:Accurate malignancy risk prediction of pulmonary lesions is essential in the context of lung cancer screening and early diagnosis. Widely used risk prediction tools, such as the Brock and Herder models, have shown limited performance in high-risk cohorts referred for bronchoscopic evaluation. The LIONS PREY (lung lesion score predicts malignancy) was specifically developed to provide a simple and reliable estimate of malignancy risk in this clinical setting. This study aimed to externally validate the LIONS PREY model and to compare its predictive performance with the Brock and Herder models in patients undergoing index navigational bronchoscopy for pulmonary lesion evaluation. METHODS:We retrospectively analysed patients who underwent index navigational bronchoscopy for peripheral pulmonary lesions between December 2019 and March 2024 at a tertiary academic centre. Malignancy risk was estimated using the LIONS PREY, Brock, and Herder models. Model performance was assessed via receiver operating characteristic (ROC) analysis and classification accuracy. RESULTS:Among 193 evaluable lesions, 134 (69.4%) were histologically confirmed malignant. Malignant lesions were associated with increased growth dynamics (2.7 ± 4.1 mm vs. 1.0 ± 4.3 mm, p < 0.001) and spiculation (56.0% vs. 23.7%, p < 0.001). The LIONS PREY achieved an area under the ROC curve (AUC) of 0.94, outperforming Herder (AUC 0.72; p < 0.001) and Brock (AUC 0.62; p < 0.001) models. Correct classification rates were highest for LIONS PREY (85.0%) versus Herder (70.3%) and Brock (69.1%) (all p < 0.001). CONCLUSION:The LIONS PREY demonstrated superior predictive accuracy over Brock and Herder in high-risk patients undergoing navigational bronchoscopy, supporting its clinical utility for malignancy risk stratification.

BACKGROUND:Pulmonary metastasectomy (PM) is an established component of multimodal oncological treatment, but its perioperative safety and long-term outcomes in patients with chronic obstructive pulmonary disease (COPD) remain insufficiently defined. We aimed to evaluate the impact of COPD on perioperative morbidity, mortality and long-term survival after PM. METHODS:We retrospectively analysed 692 patients who underwent PM with curative intent. COPD severity was graded using the GOLD spirometric classification. Patients were classified according to their postbronchodilator FEV1/FVC ratio into a COPD group (<0.70) and a control group (≥0.70). Groups were compared regarding clinical and surgical characteristics, postoperative morbidity and mortality, and overall survival (Kaplan-Meier, log-rank). Independent predictors of morbidity and survival were identified via logistic and Cox regression, and a 1:1 propensity-score-matched analysis was performed to account for baseline imbalances. RESULTS:Among 9684 patients, 692 (7.1%) patients underwent PM, of whom 171 (24.7%) had COPD. They were more frequently smokers and had a higher comorbidity burden and worse performance status and, as expected, significantly lower lung function. The main clinically relevant finding was a significantly higher rate of persistent air leak in patients with COPD (8.8% vs. 2.3%, p < 0.001). Overall morbidity and 30-day mortality, however, did not differ. With a median follow-up of 76.7 months, survival was similar between groups (3-year survival 76.5% vs. 78.4%, p = 0.495) and was unaffected by GOLD severity. Independent predictors of worse survival were preoperative systemic therapy (HR 2.18), repeat metastasectomy (HR 1.60) and increasing age (HR 1.02 per year). After propensity matching, survival remained comparable (HR 1.05, p = 0.835). CONCLUSIONS:Among carefully selected patients, COPD was not associated with increased mortality or reduced survival after PM, although persistent air leak was significantly more frequent. COPD alone should not, by itself, be considered a contraindication to curative-intent surgery in appropriately selected patients, and these findings should not be generalized to patients with severe or end-stage COPD.

Background:In the multimodal treatment of pleural mesothelioma (PM), hyperthermic intrathoracic chemotherapy (HITOC) has been investigated as an adjunct to cytoreductive surgery (CRS) to potentially improve local tumor control. The study aimed to evaluate the clinical impact of HITOC as an adjunct to CRS, specifically regarding overall survival (OS), postoperative morbidity and mortality, and operative duration. Methods:This retrospective study compared patients who underwent CRS with HITOC to those without HITOC at our institution between 2010 and 2022. Primary endpoints included OS, operative time, and perioperative morbidity and mortality. Categorical variables were compared using the Fisher's exact test. Survival analyses were performed using the Kaplan-Meier method and compared via the log-rank test. Results:A total of 114 patients underwent CRS for PM, including 14 with HITOC and 100 without. The mean age was 66 years, and 12 patients were female. The mean operative time was longer in the HITOC group (488 vs. 258 minutes). Postoperative morbidity (Clavien-Dindo Grade ≥ III) was significantly higher with HITOC [43 % vs. 10 %, odds ratio (OR) 6.07, 95 % confidence interval (CI): 1.77-20.76, P=0.007], while in-hospital mortality occurred in two patients (1.8 %), one in each group. Median OS was 13 months in the HITOC group vs. 27 months in the non-HITOC group (P=0.03). Conclusions:In this retrospective single-center cohort, adjunctive HITOC was associated with significantly longer operative time, higher postoperative morbidity, and inferior OS compared with cytoreduction alone. Given the small HITOC sample size and potential residual confounding, these findings should be interpreted cautiously but raise concerns regarding the routine use of HITOC outside clinical trials and highlight the need for prospective comparative evaluation.

Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy primarily caused by asbestos exposure. Overthe past decade, treatment strategies have evolved significantly, incorporating advancements in systemic therapies,immunotherapy, and personalized medicine. Multimodality treatment — integrating surgery, systemic therapy, and radiotherapy— may improve outcomes in carefully selected patients. This manuscript provides an overview of currenttreatment modalities for pleural mesothelioma (PM), emphasizing recent developments and emerging therapies.

Background/Objectives: Analysis of the density and spatial distribution of pulmonary infiltrates of patients with high-grade (≥3) pneumonitis after radiochemotherapy and durvalumab consolidation (RT/CTx + IO) was performed in order to define dosimetric hallmarks of the development of infiltrates following this multimodality treatment. Methods: Consecutive patients treated with RT/CTx + IO for stage III NSCLC were retrospectively reviewed with respect to the occurrence of grade ≥ 3 pneumonitis. Lung infiltrates were contoured on follow-up CT scans acquired around the time of maximum pneumonitis expression. The applied dose distribution was overlaid with the follow-up CT using elastic deformation, and infiltrates were binned according to their density in density strata of 50 HU. The dose and density dependence of partial infiltrate volumes per unit lung volume was analyzed using a mixed fixed and random effect model adjusting for patient, density and dose-dependent random effects. Results: Six patients with grade ≥ 3 pneumonitis were identified from 132 patients treated with RT/CT + IO at a comprehensive cancer center. Partial volumes of lung infiltrates captured by follow-up CT with maximum pneumonitis expression ranged from 15.5 to 60.0% (median 39.8%). A significant, systematic dose-response relationship was found for partial lung infiltrate volumes per dose and density bin. A unimodal density distribution of partial lung infiltrate volumes was also found over the infiltrate density range of -1000 to 100 HU. This was determined using a mixed model that adjusted for random effects (p < 0.0001 for both effects, F-test). There was no interaction effect between systematic dose and infiltrate density dependence of the partial infiltrate volumes. The proportion of infiltrate volumes that are attributable to the systematic dose-response relation amounts to a mean of 16.6% of the total infiltrate volume per patient according to this model. Compared to patients with pneumonitis of grade ≤ 2, patients with high-risk pneumonitis had higher partial infiltrate volumes, particularly in the low-dose regions in five grade dose bins up to 20 Gy (AUC = 1.0, p < 0.0001, likelihood-ratio test). Conclusions: Dose-dependent and -independent partial lung infiltrate volumes were found in patients with high-grade pneumonitis after RT/CTx + IO. These results indicate that pneumonitis involves contributions from both radiochemotherapy-induced and immunotherapy-related mechanisms.

Purpose:Image-guided lung biopsies play a key role in diagnosing pulmonary lesions. However, comprehensive safety and efficacy data remain limited. As lung screening expands across Europe, more indeterminate nodules require histologic clarification. This study evaluates technical success, diagnostic yield, and complications based on registry data from the German Society for Interventional Radiology and Minimally Invasive Therapy (DeGIR). Materials and Methods:A total of 27559 image-guided lung biopsies from 212 centers (2018-2024) were analyzed. Technical success was defined as verified needle placement and diagnostic yield as adequate histological sampling. Complications were classified by the Society of Interventional Radiology (SIR) criteria. Results:Most biopsies (95.9%) were inpatient. Local anesthesia was used in 97.5% of cases. CT guidance was used in 99.4% of cases. Technical success was 97.7%, and the diagnostic yield was 94.3%. Inpatient procedures showed slightly higher technical success rates (97.8% vs. 96.8%, p = 0.032), while the diagnostic yield was similar (94.3% vs. 92.9%, p = 0.063). Overall complications occurred in 19.4% of cases, major complications in 4.9% of cases and mortality in 0.06%. Coagulation disorders increased risk. Conclusion:Image-guided lung biopsies are effective, with high success and diagnostic yield. However, complication rates were substantial, with nearly 20% overall and 5% major events. Careful patient selection and individualized risk stratification are essential to optimize procedural safety. Key Points:· High technical success (97.7%) and diagnostic yield (94.3%). · Complications occur in 19.4% of procedures with major events in 4.9%. · Careful patient selection and risk stratification are essential. Citation Format:· Ocker-Serger RJ, Opitz MK, Buescher E etal. Effectiveness and Safety of Percutaneous Image-Guided Lung Biopsies: Analysis of 27559 Procedures from the German Society for Interventional Radiology and Minimally Invasive Therapy Registry. Rofo 2026; DOI 10.1055/a-2832-8029.

INTRODUCTION:Young adults are a minority of lung cancer (LC) patients, however, clinical presentation and cancer biology can differ. Here, we report the first German cohort study of young adults with LC. METHODS:We included patients diagnosed with LC between 2019 and 2023 at the West German Cancer Centre (University Medicine Essen) in this retrospective cohort study. For analysis of clinicogenomic baseline characteristics and overall survival (OS), patients were stratified by age at diagnosis into a young cohort (YC; n = 56, ≤45 years), an older cohort (OC; n = 2.682, >45 years) and analysed across age decades. RESULTS:71 of 2.738 patients with LC (2.59 %) were ≤ 45 years old. 56/71 were diagnosed with NSCLC or SCLC. YC frequently reported no history of smoking (21 % vs. 6 %; p < 0.001). Among YC, adenocarcinoma (59 % vs. 49 %) and NSCLC not-otherwise-specified (NSCLC NOS; 27 % vs. 8.2 %) were the dominant histological subtypes (p < 0.001). Stage IV disease was significantly more common in YC (stage IV: 66 % vs. 44 %; p = 0.005) with more frequent regional lymph node involvement (N1-N3 79 % vs. 56.9 %) and extrathoracic lymph node metastases (38 % vs. 14 %; p < 0.001). Frequent targetable genomic alterations in YC included ALK translocations (21 % vs. 2.2 %; p < 0.001). YC with metastatic NSCLC had similar median OS compared to OC, although OS was improved in those with targetable alterations. CONCLUSION:Early-onset LC is characterized by advanced disease stage, adenocarcinoma histopathology and frequent targetable genomic alterations, especially in patients without a history of smoking. Early diagnosis remains a critical unmet medical need in this subgroup of patients.

Evaluation of interim-[18F]FDG-PET/CT as a prognostic tool in limited disease small cell lung cancer (SCLC). We included 35 patients with limited disease SCLC from a prospective institutional registry in this retrospective study. Patients received induction chemotherapy (3–4 cycles) followed by concurrent radiochemotherapy. Baseline [18F]FDG-PET/CT was performed before or shortly after start of induction chemotherapy, interim PET/CT was acquired during late induction or concurrent chemoradiotherapy. Maximum standardized uptake value (SUVmax), metabolic target volume (MTV), and total lesion glycolysis values (TLG) were determined. An exponential decay model with an asymptotic offset was used to describe treatment response over time. Deviations > 2 standard deviations (SD) above model-predicted means after day 30 were considered poor response. Progression-free survival (PFS) was analyzed. All patients underwent twice-daily radiotherapy to a base dose of 45 Gy. SUVmax showed greater inter-patient variability than MTV. Poor treatment response was observed in 17

BACKGROUND:Preoperative immunotherapy targeting PD-1/-L1 with chemotherapy induces histopathological responses and improves survival in patients with resectable non-small cell lung cancer (NSCLC). NEOpredict-Lung (NCT04205552) established the feasibility of dual blockade of PD-1 and LAG-3 immune checkpoints prior to curatively intended resection. Here we report extended follow-up, postoperative treatments and patterns of response and recurrence. PATIENTS AND METHODS:Patients with resectable NSCLC (stages IB-IIIA) were randomized to receive two doses nivolumab (240 mg, arm A) with or without relatlimab (80 mg, arm B) every 2 weeks. Overall and disease-free survival (OS, DFS) rates, response and recurrence patterns and subsequent therapies were evaluated. RESULTS:60 patients were enrolled from March 2020 to July 2022. The present analysis was conducted per December 2024 with a median follow-up of 37.4 months. 45 patients were alive without disease recurrence,15 patients recurred (4 locoregional and 11 metastatic), and 7 patients died. The 3-year OS and DFS rates were 88.4 % and 73.3 % in arm A and 88.9 % and 60.3 % in arm B. Patients achieving major pathological response (≤10 % viable tumor cells in resected NSCLC) trended towards better DFS (HR 0.35; 95 % CI, 0.1-1.19). Downstaging was confirmed in 53.3 % of patients in arm A and in 66.7 % of patients in arm B. Nodal downstaging occurred in 28.6 % of patients with nodal disease in arm A and in 66.7 % of patients in arm B. CONCLUSIONS:Short course preoperative nivolumab with or without relatlimab showed encouraging efficacy and survival outcomes, which compare favorably with chemo-immunotherapy-based perioperative treatment regimens.

Expression of BCL-B, an anti-apoptotic BCL-2 family member, is correlated with worse survival in lung adenocarcinomas. Here, we show that BCL-B can mitigate cell death initiation through interaction with the effector protein BOK. We found that this interaction can promote sublethal mitochondrial outer membrane permeabilization (MOMP) and consequently generate apoptosis-flatliners, which represent a source of drug-tolerant persister cells (DTPs). The engagement of endothelial-mesenchymal-transition (EMT) further promotes cancer cell invasiveness in such DTPs. Our results reveal that BCL-B fosters cancer cell aggressiveness by counteracting complete MOMP.

Objectives: While the treatment of non-small-cell lung carcinoma has improved rapidly, the treatment of pulmonary large-cell neuroendocrine carcinoma (LCNEC) remains underdeveloped. The use of immunohistochemistry allows for accurate risk stratification. With our study, we investigated the outcome of patients with pulmonary LCNEC and analyzed whether CK7 correlates with long-term survival. Methods: We retrospectively collected the monocentric data of patients which underwent anatomical resection for lung cancer between January 2012 and December 2020. Patients that did not show pulmonary LCNEC or adenocarcinoma, had a positive resection margin, or underwent neoadjuvant therapy were excluded. The long-term survival rate of the LCNEC and adenocarcinoma groups were compared before and after propensity score matching. Furthermore, we performed survival analyses for a subgroup of LCNEC distinguished by CK7 expression, followed by Cox regression analyses. Results: A total of 466 patients were integrated for further analysis. The mean age was 65.3 ± 9.6 years. There were no significant differences between both groups regarding age, gender, or comorbidities. In terms of the UICC stage, the groups were equally distributed. Mean survival in the LCNEC group was significantly worse than in the adenocarcinoma group (LCENC: 36.4 ± 7.5 months; adenocarcinoma: 80.7 ± 8.1 months; p-value = 0.001). The mean survival rate was 19.23 ± 4.8 months in the CK7 expression group and 57.01 ± 8.5 months in the group without expression, which reached statistical significance (p-value = 0.019). Conclusions: Our study suggests that pulmonary LCNEC has a significantly worse prognosis than pulmonary adenocarcinoma. CK7 expression seems to be correlated with a worse outcome for the long-term survival rate of patients suffering from highly malignant pulmonary LCNEC.

Introduction: Nodal involvement is one of the most important prognostic factors in NSCLC. Skip-N2 metastasis (N0N2), which is N2 metastasis in the absence of N1 metastasis, occurs in approximately 20–30% of patients. According to the International Association for the Study of Lung Cancer, N1 and N0N2 patients may have comparable long-term survival, considering their similar tumor stages. However, this conclusion remains controversial. Therefore, we carried out this multicenter study to examine the long-term survival and disease-free interval (DFI) of N0N2- and N1 patients. Methods: One-, three-, and five-year survival rates were measured. Kaplan–Meier curves and a Cox proportional hazards model assessed survival and were used to identify prognostic factors for overall survival. Results: Between January 2010 and December 2020, 273 N0N2 and N1 patients were included in our analysis. Of those patients, 77 showed N0N2 and 196 N1. Baseline characteristics did not differ significantly between groups. Between N0N2 and N1 patients, there were no significant differences in one- (p = 0.67), three- (p = 0.20), and five-year (p = 0.27) survival. Furthermore, DFI did not differ between groups (p = 0.45). Conclusions: Our findings indicate that N0N2 patients have a prognosis comparable to that of patients with N1 disease. These results indicate that patients with N0N2 have a similar prognosis to N1 patients. N2-NSCLC is heterogeneous and would benefit from a more precise subdivision and differential treatment in the upcoming UICC 9 classification. The following question remains: are we overtreating N0N2 patients or undertreating N1 patients?

Background Immunotherapies targeting the programmed death receptor-1/programmed death ligand-1(PD-1/PD-L1) checkpoint have a major impact on the treatment of both resectable and advanced non-small cell lung cancer (NSCLC). Additional blockade of the T-cell immunoreceptor with immunoglobulin and immunoreceptor tyrosine-based inhibition motif domain (TIGIT)-receptor may synergistically foster the immune-related response. Several trials are currently investigating the combination of neoadjuvant platinum-based chemotherapy and dual checkpoint inhibition prior to curative surgery. The investigator-initiated NeoTRACK trial (EU CT number: 2022-501322-38-00; ClinicalTrials.gov identifier: NCT05825625; IKF056) aims to evaluate the feasibility and safety of perioperative anti-PD-L1 (by atezolizumab) and anti-TIGIT (by tiragolumab) treatment in combination with chemotherapy in patients with early stage NSCLC.Methods and analysis NeoTRACK is an open-label, single-arm, prospective, bicentric phase II trial. Patients with NSCLC in clinical stages II, IIIA and IIIB (only T3N2) will receive two cycles of standard platinum-based chemotherapy in combination with the anti-TIGIT antibody tiragolumab and the anti-PD-L1 antibody atezolizumab, followed by curative surgery. After surgery, patients without pathological complete response (pCR) will receive another two cycles of chemotherapy in combination with tiragolumab and atezolizumab, followed by tiragolumab/atezolizumab maintenance for up to 1 year (maximum 16 cycles). Patients with pCR will only receive dual immunotherapy. All patients will be followed-up for 30 months after the last study treatment. The clinical study will be aligned with a translational research programme to investigate treatment-naïve tumour tissues, surgical specimens and longitudinally collected blood samples. 35 patients are planned for enrolment. Patient recruitment started in August 2023, and treatment of the last patient is estimated to start 2.5 years thereafter.Discussion The NeoTRACK trial aims to assess the feasibility and efficacy of combining tiragolumab and atezolizumab as both neoadjuvant and adjuvant therapies in patients with resectable NSCLC. The concept of treatment personalisation based on postoperative pCR is of great clinical interest.Ethics and dissemination The trial obtained ethical and regulatory approval in Germany through the Clinical Trials Information System (CTIS, ID: 2022-501322-38-00) and the Paul Ehrlich Institute (PEI, competent authority for approval of clinical trials using medicinal products for human use in Germany, process number: PB00148) on 30 March 2023. A data safety and monitoring board will meet regularly to review ongoing treatment in terms of safety.Study results will be published in peer-reviewed journals, presented at conferences and in the public registry of CTIS, following trial completion.Trial registration number NCT05825625.

Sarcomas are a heterogeneous group of rare and aggressive malignancies and have a propensity to metastasize to the thoracic cavity. While sarcoma lung metastasectomy is an established modality, only scarce information is available about potential prognostic factors for sarcoma patients with pleural dissemination. Accordingly, all consecutive sarcoma patients treated at our thoracic surgery department between 2010 and 2023 with pleural sarcomatosis and/or malignant pleural effusion were retrospectively analyzed. Preoperative circulating biomarker values were collected at the time of first pleural involvement. Overall survival was calculated from the first sarcoma diagnosis as well as from the first diagnosis of pleural dissemination. 98 patients (42 female) were included in the cohort with a median age of 54.6 years (range: 15.9–84.3 years) at the time of pleural involvement. 77 patients had soft tissue sarcoma, while 21 patients had primary sarcoma in the bone including 4 chondrosarcoma. Among the 19 different sarcoma types, synovial sarcoma (13%), liposarcoma (11%), undifferentiated pleomorphic sarcoma (11%), Ewing (like) sarcoma (10%) and leiomyosarcoma (9%) were the most frequent. Pleural dissemination was mostly metachronous, while only 7 cases were synchronous. The median pleural dissemination-free interval was 17.1 months after sarcoma diagnosis. The median overall survival after pleural dissemination was 12 months. WBC values outside the normal range had no significant impact on overall survival. High LDH (>250 U/L) and CRP (>1 mg/dL) conferred significantly lower overall survival (8.6 months vs. 19.1 months (p < 0.0001) and 4.9 months vs. 29 months (p < 0.0001), respectively). Albumin alone showed no prognostic impact, however, the modified Glasgow prognostic score (0, 1, and 2) was a strong prognosticator (20.4 vs. 8.6 vs. 1.7 months (p < 0.0001). In a multivariable analysis, CRP remained a significant prognostic factor. In conclusion, routine circulating biomarkers carry prognostic information for sarcoma patients with pleural dissemination and should be considered for risk stratification and personalized therapeutic decisions.

Objectives: Pleural mesothelioma (PM) is a rare cancer that often develops after a decades-long latency period and confers a grim prognosis. Novel, biomarker-based therapeutic modalities are expected to improve the outcome of patients with advanced PM. CUDC-907 (fimepinostat) is a dual inhibitor that affects both histone deacetylases and PI3K enzymes. Its antitumor activity was described in several cancer types, but it has not yet been explored in PM. Materials and Methods: The sensitivity of 22 PM cell lines—including 18 models established in our laboratory—to cisplatin and CUDC-907 was determined using a cell viability assay. BAP1, PTEN, and c-Myc expression, as well as MYC copy number variation, were measured. The effect of combination treatment with cisplatin was assessed with cell viability, cell cycle, and 3D spheroid formation assays. Results: Most PM cell lines were sensitive to CUDC-907 treatment, and the CUDC-907 response was significantly higher in cell lines with higher c-Myc expression due to MYC copy number gain or amplification. Importantly, all cisplatin-insensitive cell lines were sensitive to CUDC-907. Combination treatment with cisplatin synergistically decreased cell viability and induced G2/M arrest or cell death. We tested cisplatin-sensitive P31WT and cisplatin resistant P31cis isogeneic pair and found that in both 2D and 3D assays the cisplatin-resistant cells showed a higher sensitivity to CUDC-907 single treatment. Combining CUDC-907 with cisplatin further decreased cell growth even in cisplatin-resistant cells. Conclusions: The majority of PM cell models are sensitive to CUDC-907, which may be a potent therapeutic agent in PM.