肺がん治療 MOC
肺がん (NSCLC・SCLC・NEC) および胸部悪性腫瘍 (胸腺腫・中皮腫) の治療研究を統合する。Driver 別の標的治療、免疫療法、化学療法、放射線併用、周術期療法、supportive care、irAE 管理を含む。手術 / 放射線療法単独研究は含まないが、薬物療法との集学的治療として登場するものは対象。
ドメイン定義
含む: NSCLC (EGFR / ALK / ROS1 / HER2 / Driver-Other / Driver negative)、SCLC、NEC、胸腺上皮性腫瘍、悪性中皮腫の薬物療法臨床研究。oncogene-matched な標的治療 (1L 選択的 TKI、耐性後 ADC / 二重特異性抗体 / 次世代 TKI、術後補助標的療法、KRAS G12D 分解剤等の新規標的)、免疫療法 (ICI 単剤 / 化学療法併用 / dual IO / 周術期 IO)、化学療法・抗血管新生療法、DLL3 BiTE などの新規モダリティ。Supportive care、irAE 管理。
含まない: 手術・放射線療法単独研究 (集学的治療の一部として薬物療法と併記される場合は対象)、肺がん非腫瘍領域の呼吸器疾患 (→ respiratory-diseases)、driver 機序・耐性生物学そのものの基礎研究 (→ lung-cancer-biology)。
現状の合意 (State of the Field)
Driver 陽性 NSCLC の 1 次治療標準:EGFR 変異陽性では FLAURA Soria et al. NEnglJMed 2018 で osimertinib が gefitinib/erlotinib に対し mPFS 18.9 vs 10.2 か月 (HR 0.46)・新規 CNS 病変 6% vs 15% を示し 3rd-gen TKI 1L 標準を確立、final OS も 38.6 vs 31.8 か月で延長した。治療強化として FLAURA2 では Osimertinib + Platinum/Pemetrexed が単剤に PFS HR 0.62 (29.4 vs 19.9 か月) で優越し、最終解析で OS も 47.5 vs 36.7 か月 (HR 0.77) と有意延長が確定した (Zhao et al. NatRevClinOncol 2026)。並行して MARIPOSA (Cho et al. NEnglJMed 2024) で Amivantamab (EGFR×MET 二重特異性抗体) + Lazertinib が単剤に PFS (progression-free survival) HR 0.70 (23.7 vs 16.6 か月)・OS (overall survival) HR 0.75 で優越し、「TKI (tyrosine kinase inhibitor) 単剤 (FLAURA) vs TKI+化学療法 (FLAURA2) vs TKI+二重特異性抗体 (MARIPOSA)」の 3 択 1L (first-line) 戦略時代となった。いずれも DTP (drug-tolerant persister) 細胞・早期耐性クローンを upfront で削ぐことで耐性出現を遅延させる戦略であり、高リスク (L858R / TP53・RB1 co-mutation / 脳転移 / high tumor burden) での add-on 選択と、強化で増える「未知の耐性表現型」の制御が central question である (Zhao et al. NatRevClinOncol 2026)。
Osimertinib 耐性後の ADC (antibody-drug conjugate)・二重特異性抗体シーケンス:1L osimertinib 耐性は C797S (約 6%)・MET 増幅 (15% 超)・SCLC 転換 (3-10%、RB1/TP53 共欠失で転換リスク約 40 倍) など多層的で、約半数は既知の単一遺伝子異常で説明できず、ctDNA 動態による「分子生物学的耐性」の早期検出と適応的介入へのパラダイムシフトが進む (Zhao et al. NatRevClinOncol 2026)。耐性機序別の biomarker (生体指標) 誘導戦略として、MET 増幅例では savolitinib + osimertinib が化学療法に PFS HR 0.32 (SACHI 第 III 相、3rd-gen 既治療サブ群 6.9 vs 3.0 か月) で優越し、MET ADC では telisotuzumab vedotin が ORR (objective response rate) 50%、TOPO1 (topoisomerase I、トポイソメラーゼ I) payload の新規 MET ADC telisotuzumab adizutecan が MET 発現非依存に ORR 63.4%・mPFS 10.9 か月、HER2 共発現への T-DXd (trastuzumab deruxtecan) は DESTINY-Lung03 で ORR 68.4% を示した (Zhao et al. NatRevClinOncol 2026)。biomarker 非選択の ADC では TROP2 標的 Dato-DXd (datopotamab deruxtecan; ORR 43%・OS 15.6 か月)・sac-TMT (sacituzumab tirumotecan; OptiTROP-Lung04 で PFS 8.3 vs 4.3 か月、HR 0.49)、HER3 標的 patritumab deruxtecan (HERTHENA-Lung01 ORR 29.8%・OS 11.9 か月) が確立しつつあり、PD-1×VEGF 二重特異性抗体の ivonescimab + 化学療法も EGFR-TKI 既治療で PFS HR 0.46 (HARMONi-A、7.1 vs 4.8 か月) を示した (Zhao et al. NatRevClinOncol 2026)。これにより osimertinib 耐性後は「組織 / 液体生検で耐性機序を同定 → MET/HER2 標的または非選択 ADC を sequencing」というアルゴリズムが具体化し、4th-gen EGFR-TKI による C797S 共変異克服と組み合わせる段階に入った。
希少 driver の標的治療と耐性後シーケンス:ALK 陽性では CROWN Shaw et al. NEnglJMed 2020 で lorlatinib が crizotinib に PFS HR 0.28・頭蓋内 CR (complete response、完全奏効) 71% を示し、5 年解析でも mPFS 未到達・5 年 PFS 60% (Solomon et al. JClinOncol 2024) と固形腫瘍で最長の単剤 PFS を記録。ROS1 では TRIDENT-1 Drilon et al. NEnglJMed 2024 で repotrectinib が TKI-naive ORR 79%・mPFS 35.7 か月・G2032R 耐性 ORR 59% を示し標準を更新、さらに TRK 温存設計 (シアノ基で TRKA Tyr591 と立体衝突) で CNS 毒性を抑えた次世代 brain-penetrant 阻害薬 JYP0322 が TKI-naive ORR 95.7%・G2032R ORR 78%・頭蓋内 ORR 56%、めまい 6.7% と既存 2nd-gen の CNS 毒性 30-50% を大幅に下回る忍容性を報告した (Ma et al. CancerCell 2026)。RET では LIBRETTO-431 Zhou et al. NEnglJMed 2023 で selpercatinib 1L が IO+chemo に PFS HR 0.46 で勝利し、術後補助でも LIBRETTO-432 で stage IB-IIIA に 2 年 EFS (event-free survival、無イベント生存) 92% vs 61% (HR 0.17) と ADAURA・ALINA に匹敵する効果量で再発リスクを 83% 低減した (Wu et al. NEnglJMed 2026)。HER2 変異では DESTINY-Lung02 Goto et al. JClinOncol 2023 で T-DXd 5.4 mg/kg が ORR 49%・ILD 13% と 6.4 mg/kg より良好な安全性で最適用量を確立し、DESTINY-Lung04 (1L T-DXd vs platinum+pembrolizumab) の readout が 1L 標準を確定する見込みである。KRAS では G12C 阻害薬 sotorasib / adagrasib / divarasib に加え、システイン残基を欠き従来 undruggable とされた G12D を標的とする first-in-class 分解剤 setidegrasib (VHL E3 リガーゼ動員型 PROTAC (proteolysis-targeting chimera、標的タンパク質分解誘導キメラ)) が NSCLC で PR (partial response、部分奏効) 36%・mPFS 8.3 か月、PDAC (pancreatic ductal adenocarcinoma、膵管腺癌) でも OS 10.3 か月を示し (Park et al. NEnglJMed 2026)、標的が pan-RAS / G12D へ拡張しつつある。総じて driver 陽性肺がんは「mutation-matched 1L selective TKI → 耐性機構別の ADC / bispecific / 次世代 TKI」のアルゴリズムが標準化され、術後補助でも ADAURA の Osimertinib (DFS (disease-free survival、無病生存) HR 0.20 / OS HR 0.49) を起点に EGFR・ALK・RET へ oncogene-matched adjuvant が広がった。
Driver 陰性 NSCLC における免疫療法の階層化:PD-L1 TPS (tumor proportion score) ≥50% では KEYNOTE-024 Reck et al. NEnglJMed 2016 が pembrolizumab 単剤の優越性 (OS HR 0.60) を確立し、PD-L1 低発現〜陰性では KEYNOTE-189 Gandhi et al. NEnglJMed 2018 の IO (immuno-oncology) + 化学療法が OS HR 0.49 で PD-L1 全層 benefit を確認した。HARMONi-2 (Zhou 2024) では PD-1×VEGF 二重特異性抗体の Ivonescimab 単剤が PD-L1+ NSCLC 1L で pembrolizumab 単剤に PFS HR 0.51 で優越を示し、IO 1L の標準を二重特異性抗体が塗り替える可能性が浮上した (国際第 III 相進行中)。切除不能 Stage III では PACIFIC の CRT (chemoradiotherapy、化学放射線療法) 後 durvalumab が OS HR 0.68 で標準。周術期 IO が新たな標準として確立: KEYNOTE-671 Wakelee et al. NEnglJMed 2023 で 周術期 pembrolizumab + 化学療法が EFS (event-free survival) HR 0.58・MPR (major pathological response) 30.2% vs 11.0%・pCR (pathological complete response) 18.1% vs 4.0% を示し、AEGEAN Heymach et al. NEnglJMed 2023 で 周術期 durvalumab + 化学療法が EFS HR 0.68・pCR 17.2% vs 4.3% を達成。CheckMate-816 の術前 Nivo + 化学療法 (pCR 24%) と合わせ、Stage II–IIIB 切除可能 NSCLC に対する周術期 IO + 化学療法は class effect (クラス効果) として確認された。一方 STK11/KEAP1 共変異 (KL group) は IO primary resistance を示す層として再認識され、glutaminase 阻害・radiotherapy 併用・metabolic vulnerability 標的化の臨床試験が進行する。
SCLC・NEC・希少胸部腫瘍:SCLC では IMpower133 / CASPIAN で IO 化療併用が 1L 標準となったが OS 改善は中央値 2–3 か月で「IO の SCLC への効果は限定的」と認識されている。転機となったのが DLL3×CD3 BiTE (bispecific T-cell engager、二重特異性 T 細胞誘導抗体) の Tarlatamab で、第 II 相 DeLLphi-301 で 既治療 SCLC に ORR 40% を示した後、第 III 相 DeLLphi-304 (n=509) でプラチナ既治療 2L において標準化学療法 (topotecan / lurbinectedin / amrubicin) に OS 13.6 vs 8.3 か月 (HR 0.60)・ORR 35% vs 20%・Grade ≥3 AE 54% vs 80% で優越し、プラチナ抵抗性サブ群でも OS HR 0.62 と一貫、CRS (cytokine release syndrome、サイトカイン放出症候群) の大半が Grade 1-2 で外来 step-up dosing 管理が確立した (Mountzios et al. NEnglJMed 2025)。維持療法でも lurbinectedin + atezolizumab が atezolizumab 単独に PFS 5.4 vs 2.1 か月 (HR 0.54)・OS 13.2 vs 10.6 か月 (HR 0.73) で優越し (IMforte 第 III 相、Paz-Ares et al. Lancet 2025)、CheckMate 451 / MERU など過去の維持強化が陰性だった中で初めて両主要評価項目を満たした。DeLLphi-305 (1L 維持) / DeLLphi-306 (LS-SCLC 維持) と合わせ、SCLC は IO+化療 plateau 後の DLL3 BiTE / cfDNA (cell-free DNA、無細胞 DNA) methylome subtype-driven sequencing 時代へ移行しつつある。胸腺腫・胸腺がんは ITMIG (International Thymic Malignancy Interest Group) / NCCN (National Comprehensive Cancer Network) ガイドライン中心、悪性中皮腫では nivolumab + ipilimumab dual IO (CheckMate-743) が pemetrexed + cisplatin に対し OS 優越を示し、TROP2 ADC の胸腺上皮腫瘍展開も検討段階。
Supportive / irAE (immune-related adverse events、免疫関連有害事象):化学療法・分子標的薬・ICI (immune checkpoint inhibitor、免疫チェックポイント阻害薬) 共通の FN (febrile neutropenia、発熱性好中球減少症) 予防・制吐・骨髄抑制管理に加え、ICI 特有の irAE (pneumonitis・colitis・thyroiditis・myocarditis・hypophysitis) の早期検出と steroid / 免疫抑制管理が標準化された。ADC class effect の ILD (interstitial lung disease、間質性肺疾患) (deruxtecan 系列の 5-13%, fatal 約1%) が新たな major toxicity として認識され、既存肺疾患 / アジア人種 / 肺転移を危険因子とする早期 CT 検出 + steroid 介入プロトコルが確立しつつある。CAR-T (chimeric antigen receptor T-cell、キメラ抗原受容体 T 細胞) 系では CRS / ICANS (immune effector cell-associated neurotoxicity syndrome) の Lee criteria + tocilizumab 早期介入が血液腫瘍領域で確立し、固形腫瘍 BiTE (Tarlatamab) でも step-up dosing で外来管理可能となった。
主要エンティティ
薬剤クラス (17 classes — Phase B Top 20 拡張)
Driver targeted (6):
- EGFR-TKI — Gefitinib / Erlotinib / Afatinib / Osimertinib / Lazertinib 等の世代展開
- ALK-TKI — Crizotinib / Alectinib / Brigatinib / Lorlatinib 等の世代展開
- ROS1-TKI — Crizotinib / Entrectinib / Repotrectinib / Lorlatinib (ALK と kinase 77% 同一)
- RET-inhibitor — Selpercatinib / Pralsetinib (LIBRETTO-431 で IO+chemo 撃破)
- KRAS-G12C-inhibitor — Sotorasib / Adagrasib / Divarasib
- NTRK-inhibitor — Larotrectinib / Entrectinib / Repotrectinib (tissue-agnostic paradigm)
Immunotherapy (3):
- PD-1-inhibitor — Pembrolizumab / Nivolumab 等 8 members
- PD-L1-inhibitor — Atezolizumab / Durvalumab / Avelumab / Sugemalimab
- CTLA-4-inhibitor — Ipilimumab / Tremelimumab (dual IO partner)
Novel modalities (2):
- ADC — T-DXd / Dato-DXd / HER3-DXd / Telisotuzumab vedotin (payload diversity)
- BiTE-bispecific — Tarlatamab (DLL3) / Amivantamab (EGFR×MET) / Ivonescimab (PD-1×VEGF)
Antibody / chemo / DDR backbone (6):
- anti-VEGF-antibody — Bevacizumab / Ramucirumab (IMpower150 / RELAY backbone)
- anti-EGFR-antibody — Cetuximab / Necitumumab (historical, 現代 niche)
- Platinum-chemotherapy — Cisplatin / Carboplatin (IO+chemo の foundation)
- Pemetrexed — 非扁平 NSCLC + mesothelioma backbone (histology-specific paradigm)
- Taxane — Paclitaxel / nab-paclitaxel / Docetaxel (KEYNOTE-407 backbone, 2L 単剤)
- PARP-inhibitor — Olaparib / Niraparib (NSCLC niche、SCLC SLFN11+ で開発)
(Phase B 拡張候補: MET 個別 inhibitor / TIGIT inhibitor / LAG-3 inhibitor / 4th-gen ALK 等)
遺伝子 (治療標的 / biomarker、詳細は lung-cancer-biology)
- Major drivers: EGFR / ALK / KRAS / ROS1 / HER2 / MET / BRAF / RET / NTRK
- IO biomarker / co-mutation: PD-L1 / TP53 / STK11 / KEAP1
- SCLC subtype (治療応答性に関連) : ASCL1 / MYC (→ DLL3 / Aurora kinase 標的化), RB1 (dual loss baseline)
試験 (20 trials — Phase B Top 20 拡張)
EGFR-targeted (5):
- FLAURA — 1L EGFR+ Osimertinib (PFS HR 0.46 / OS HR 0.799)
- FLAURA2 — 1L EGFR+ Osimertinib+chemo vs Osimertinib (PFS HR 0.62 / CNS PFS HR 0.47)
- AURA3 — 2L T790M+ Osimertinib (PFS HR 0.30)
- ADAURA — Adjuvant Osimertinib (DFS HR 0.20 / OS HR 0.49)
- IPASS — 1L Gefitinib EGFR+ paradigm 起点 (PFS HR 0.48 EGFR+)
ALK-targeted (4):
- ALEX — 1L ALK+ Alectinib (PFS HR 0.47 / 5-yr OS 62.5%)
- CROWN — 1L ALK+ Lorlatinib (5-yr PFS 60%)
- ALTA-1L — 1L ALK+ Brigatinib (PFS HR 0.49)
- PROFILE-1014 — 1L ALK+ Crizotinib paradigm 起点 (PFS HR 0.45)
IO 1L NSCLC (6):
- KEYNOTE-024 — 1L PD-L1 ≥50% Pembrolizumab 単剤 (OS HR 0.60)
- KEYNOTE-189 — 1L 非扁平 IO+chemo (OS HR 0.49)
- KEYNOTE-407 — 1L 扁平 IO+chemo (OS HR 0.64)
- CheckMate-227 — 1L dual IO chemo-free (OS HR 0.79 PD-L1 ≥1%)
- CheckMate-9LA — 1L dual IO + 限定 2 cycles chemo (OS HR 0.66)
- IMpower150 — 1L 非扁平 ABCP (atezo+bev+chemo, EGFR+ subset 含む, OS HR 0.78)
Stage III / 周術期 (3):
- PACIFIC — Stage III 化療放射線後 Durvalumab consolidation (PFS HR 0.51)
- CheckMate-816 — 術前 Nivolumab+chemo (pCR 24% vs 2.2% / EFS HR 0.63)
- KEYNOTE-671 — Perioperative Pembrolizumab+chemo (EFS HR 0.58 / OS HR 0.72)
SCLC paradigm (3):
- IMpower133 — 1L ES-SCLC Atezo+chemo (OS HR 0.70、SCLC IO 化療 30+ 年ぶり改革)
- CASPIAN — 1L ES-SCLC Durvalumab+chemo (OS HR 0.73、Tremelimumab 追加陰性)
- DeLLphi-301 — Tarlatamab (DLL3 BiTE) 既治療 SCLC (ORR 40% / mOS 14.3 mo、SCLC paradigm shift)
主要概念
- EGFR-T790M-resistance — 1st/2nd-gen EGFR-TKI 耐性 paradigm
- EGFR-C797S-resistance — 3rd-gen Osimertinib 後耐性、cis/trans allele、4th-gen 開発
- ALK-G1202R-compound-mutations — Lorlatinib 後 compound mutation、4th-gen 設計
- KRAS-co-mutation-landscape — KP / KL / KC 三亜型と STK11/KEAP1 IO 抵抗性
- Lineage-plasticity — SCLC transformation / HPCS lineage hub
- Perioperative-IO — KEYNOTE-671 / AEGEAN / CheckMate-816 による周術期 IO class effect 確立
- ADC-resistance-mechanisms — antigen loss / payload efflux / internalization 障害の多層構造
- irAE-pathophysiology — IO 治療下 immune-related adverse events の機序と管理
- Cancer-dormancy — adjuvant / MRD context, awakening prevention strategy
- IO-primary-resistance — STK11/KEAP1 loss、immune-excluded TME、MHC-I loss
- Tumor-angiogenesis — anti-VEGF + IO の vessel normalization 根拠
Open Questions
- EGFR 1L 強化の患者選択:FLAURA2 (TKI+chemo) vs MARIPOSA (TKI+bispecific) vs FLAURA (TKI 単剤) の 3 択を L858R・TP53/RB1 co-mutation・脳転移・腫瘍量・毒性許容度でどう層別化するか、upfront 強化後の OS gain と引き換えに増える「未知の耐性表現型」(既知単一遺伝子で説明できない約半数) をどう制御するか
- 耐性後 ADC シーケンスの最適化:osimertinib 耐性後の MET/HER2 標的 ADC (telisotuzumab vedotin / adizutecan / T-DXd) と TROP2 (Dato-DXd / sac-TMT)・HER3 (patritumab deruxtecan) 非選択 ADC・ivonescimab の投与順序と biomarker、ADC 間 cross-resistance と deruxtecan 系 ILD の管理、4th-gen EGFR-TKI との組合せ
- 標的補助療法は治癒か遅延か:ADAURA / LIBRETTO-432 / ALINA の補助標的療法が再発を治癒するのか遅延に留まるのか (RET 補助は OS データ未成熟)、最適投与期間、ctDNA (circulating tumor DNA) -MRD (minimal residual disease、微小残存病変) ガイドによる個別化
- SCLC DLL3 治療の位置づけ:tarlatamab を 1L 維持 (DeLLphi-305) / LS-SCLC (DeLLphi-306) へ前倒しする意義と IMforte (lurbinectedin 維持) との棲み分け、DLL3 発現・cfDNA methylome subtype による responder 選別、CRS / ICANS の外来管理標準化
- KRAS 標的の拡張:first-in-class G12D 分解剤 (setidegrasib) ・pan-RAS 阻害薬の単剤・併用での臨床的位置づけと耐性機構、STK11 / KEAP1 co-mutation による IO・標的療法抵抗性の克服
- PD-L1 を超える IO biomarker:TMB (tumor mutational burden、腫瘍遺伝子変異量)・HLA・MHC-II・TIL (tumor-infiltrating lymphocyte、腫瘍浸潤リンパ球)・腸内細菌叢の実装、PD-1×VEGF 二重特異性抗体 (ivonescimab) が IO 1L 標準を塗り替えるか、irAE 発症予測
重要論文 Top 10
- ★★★★★ Gandhi et al. NEnglJMed 2018 — KEYNOTE-189: 非扁平 1L IO+chemo で OS HR 0.49、PD-L1 全層で benefit
- ★★★★★ Soria et al. NEnglJMed 2018 — FLAURA: EGFR+ 1L Osimertinib で mPFS 18.9 vs 10.2 mo (HR 0.46), 3rd-gen TKI 標準化
- ★★★★★ Antonia et al. NEnglJMed 2017 — PACIFIC: Stage III CRT 後 Durvalumab consolidation で OS HR 0.68
- ★★★★★ Peters et al. NEnglJMed 2017 — ALEX: 1L ALK+ Alectinib で PFS HR 0.47, CNS 進行 HR 0.16
- ★★★★★ Reck et al. NEnglJMed 2016 — KEYNOTE-024: PD-L1 TPS≥50% で Pembro 単剤 OS HR 0.60
- ★★★★★ Wu et al. NEnglJMed 2020 — ADAURA: 切除後 EGFR+ adjuvant Osimertinib 3 年, DFS HR 0.20 / OS HR 0.49
- ★★★★★ Forde et al. NEnglJMed 2022 — CheckMate-816: 術前 Nivo+chemo, pCR 24% vs 2.2%, EFS HR 0.63
- ★★★★★ Shaw et al. NEnglJMed 2020 — CROWN: 1L Lorlatinib, 5-yr PFS 60%, intracranial PFS 96% at 12mo
- ★★★★★ Mok et al. NEnglJMed 2009 — IPASS: EGFR mutation を predictive biomarker として確立、targeted therapy paradigm 起点
- ★★★★ Paz-Ares et al. JThoracOncol 2020 — KEYNOTE-407: 1L 扁平 IO+chemo, OS HR 0.64, PD-L1 全層 benefit
最新追加論文 Top 10
- Okamoto et al. LungCancer 2026 — Clinical-NSCLC-EGFR
- Itchins et al. LungCancer 2026 — Clinical-NSCLC-ROS1
- Borghaei et al. ClinCancerRes 2026 — Clinical-NSCLC-Driver negative
- Zamulko et al. ClinCancerRes 2026 — Clinical-NSCLC-Driver negative
- Vujanovic et al. ClinCancerRes 2026 — Clinical-NSCLC-Driver negative
- Trotta et al. Cell 2026 — Clinical-SCLC
- Chien et al. CancerImmunolImmunother 2026 — Clinical-NSCLC-Driver negative
- Ulas et al. JImmunotherCancer 2026 — Clinical-NSCLC-Driver negative
- Zhang et al. FrontImmunol 2026 — Clinical-SCLC
- Lu et al. ClinLungCancer 2026 — Clinical-NSCLC-EGFR
全論文リスト (カテゴリ別、自動生成)
Clinical-Mesothelioma
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- Zhao et al. CancerRes 2010 — Multiple injections of electroporated autologous T cells expressing a chimeric antigen receptor mediate regression of
- Muhsin et al. NatRevDrugDiscov 2004 — Pemetrexed disodium
Clinical-NEC
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- Sen et al. LancetOncol 2025 — Pulmonary neuroendocrine neoplasms the molecular landscape, therapeutic challenges, and diagnosis and management
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- Fujiwara et al. AnnSurgOncol 2024 — Clinical and pathologic differences between small-cell carcinoma and large-cell neuroendocrine carcinoma of the lung
- Nicholson et al. JThoracOncol 2022 — The 2021 WHO classification of lung tumors impact of advances since 2015
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- Fisch et al. FrontOncol 2021 — Comprehensive dissection of treatment patterns and outcome for patients with metastatic large-cell neuroendocrine lung
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- Tashiro et al. IntJMolSci 2020 — Heterogeneous tumor-immune microenvironments between primary and metastatic tumors in a patient with ALK
- Kenmotsu et al. JClinOncol 2020 — Randomized phase III study of irinotecan plus cisplatin versus etoposide plus cisplatin for completely resected
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- Deng et al. MedSciMonit 2019 — Lung large cell neuroendocrine carcinoma an analysis of patients from the surveillance, epidemiology, and end-results
- Derks et al. ClinCancerRes 2018 — Molecular subtypes of pulmonary large-cell neuroendocrine carcinoma predict chemotherapy treatment outcome
- Christopoulos et al. LungCancer 2018 — Large cell neuroendocrine lung carcinoma induces peripheral T-cell repertoire alterations with predictive and
- George et al. NatCommun 2018 — Integrative genomic profiling of large-cell neuroendocrine carcinomas reveals distinct subtypes of high-grade
- Alvarez et al. NatGenet 2018 — A precision oncology approach to the pharmacological targeting of mechanistic dependencies in neuroendocrine
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- Miyoshi et al. ClinCancerRes 2017 — Genomic profiling of large-cell neuroendocrine carcinoma of the lung
- Derks et al. EurRespirJ 2017 — Chemotherapy for pulmonary large cell neuroendocrine carcinomas does the regimen matter
- Hiroshima et al. TranslLungCancerRes 2017 — Update on large cell neuroendocrine carcinoma
- Rekhtman et al. ClinCancerRes 2016 — Next-generation sequencing of pulmonary large cell neuroendocrine carcinoma reveals small cell carcinoma-like and
- Naidoo et al. ClinLungCancer 2016 — LCNEC of the lung
- Derks et al. EurRespirJ 2016 — Clinical features of large cell neuroendocrine carcinoma a population-based overview
- Kunz et al. JClinOncol 2015 — Carcinoid and neuroendocrine tumors building on success
- Steuer et al. JThoracOncol 2015 — Atypical carcinoid tumor of the lung a surveillance, epidemiology, and end results database analysis
- Eba et al. JpnJClinOncol 2014 — A phase III trial comparing irinotecan and cisplatin with etoposide and cisplatin in adjuvant chemotherapy for
- LeTreut et al. AnnOncol 2013 — Multicentre phase II study of cisplatin-etoposide chemotherapy for advanced large-cell neuroendocrine lung carcinoma
- Niho et al. JThoracOncol 2013 — Combination chemotherapy with irinotecan and cisplatin for large-cell neuroendocrine carcinoma of the lung a
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- Jones et al. Lancet 2004 — Two prognostically significant subtypes of high-grade lung neuroendocrine tumours independent of small-cell and
- Iyoda et al. Cancer 2001 — Clinical characterization of pulmonary large cell neuroendocrine carcinoma and large cell carcinoma with neuroendocrine
Clinical-NSCLC-ALK
- Mascarenhas et al. JCOGlobOncol 2026 — Current access to anaplastic lymphoma kinase testing and targeted therapies for non-small cell lung cancer in brazil
- Solomon et al. JClinOncol 2024 — Lorlatinib versus crizotinib in patients with advanced ALK-positive non-small cell lung cancer 5-year outcomes from the
- Felip et al. AnnOncol 2021 — Intracranial and extracranial efficacy of lorlatinib in patients with ALK-positive non-small-cell lung cancer
- Tanimoto et al. ClinCancerRes 2021 — Proteasome inhibition overcomes ALK-TKI resistance in ALK-RearrangedTP53-mutant NSCLC via noxa expression
- Ito et al. EurJCancer 2021 — Sequential therapy of crizotinib followed by alectinib for non-small cell lung cancer harbouring anaplastic lymphoma
- Kim et al. FutureOncol 2021 — ALTA-2 phase II study of brigatinib in patients with ALK-positive, advanced non-small-cell lung cancer who progressed
- Camidge et al. JThoracOncol 2021 — Brigatinib versus crizotinib in ALK inhibitor-naive advanced ALK-positive NSCLC final results of phase 3 ALTA-1l trial
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- Dagogo-Jack et al. ClinCancerRes 2020 — MET alterations are a recurring and actionable resistance mechanism in ALK-positive lung cancer
- Recondo et al. ClinCancerRes 2020 — Diverse resistance mechanisms to the third-generation ALK inhibitor lorlatinib in ALK-rearranged lung cancer
- Lin et al. FutureOncol 2020 — Real-world treatment duration in ALK-positive non-small-cell lung cancer patients receiving brigatinib through the
- Camidge et al. JClinOncol 2020 — Brigatinib versus crizotinib in advanced ALK inhibitor-naive ALK-positive non-small cell lung cancer second interim
- Arai et al. JThoracOncol 2020 — Osimertinib overcomes alectinib resistance caused by amphiregulin in a leptomeningeal carcinomatosis model of
- Felip et al. JThoracOncol 2020 — Ceritinib plus nivolumab in patients with advanced ALK-rearranged non-small cell lung cancer results of an open-label,
- Huber et al. JThoracOncol 2020 — Brigatinib in crizotinib-refractory ALK+ NSCLC 2-year follow-up on systemic and intracranial outcomes in the phase 2
- Lin et al. JThoracOncol 2020 — Efficacy of PlatinumPemetrexed combination chemotherapy in ALK-positive NSCLC refractory to second-generation ALK
- Ng et al. JThoracOncol 2020 — Early-onset pulmonary events associated with brigatinib use in advanced NSCLC
- Nishio et al. JThoracOncol 2020 — Final overall survival and other efficacy and safety results from ASCEND-3 phase II study of ceritinib in ALKi-naive
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- Shaw et al. NEnglJMed 2020 — First-line lorlatinib or crizotinib in advanced ALK-positive lung cancer
- Jahanzeb et al. Oncologist 2020 — Real-world treatment patterns and progression-free survival associated with anaplastic lymphoma kinase (ALK) tyrosine
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- Fukuda et al. CancerRes 2019 — Epithelial-to-mesenchymal transition is a mechanism of ALK inhibitor resistance in lung cancer independent of ALK
- Pailler et al. ClinCancerRes 2019 — Acquired resistance mutations to ALK inhibitors identified by single circulating tumor cell sequencing in
- Shaw et al. JClinOncol 2019 — ALK resistance mutations and efficacy of lorlatinib in advanced anaplastic lymphoma kinase-positive non-small-cell lung
- Camidge et al. JThoracOncol 2019 — Management strategies for early-onset pulmonary events associated with brigatinib
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- Makimoto et al. JThoracOncol 2019 — Rapid acquisition of alectinib resistance in ALK-positive lung cancer with high tumor mutation burden
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- Trigg et al. NatCommun 2019 — The targetable kinase PIM1 drives ALK inhibitor resistance in high-risk neuroblastoma independent of MYCN status
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- Yoda et al. CancerDiscov 2018 — Sequential ALK inhibitors can select for lorlatinib-resistant compound ALK mutations in ALK-positive lung cancer
- Redaelli et al. CancerRes 2018 — Lorlatinib treatment elicits multiple on-and off-target mechanisms of resistance in ALK-driven cancer
- Hida et al. CancerSci 2018 — Phase II study of ceritinib in alectinib-pretreated patients with anaplastic lymphoma kinase-rearranged metastatic
- Katayama et al. CancerSci 2018 — Drug resistance in anaplastic lymphoma kinase-rearranged lung cancer
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- McCoach et al. ClinCancerRes 2018 — Resistance mechanisms to targeted therapies in ROS1+ and ALK+ non-small cell lung cancer
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- Lin et al. JClinOncol 2018 — Impact of EML4-ALK variant on resistance mechanisms and clinical outcomes in ALK-positive lung cancer
- Solomon et al. JClinOncol 2018 — Final overall survival analysis from a study comparing first-line crizotinib versus chemotherapy in
- Kiura et al. JpnJClinOncol 2018 — Phase 3 study of ceritinib vs chemotherapy in ALK-rearranged NSCLC patients previously treated with chemotherapy and
- Nishio et al. LungCancer 2018 — Analysis of central nervous system efficacy in the J-ALEX study of alectinib versus crizotinib in ALK-positive
- Camidge et al. NEnglJMed 2018 — Brigatinib versus crizotinib in ALK-positive non-small-cell lung cancer
- Dardaei et al. NatMed 2018 — SHP2 inhibition restores sensitivity in ALK-rearranged non-small-cell lung cancer resistant to ALK inhibitors
- Lovly et al. AmSocClinOncolEducBook 2017 — Managing resistance to EFGR-and ALK-targeted therapies
- Woo et al. AnnOncol 2017 — Differential protein stability and clinical responses of EML4-ALK fusion variants to various ALK inhibitors in advanced
- Lin et al. CancerDiscov 2017 — Targeting ALK Precision medicine takes on drug resistance
- Asao et al. ClinLungCancer 2017 — Sequential use of anaplastic lymphoma kinase inhibitors in japanese patients with ALK-rearranged non-small-cell lung
- Kim et al. JClinOncol 2017 — Brigatinib in patients with crizotinib-refractory anaplastic lymphoma kinase-positive non-small-cell lung cancer A
- Tamura et al. JClinOncol 2017 — Three-year follow-up of an alectinib phase III study in ALK-positive non-small-cell lung cancer AF-001jp
- Cho et al. JThoracOncol 2017 — ASCEND-8 A randomized phase 1 study of ceritinib, 450 mg or 600 mg, taken with a low-fat meal versus 750 mg in fasted
- Ito et al. JThoracOncol 2017 — Sequential therapy with crizotinib and alectinib in ALK-rearranged non-small cell lung cancer-A multicenter
- Hida et al. Lancet 2017 — Alectinib versus crizotinib in patients with ALK-positive non-small-cell lung cancer (J-ALEX) an open-label, randomised
- Soria et al. Lancet 2017 — First-line ceritinib versus platinum-based chemotherapy in advanced ALK-rearranged non-small-cell lung cancer
- Shaw et al. LancetOncol 2017 — Ceritinib versus chemotherapy in patients with ALK-rearranged non-small-cell lung cancer previously given chemotherapy
- Shaw et al. LancetOncol 2017 — Lorlatinib in non-small-cell lung cancer with ALK or ROS1 rearrangement an international, multicentre, open-label,
- Califano et al. LungCancer 2017 — Management of ceritinib therapy and adverse events in patients with ALK-rearranged non-small cell lung cancer
- Peters et al. NEnglJMed 2017 — Alectinib versus crizotinib in untreated ALK-positive non-small-cell lung cancer
- Duruisseaux et al. Oncotarget 2017 — Overall survival with crizotinib and next-generation ALK inhibitors in ALK-positive non-small-cell lung cancer
- Gainor et al. CancerDiscov 2016 — Molecular mechanisms of resistance to first-and second-generation ALK inhibitors in ALK-rearranged lung cancer
- Infarinato et al. CancerDiscov 2016 — The ALKROS1 inhibitor PF-06463922 overcomes primary resistance to crizotinib in ALK-driven neuroblastoma
- Zhang et al. ClinCancerRes 2016 — The potent ALK inhibitor brigatinib (AP26113) overcomes mechanisms of resistance to first-and second-generation ALK
- Matikas et al. ClinLungCancer 2016 — Management of resistance to crizotinib in anaplastic lymphoma kinase-positive non-small-cell lung cancer
- Watanabe et al. ClinLungCancer 2016 — Progression-free and overall survival of patients with ALK rearrangement-positive non-small cell lung cancer treated
- Tsao et al. IASLC 2016 — Atlas of ALK and ROS1 Testing in Lung Cancer Second Edition
- Crino et al. JClinOncol 2016 — Multicenter phase II study of whole-body and intracranial activity with ceritinib in patients with ALK-rearranged
- Johung et al. JClinOncol 2016 — Extended survival and prognostic factors for patients with ALK-rearranged non-small-cell lung cancer and brain
- Ou et al. JClinOncol 2016 — Alectinib in crizotinib-refractory ALK-rearranged non-small-cell lung cancer A phase II global study
- Yoshida et al. JClinOncol 2016 — Differential crizotinib response duration among ALK fusion variants in ALK-positive non-small-cell lung cancer
- Janne et al. JThoracOncol 2016 — Combined pan-HER and ALKROS1MET inhibition with dacomitinib and crizotinib in advanced non-small cell lung cancer
- Gettinger et al. LancetOncol 2016 — Activity and safety of brigatinib in ALK-rearranged non-small-cell lung cancer and other malignancies a single-arm,
- Kim et al. LancetOncol 2016 — Activity and safety of ceritinib in patients with ALK-rearranged non-small-cell lung cancer (ASCEND-1) updated results
- Shaw et al. LancetOncol 2016 — Alectinib in ALK-positive, crizotinib-resistant, non-small-cell lung cancer a single-group, multicentre, phase 2 trial
- Yoshida et al. LungCancer 2016 — Clinical impact of crizotinib on central nervous system progression in ALK-positive non-small lung cancer
- Shaw et al. NEnglJMed 2016 — Resensitization to crizotinib by the lorlatinib ALK resistance mutation L1198F
- Hong et al. OncoImmunology 2016 — Upregulation of PD-L1 by EML4-ALK fusion protein mediates the immune escape in ALK positive NSCLC implication for
- Koh et al. OncoImmunology 2016 — EML4-ALK enhances programmed cell death-ligand 1 expression in pulmonary adenocarcinoma via hypoxia-inducible factor
- Wilson et al. CancerCell 2015 — A functional landscape of resistance to ALK inhibition in lung cancer
- Zou et al. CancerCell 2015 — PF-06463922, an ALKROS1 inhibitor, overcomes resistance to first and second generation ALK inhibitors in preclinical
- Toyokawa et al. CancerMetastasisRev 2015 — Insights into brain metastasis in patients with ALK+ lung cancer is the brain truly a sanctuary
- Gainor et al. ClinCancerRes 2015 — Progression-free and overall survival in ALK-positive NSCLC patients treated with sequential crizotinib and ceritinib
- Costa et al. JClinOncol 2015 — Clinical experience with crizotinib in patients with advanced ALK-rearranged non-small-cell lung cancer and brain
- Nishio et al. JThoracOncol 2015 — Phase I study of ceritinib (LDK378) in japanese patients with advanced, anaplastic lymphoma kinase-rearranged
- Chiari et al. LungCancer 2015 — Clinical impact of sequential treatment with ALK-TKIs in patients with advanced ALK-positive non-small cell lung cancer
- Chino et al. LungCancer 2015 — Successful treatment with alectinib after crizotinib-induced ILD
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- Friboulet et al. CancerDiscov 2014 — The ALK inhibitor ceritinib overcomes crizotinib resistance in non-small cell lung cancer
- Gridelli et al. CancerTreatRev 2014 — ALK inhibitors in the treatment of advanced NSCLC
- Katayama et al. ClinCancerRes 2014 — Two novel ALK mutations mediate acquired resistance to the next-generation ALK inhibitor alectinib
- Jhaveri et al. ExpertOpinInvestigDrugs 2014 — Heat shock protein 90 inhibitors in the treatment of cancer current status and future directions
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- Shaw et al. NEnglJMed 2014 — Ceritinib in ALK-rearranged non-small-cell lung cancer
- Solomon et al. NEnglJMed 2014 — First-line crizotinib versus chemotherapy in ALK-positive lung cancer
- Lovly et al. NatMed 2014 — Rationale for co-targeting IGF-1R and ALK in ALK fusion-positive lung cancer
- Shaw et al. AnnOncol 2013 — Pemetrexed-based chemotherapy in patients with advanced, ALK-positive non-small cell lung cancer
- Ying et al. AnnOncol 2013 — Diagnostic value of a novel fully automated immunochimistry assay for detection of ALK rearrangement in primary lung …
- Gainor et al. ClinCancerRes 2013 — ALK rearrangements are mutually exclusive with mutations in EGFR or KRAS an analysis of 1,683 patients with non-small
- Conklin et al. JThoracOncol 2013 — Immunohistochemistry is a reliable screening tool for identification of ALK rearrangement in non-small-cell lung
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- Seto et al. LancetOncol 2013 — CH5424802 (RO5424802) for patients with ALK-rearranged advanced non-small-cell lung cancer (AF-001jp study) a
- Yang et al. LancetOncol 2013 — A selective ALK inhibitor in ALK-rearranged patients
- Selinger et al. ModPathol 2013 — Testing for ALK rearrangement in lung adenocarcinoma a multicenter comparison of immunohistochemistry and fluorescent
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- Lee et al. Cancer 2012 — Comparative analyses of overall survival in patients with anaplastic lymphoma kinase-positive and matched wild-type
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- Sakamoto et al. CancerCell 2011 — CH5424802, a selective ALK inhibitor capable of blocking the resistant gatekeeper mutant
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- Costa et al. JClinOncol 2011 — CSF concentration of the anaplastic lymphoma kinase inhibitor crizotinib
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- Camidge et al. JThoracOncol 2011 — Anaplastic lymphoma kinase gene rearrangements in non-small cell lung cancer are associated with prolonged
- Shaw et al. LancetOncol 2011 — Effect of crizotinib on overall survival in patients with advanced non-small-cell lung cancer harbouring ALK gene
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- Camidge et al. ClinCancerRes 2010 — Optimizing the detection of lung cancer patients harboring anaplastic lymphoma kinase (ALK) gene rearrangements
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- Horn et al. JClinOncol 2009 — EML4-ALK honing in on a new target in non-small-cell lung cancer
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Clinical-NSCLC-Driver negative
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- Marinelli et al. CancerTreatRev 2026 — PD-(l)1 containing rechallenge strategies in patients with advanced NSCLC previously treated with immunotherapy A
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- Vujanovic et al. ClinCancerRes 2026 — Tumoral and systemic immune correlates of response to concurrent pembrolizumab and chemoradiotherapy in patients with
- Zamulko et al. ClinCancerRes 2026 — A phase 2 feasibility study combining pembrolizumab and metformin in patients with metastatic head and neck cancer
- Li et al. FrontImmunol 2026 — The application and challenges of immune checkpoint inhibitors in lung cancer therapy
- Han et al. FrontOncol 2026 — Efficacy and safety of local consolidative therapy combined with systemic therapy in driver-negative oligometastatic
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- DiFederico et al. JAMAOncol 2026 — PD-(l)1 inhibitor monotherapy vs chemoimmunotherapy
- Socinski et al. JAMAOncol 2026 — Tiragolumab plus atezolizumab and chemotherapy for advanced nonsquamous non-small cell lung cancer the phase 3
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- Lee et al. JImmunotherCancer 2026 — Phase I trial of CJRB-101 plus pembrolizumab in patients with metastatic non-small cell lung cancer, head and neck
- Ulas et al. JImmunotherCancer 2026 — Rescue by radiotherapy and anti-CTLA4PD-1 after failure of anti-PD-1 therapy in patients with metastatic NSCLC the
- Lu et al. Lancet 2026 — Ivonescimab plus chemotherapy versus tislelizumab plus chemotherapy in advanced squamous non-small-cell lung cancer
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- Shiraishi et al. LungCancer 2026 — Final overall survival analysis of the APPLE study atezolizumab and platinum-pemetrexed with or without bevacizumab for
- Provencio et al. NatCancer 2026 — Clinical outcomes with perioperative nivolumab by nodal status in patients with stage III resectable NSCLC phase 3
- Huang et al. NatMed 2026 — Time-of-day immunochemotherapy in non-small cell lung cancer a randomized phase 3 trial
- Cengiz et al. SciRep 2026 — Comparison of flat-dose versus weight-based dose nivolumab treatment in NSCLC patients
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