Hisao Imai

Arterial tumor embolism is a fatal complication of human neoplasia. Here, we report a case of an arterial tumor embolism in the lower limb that occurred after chemoradiotherapy for primary pulmonary sarcoma. Initially, the primary tumor had invaded the left atrium, originating from the right pulmonary vein.

Background: Post-bronchoscopy sputum cytology (PBS) is traditionally considered a supplementary diagnostic tool for lung cancer; however, its prognostic relevance in bronchoscopically confirmed cases remains unclear. This study evaluated the clinicopathological characteristics and prognostic value of PBS positivity in patients with bronchoscopically diagnosed lung cancer. Methods: This single-center retrospective cohort study included 625 patients with newly diagnosed, bronchoscopically confirmed lung cancer, who underwent PBS between May 2007 and December 2024. Patients were classified as PBS-positive and PBS-negative. Clinical characteristics, tumor features, and overall survival (OS) were compared. Factors associated with PBS positivity were evaluated using multivariate logistic regression. Prognostic factors for OS were assessed using univariate and multivariate Cox proportional hazards models. Survival was estimated using the Kaplan-Meier method. Results: Among the 625 patients, 82 (13.1%) were PBS-positive. PBS-positive patients were significantly younger and more likely to have advanced T-factor tumors, larger primary tumors, and proximal airway involvement. Younger age and advanced T-factor were independently associated with PBS positivity. Median OS was significantly shorter in the PBS-positive group than in the PBS-negative group (median 14.3 vs. 25.3 months; log-rank PConclusions: PBS positivity was associated with aggressive tumor characteristics and independently predicted poor OS in bronchoscopically confirmed lung cancer. Although its diagnostic value may be limited, PBS positivity represents a simple, noninvasive prognostic marker that may support risk stratification and clinical decision-making.

CD4⁺ T cells support the priming, expansion, and function of CD8⁺ T cells through dendritic cells. Precursor exhausted T cells (Tpex) maintain self-renewal and supply cytotoxic CD8⁺ T cells in the tumor microenvironment (TME), but the identity of their CD4⁺ T-cell partners remains unclear. Here, we perform scRNA-seq, scTCR-seq, and mass cytometry analysis on peripheral blood, tumor, and lymph nodes primarily from lung cancer patients and, in part, renal cell carcinoma. We identify an IL-7R^high CCR6⁺ Th1-like CD4⁺ T cell-population, named Th7R, that is numerically and spatially partnered with Tpex. Th7R cells express lymphotoxin-β and CXCL13, correlate with high endothelial venules, and co-localize with Tpex in tertiary lymphoid structures. Th7R cell abundance correlates with Tpex numbers in the TME and lymph nodes, and adoptive transfer of Th7R increases Tpex in a preclinical mouse model. Intratumoral Th7R and Tpex associate with improved response to neoadjuvant PD-1 blockade therapy. These results suggest that Th7R cells act as partners of Tpex to sustain antitumor T-cell immunity.

Older patients with unresectable locally advanced non-small-cell lung cancer (NSCLC) frequently receive concurrent chemoradiotherapy (CCRT) with daily low-dose carboplatin; however, real-world data on its efficacy, safety, and prognostic factors remain limited. We aimed to retrospectively evaluate the clinical outcomes of this regimen and examined whether systemic inflammation-based indices predict prognosis in this setting. We reviewed 52 consecutive patients with locally advanced NSCLC treated with first-line CCRT using daily low-dose carboplatin at three Japanese institutions between April 2007 and December 2019. The median progression-free survival (PFS) and overall survival (OS) were 11.5 and 40.1 months, respectively. Twenty patients received durvalumab as consolidation therapy. In the overall cohort, multivariate analysis identified the Glasgow Prognostic Score (GPS) as an independent predictor of PFS. A GPS of 0–1 was also associated with a significantly longer OS in univariate analysis. CCRT with daily low-dose carboplatin provided durable disease control with acceptable toxicity in older patients with unresectable stage II/III NSCLC. The GPS appears to be a simple marker for PFS in this population and may aid in pretreatment risk stratification alongside histology and consolidation strategies.

Older patients with unresectable locally advanced non-small cell lung cancer (NSCLC) frequently receive concurrent chemoradiotherapy (CCRT) with daily low-dose carboplatin; however, real-world data on its efficacy, safety, and prognostic factors remain limited. We aimed to retrospectively evaluate the clinical outcomes of this regimen and examined whether systemic inflammation-based indices predict prognosis in this setting. We reviewed 52 consecutive patients with locally advanced NSCLC treated with first-line CCRT using daily low-dose carboplatin at three Japanese institutions between April 2007 and December 2019. The median progression-free survival (PFS) and overall survival (OS) were 11.5 and 40.1 months, respectively. Twenty patients received durvalumab as maintenance therapy. In the overall cohort, multivariate analysis identified the Glasgow Prognostic Score (GPS) as an independent predictor of PFS. A GPS of 0–1 was also associated with a significantly longer OS in univariate analysis. CCRT with daily low-dose carboplatin provided durable disease control with acceptable toxicity in older patients with unresectable stage II/III NSCLC. The GPS appears to be a simple marker for PFS in this population and may aid in pretreatment risk stratification alongside histology and consolidation strategies.

Legends of Supplementary Figures and Tables, and Supplementary Methods.

Supplementary Table 2, 4, 5, 6, 7.