{"doi":"10.1093/ejcts/ezaf269","title":"Association Between Pathologic Response and Survival Following Neoadjuvant Targeted Therapy in Epidermal Growth Factor Receptor-Mutant Lung Adenocarcinoma","abstract":"<jats:title>Abstract</jats:title>\n               <jats:sec>\n                  <jats:title>Objectives</jats:title>\n                  <jats:p>The International Association for the Study of Lung Cancer (IASLC) recommended applying a 10% residual viable tumour (%RVT) threshold for major pathological response (MPR) to all therapies. However, evidence supporting the association between pathological regression and prognosis after neoadjuvant targeted therapy is lacking.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Methods</jats:title>\n                  <jats:p>This study retrospectively included 228 patients with epidermal growth factor receptor-mutant adenocarcinoma receiving neoadjuvant targeted therapy. The optimal %RVT cutoff for predicting recurrence-free survival (RFS) was determined using maximally selected rank statistics and Youden’s index. RFS was evaluated utilizing Kaplan-Meier methods and Cox proportional hazard analyses.</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Results</jats:title>\n                  <jats:p>The median %RVT was 50%, with 17% of patients achieving MPR. Patients with %RVT ≤ 10% (MPR) had a significantly better RFS than those with %RVT &amp;gt; 10% (non-MPR) (P = .012). Moreover, the optimal %RVT cutoff for RFS was 75%. Multivariable analysis revealed that %RVT &amp;gt; 75% was an independent risk factor for RFS (P = .045). When stratified by 10% and 75% RVT, patients with %RVT &amp;gt; 75% had the worst RFS, followed by those with %RVT 10%-75%, while patients with %RVT ≤10% had the best survival (P = .0023). The IASLC adenocarcinoma grading system retained prognostic significance after targeted therapy (P &amp;lt; .0001) and was confirmed as an independent prognostic factor (P = .006). It also exhibited synergistic prognostic value with a 10% RVT (P &amp;lt; .0001).</jats:p>\n               </jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions</jats:title>\n                  <jats:p>This study verified the association between tumour regression and prognosis after neoadjuvant targeted therapy. A 10% RVT threshold stratified the prognosis, validating the IASLC’s MPR for use in neoadjuvant targeted therapy, while a 75% RVT cutoff also proved useful for prognostic discrimination. These findings require validation by prospective studies.</jats:p>\n               </jats:sec>","journal":"European Journal of Cardio-Thoracic Surgery","year":2025,"id":633003,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":416141,"name":"Xiaodong Yang","orcid":"0009-0005-2528-4710","position":1,"is_corresponding":false},{"id":1641018,"name":"Delun Yang","orcid":null,"position":2,"is_corresponding":false},{"id":1641019,"name":"Zhao An","orcid":null,"position":3,"is_corresponding":false},{"id":1641020,"name":"Huikang Xie","orcid":null,"position":4,"is_corresponding":false},{"id":1641021,"name":"Shengnan Zhao","orcid":null,"position":5,"is_corresponding":false},{"id":727468,"name":"Chunyan Wu","orcid":"0000-0003-3192-3126","position":6,"is_corresponding":false},{"id":1641023,"name":"Deping Zhao","orcid":null,"position":7,"is_corresponding":false},{"id":1123460,"name":"Chang Chen","orcid":"0000-0002-9981-3110","position":8,"is_corresponding":false},{"id":1641017,"name":"Chenyang Dai","orcid":"0000-0001-9609-0343","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-08-06T10:43:34.275774Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}