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The 2025 lung cancer landscape: advances in screening, molecular taxonomy and therapeutic strategy: a narrative review

Transl Lung Cancer Res. 2026 Mar 23;15(3):62. doi: 10.21037/tlcr-2025-1-1477. Epub 2026 Mar 18.

ABSTRACT

BACKGROUND AND OBJECTIVE: In 2025, lung cancer research advanced rapidly across the disease continuum, from population-level risk assessment and screening to mechanistic studies of early carcinogenesis and therapeutic innovation in perioperative and metastatic settings. A key shift moved beyond a smoking-centred paradigm toward a multidimensional risk framework reflecting the growing burden among never-smokers and the roles of air pollution, occupational exposures, and systemic metabolic-inflammatory states. This narrative review aims to synthesize influential 2025 evidence across prevention, diagnosis, treatment, and survivorship, and to identify convergent themes and translational gaps relevant to clinical practice and policy.

METHODS: We performed a narrative synthesis of influential lung cancer studies published in major international journals in 2025. Evidence was organized along a clinically oriented pathway spanning carcinogenesis and screening, precision diagnosis, treatment optimization in resectable and advanced disease, and survivorship, emphasizing practice-informing trials, high-impact translational research, and implementation-relevant technologies.

KEY CONTENT AND FINDINGS: Lineage tracing, single-cell and spatial omics, and evolutionary inference refined concepts of field cancerization, clonal selection, and copy-number-driven fitness. In small-cell lung cancer, evidence further supported neuronal coupling and synapse-like programs as potentially tractable vulnerabilities. Clinically, low-dose computed tomography (CT) strategies and data-informed nodule thresholds aimed to balance under-detection against over-surveillance harms. In diagnostics, artificial intelligence (AI) models increasingly inferred molecular features from routine histopathology ("virtual molecular testing") and should be regarded as decision support requiring prospective validation, population calibration, and explicit failure-mode reporting. Multimodal approaches integrating imaging with circulating tumor DNA (ctDNA) improved feasibility in tissue-limited settings, but clinical utility remains contingent on assay standardization and pathway-level implementation. In resectable disease, longer follow-up consolidated neoadjuvant chemo-immunotherapy for selected patients, while ctDNA kinetics emerged as a candidate biomarker for response-adaptive escalation and de-escalation. In advanced non-small cell lung cancer (NSCLC), phase III evidence for antibody-drug conjugates and bispecific antibodies began reshaping sequencing, while highlighting challenges in toxicity, access, affordability, and immature overall survival in several programs.

CONCLUSIONS: The 2025 landscape reflects coordinated progress in risk conceptualization, biology, diagnostics, and therapeutics, yet gaps in validation, standardization, and real-world deliverability persist. Priorities include prospective evaluation of AI- and ctDNA-enabled pathways, toxicity-informed sequencing, and equitable implementation aligned with health-system capacity.

PMID:41982682 | PMC:PMC13071762 | DOI:10.21037/tlcr-2025-1-1477

Integrative fragmentomic and mutational signature profile of plasma cfDNA for early lung cancer detection

NPJ Precis Oncol. 2026 Apr 15. doi: 10.1038/s41698-026-01416-y. Online ahead of print.

ABSTRACT

Detecting lung cancer effectively in the general population is essential for optimizing treatment outcomes and improving the 5-year survival rate. While low-dose computed tomography (LDCT) is the current standard, it has limitations in broader populations. We developed a blood-based multi-omics model using whole-genome cell-free DNA (cfDNA) features to distinguish lung cancer from non-cancer individuals. This study included 1600 patients and an equal number of non-cancer controls, divided into training and validation cohorts. The model achieved an area under the curve (AUC) of 95.59% for the training cohort and 95.74% for the validation cohort. The model consistently performed well across various cancer stages and histological subtypes. To further validate the performance of the model, an external validation cohort was utilized. Notably, it also effectively differentiated non-cancer samples from cancer samples in the external validation cohort, with 85.9% sensitivity and 94.78% specificity. Importantly, in simulated population screenings, our ctDNA assay outperformed both LDCT and a previously established method. This suggests its potential utility in wider lung cancer screening programs, possibly complementing the LDCT approach. In conclusion, our ctDNA assay emerges as a promising and highly sensitive tool for the early detection and categorization of lung cancer.

PMID:41986614 | DOI:10.1038/s41698-026-01416-y

Finch: Benchmarking Finance & Accounting across Spreadsheet-Centric Enterprise Workflows

arXiv:2512.13168v4 Announce Type: replace Abstract: We introduce FinWorkBench (a.k.a. Finch), a benchmark for evaluating agents on real-world, enterprise-grade finance and accounting workflows that interleave data entry, structuring, formatting, web search, cross-file retrieval, calculation, modeling, validation, translation, visualization, and reporting. Finch is built from authentic enterprise workspaces from Enron (15,000 files and 500,000 emails) and other financial institutions spanning 2000 to 2025, preserving the in-the-wild messiness of multimodal artifacts such as tables and charts across diverse domains including budgeting, trading, and asset management. We propose a workflow construction process that combines LLM-assisted mining of workflows from authentic enterprise environments with expert annotation. Specifically, we use LLM-assisted, expert-verified derivation of workflows from real-world email threads and spreadsheet version histories, followed by meticulous workflow annotation requiring more than 700 hours of expert effort. This process yields 172 composite workflows with 384 tasks, involving 1,710 spreadsheets with 27 million cells, along with PDFs and other artifacts, capturing the intrinsically messy, long-horizon, knowledge-intensive, and collaborative nature of enterprise work. We conduct both human and automated evaluations of frontier AI systems, including GPT 5.1, Claude Sonnet/Opus 4.5, Gemini 3 Pro, Grok 4, and Qwen 3 Max. GPT 5.1 Pro spends an average of 16.8 minutes per workflow yet passes only 38.4% of workflows. Comprehensive case studies further highlight the challenges that real-world enterprise workflows pose for AI agents.

Pathogenesis and immune regulation of rheumatoid arthritis-associated interstitial lung disease: from basic research to clinical implications

Front Immunol. 2026 Mar 13;17:1770348. doi: 10.3389/fimmu.2026.1770348. eCollection 2026.

ABSTRACT

Interstitial lung disease (ILD) is one of the most common extra-articular manifestations of rheumatoid arthritis (RA). Some patients with RA-ILD may develop progressive pulmonary fibrosis, leading to severe impairment of lung function and respiratory failure, which impacts quality of life and can even be life-threatening. This review identified genetic susceptibility, environmental factors, and immune dysregulation as key contributors to the etiology and pathogenesis of RA-ILD. We highlight that autoantibodies, adaptive immune abnormalities, and tertiary lymphoid organ formation significantly drive pulmonary inflammation and fibrosis, while pro-inflammatory cytokines and epithelial-mesenchymal transition (EMT) further contribute to lung tissue injury. Current treatment options, including glucocorticoids, immunosuppressants, and antifibrotic agents such as nintedanib and pirfenidone, are often limited by substantial side effects. Additionally, emerging therapies like JAK inhibitors, CAR-T cells, and the upcoming phosphodiesterase-4B inhibitor, nerandomilast, show promise, but no curative treatment exists to date. Future research could focus on multi-omics technologies and conducting multicenter clinical trials to establish therapeutic targets and advance precision medicine for RA-ILD.

PMID:41909710 | PMC:PMC13021622 | DOI:10.3389/fimmu.2026.1770348

AttestLLM: Efficient Attestation Framework for Billion-scale On-device LLMs

arXiv:2509.06326v2 Announce Type: replace-cross Abstract: As on-device LLMs(e.g., Apple on-device Intelligence) are widely adopted to reduce network dependency, improve privacy, and enhance responsiveness, verifying the legitimacy of models running on local devices becomes critical. Existing attestation techniques are not suitable for billion-parameter Large Language Models (LLMs), struggling to remain both time- and memory-efficient while addressing emerging threats in the LLM era. In this paper, we present AttestLLM, the first-of-its-kind attestation framework to protect the hardware-level intellectual property (IP) of device vendors by ensuring that only authorized LLMs can execute on target platforms. AttestLLM leverages an algorithm/software/hardware co-design approach to embed robust watermarking signatures onto the activation distributions of LLM building blocks. It also optimizes the attestation protocol within the Trusted Execution Environment (TEE), providing efficient verification without compromising inference throughput. Extensive proof-of-concept evaluations on LLMs from Llama, Qwen, and Phi families for on-device use cases demonstrate AttestLLM's attestation reliability, fidelity, and efficiency. Furthermore, AttestLLM enforces model legitimacy and exhibits resilience against model replacement and forgery attacks.
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