pemetrexed

P2, N=16, Not yet recruiting, Jonsson Comprehensive Cancer Center | Trial completion date: Dec 2029 --> Jun 2030 | Initiation date: Jan 2026 --> Jun 2027 | Trial primary completion date: Dec 2028 --> Jun 2029

Management required multidisciplinary coordination and included carboplatin, paclitaxel, and pembrolizumab, followed by radiation to the orbit, iliac crest, and mediastinal sites of disease. Unfortunately, he experienced progression while on maintenance immunotherapy with new rib and brain lesions, for which he underwent treatment with platinum, pemetrexed, and bevacizumab with additional radiotherapy...Our findings underscore the need for ophthalmology, radiation oncology, and medical oncology collaboration when vision-threatening or occult metastatic lesions arise., For readers, the takeaway is that choroidal metastasis-particularly in the era of immunotherapy-warrants individualized, multidisciplinary evaluation rather than default palliation. Our case demonstrates that coordinated multimodality management can achieve long-term disease control, highlighting a treatment paradigm worth considering for selected patients and calling for updated guidelines that reflect modern therapeutic capabilities.

This case highlights the diagnostic challenge posed by TTF-1-positive gastric tumors, which may be mistaken for metastatic lesions from lung cancer. As TTF-1 expression is not entirely specific to tissues of lung or thyroid origin, diagnosis should be based on a comprehensive evaluation of morphological and immunohistochemical findings, together with clinical information, including treatment response and disease course.

A 72-year-old man with metastatic lung adenocarcinoma (epidermal growth factor receptor (EGFR) exon 19 del) progressing on osimertinib initiated treatment with amivantamab, pemetrexed, and carboplatin. Early recognition, based on clinical suspicion and characteristic cytokine profiles, and differentiation from infection are crucial. The concurrent rapid tumor response indicates that effective immune activation drives both toxicity and efficacy, underscoring the need for optimal management strategies to mitigate CRS without compromising antitumor activity.

Despite first-line carboplatin, nab-paclitaxel, and pembrolizumab followed by second-line carboplatin, pemetrexed, nivolumab, and ipilimumab, the disease progressed rapidly, and the patient died four months after diagnosis. This case illustrates that isolated PIK3CA-mutant NSCLC can be highly refractory to conventional chemoimmunotherapy, including regimens incorporating a cytotoxic T-lymphocyte-associated antigen 4 inhibitor. Further clinical investigation of PI3K-targeted therapies is warranted to establish effective treatment strategies for PIK3CA-mutant NSCLC.

P3, N=500, Not yet recruiting, Shanghai Huaota Biopharmaceutical Co., Ltd.

P1/2, N=40, Recruiting, GlaxoSmithKline | Not yet recruiting --> Recruiting | Trial completion date: Jun 2029 --> Oct 2029 | Trial primary completion date: Apr 2028 --> Aug 2028

P1, N=328, Recruiting, HC Biopharma Inc.

P2/3, N=30, Recruiting, Second Affiliated Hospital of Nanchang University | Not yet recruiting --> Recruiting | Initiation date: Oct 2025 --> Apr 2025

P2, N=36, Recruiting, Guangzhou Medical University | Not yet recruiting --> Recruiting | Trial completion date: Mar 2026 --> Mar 2027

P=N/A, N=87, Recruiting, University Medical Center Groningen | Not yet recruiting --> Recruiting

P2, N=150, Active, not recruiting, TJ Biopharma Co., Ltd. | Recruiting --> Active, not recruiting