WCLC 2025 - Posters & ePosters-PT1.09.02 Double Lung Transplantation in Patients With Metastatic Lung-Limited Non-Small Cell Lung Carcinoma (NSCLC): A Case Series

PT1.09.02 Double Lung Transplantation in Patients With Metastatic Lung-Limited Non-Small Cell Lung Carcinoma (NSCLC): A Case Series

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This study from Northwestern University evaluates double lung transplantation (DLT) as a treatment for patients with advanced bilateral lung-limited non-small cell lung cancer (NSCLC), using prospective data from the DREAM registry (NCT05671887). Seventeen patients, median age 60, predominantly White (76%) and female (59%), with disease refractory to standard therapies were included. Most patients (65%) had invasive mucinous adenocarcinoma. No patients had extrapulmonary disease. <br /><br />Patients were transplanted between September 2021 and July 2025, with a median waitlist duration of 12 days. There was no 30-day post-transplant mortality. One patient had acute humoral rejection, managed successfully, and all were weaned off supplemental oxygen post-transplant. Three with lymph node–positive disease received adjuvant chemotherapy. <br /><br />Over a median follow-up of 11 months, five patients developed cancer recurrence—one in the lung, four with bone metastases, and one also with brain metastasis. Sixteen remain alive at reporting; one died of cardiopulmonary arrest during chemotherapy five months post-DLT. One patient with pulmonary recurrence achieved remission following stereotactic body radiation therapy (SBRT).<br /><br />Pathological analyses confirmed negative margins in all explants. Patients showed improved respiratory function and quality of life. Despite concerns about recurrence, post-transplant treatments allowed for disease management. <br /><br />The study concludes that DLT in highly selected patients with bilateral lung-limited NSCLC is feasible and safe, with promising functional and survival benefits in what is otherwise a terminal population. The DREAM cohort continues to investigate the long-term safety and efficacy of this approach. This work expands on previous literature and supports exploring lung transplantation as a therapeutic modality for refractory lung-limited NSCLC patients.

Asset Subtitle

Young Chae

Meta Tag

Speaker Young Chae

Topic Metastatic Non-small Cell Lung Cancer – Local Therapies

Keywords

double lung transplantation

non-small cell lung cancer

bilateral lung-limited NSCLC

DREAM registry

invasive mucinous adenocarcinoma

post-transplant outcomes

cancer recurrence

stereotactic body radiation therapy

respiratory function improvement

lung transplantation feasibility