Authors of a multicenter prospective study in France evaluated 150 adults aged 18 to 60 years with primary lung cancer to compare dual cannabis/tobacco smokers (CTS) with tobacco-only smokers (TS) and nonsmokers (NS). Overall, 39% were CTS, 52% TS, and 9% NS; all cannabis users also smoked tobacco. Despite similar tobacco exposure and hair cotinine levels between CTS and TS, CTS patients had a long history of cannabis use (median 26 years, about 4 times per day). Compared with TS, CTS patients were slightly younger at diagnosis (median age 53 vs 56 years), had lower body mass index, were somewhat less often women, and more frequently reported chest pain at presentation. Smoking behavior was confirmed using hair testing for nicotine, cotinine, THC, and CBD, strengthening the validity of exposure classification.

Clinically, dual cannabis/tobacco smokers demonstrated a more concerning pulmonary and tumor profile than tobacco-only smokers. CTS patients had higher rates of emphysema (64% vs 38%), lower gas diffusion capacity, and a greater frequency of aggressive or rare lung cancer histologies (17% vs 4%), suggesting a distinct and more severe lung cancer phenotype. Although this study was underpowered to detect differences in stage at diagnosis or survival, its generalizability is also limited by the illegality of cannabis in France (where cannabis resin is often mixed with other substances). Even so, the findings indicate that co-use of cannabis and tobacco may be associated with earlier lung cancer onset, worse underlying lung damage, more complex surgical outcomes, and more aggressive disease. The authors conclude that these patterns are consistent with a potential specific impact of cannabis consumption beyond tobacco alone.

Reference: Goldberg R. Dual Cannabis, Tobacco Smoking Linked to Higher Incidence of Lung Cancer. Pulmonology Advisor. Published November 17, 2025. Accessed December 5, 2025. https://www.pulmonologyadvisor.com/news/dual-cannabis-tobacco-smoking-tied-to-more-worse-lung-cancer/

Amivantamab is an EGFR-MET bispecific antibody used intravenously—often with lazertinib—for EGFR-mutated advanced non–small-cell lung cancer (NSCLC). The phase 2 SKIPPirr trial tested four prophylactic strategies on top of standard premedication (antihistamines, antipyretics, intravenous dexamethasone 10 mg) in patients with advanced EGFR exon 19 deletion or L858R–mutated NSCLC previously treated with osimertinib and platinum chemotherapy. Cohorts received either low-dose oral dexamethasone 4 mg twice daily (BID), higher-dose dexamethasone 8 mg BID, montelukast, or a single dose of subcutaneous methotrexate, in a Simon two-stage design. Among 68 participants (median age 63.5 years; 65% female; 62% Asian), the dexamethasone 8 mg BID cohort was the only regimen to meet predefined criteria and advance to expansion.

In the dexamethasone 8 mg cohort, infusion-related reaction (IRRs) on the first infusion (C1D1) occurred in 22.5% of patients—all grade 1 to 2—representing roughly a threefold reduction versus historical data with standard IRR management alone. By the end of cycle 3, 24.4% had experienced an IRR, with only one grade 3 event. Overall adverse events (rash, paronychia, hypoalbuminemia) were consistent with known EGFR/MET inhibition, and steroid-related toxicities were minimal. The investigator-assessed objective response rate with amivantamab–lazertinib plus dexamethasone 8 mg BID was 33% (28% confirmed), aligning with prior trials and suggesting no loss of efficacy. Infusion times were modestly shorter than historical controls. The authors conclude that adding short-course dexamethasone 8 mg BID to standard premedication meaningfully reduces IRRs, maintains antitumor activity, and may improve the practicality and tolerability of intravenous amivantamab in routine care.

Reference: Spira AI, Paz-Ares L, Han JY, et al. Preventing Infusion-Related Reactions With Intravenous Amivantamab-Results From SKIPPirr, a Phase 2 Study: A Brief Report. J Thorac Oncol. 2025;20(6):809-816. doi: 10.1016/j.jtho.2025.01.018.

Authors of a recent review outline how non–small-cell lung cancer (NSCLC) management has rapidly evolved through advances in screening, diagnostics, and systemic therapies across early-stage and advanced disease. Low-dose CT screening has reduced lung cancer mortality. Updated United States Preventive Services Task Force and American Cancer Society criteria now capture younger, higher-risk, and historically underserved populations, though further outreach to low-socioeconomic status groups is still needed. Staging continues to be refined by International Association for the Study of Lung Cancer to better reflect prognosis and treatment planning. Molecular profiling via next-generation sequencing has become central to care—identifying key driver alterations and immunotherapy biomarkers and increasingly incorporating tools like circulating tumor DNA.

On the treatment side, immunotherapy has moved from metastatic salvage to frontline and perioperative standard of care in actionable genomic alteration-negative NSCLC. It improves event-free and disease-free survival in resectable disease and overall survival in unresectable stage III and metastatic settings. For tumors with actionable genomic alterations, targeted agents are now used in both early-stage adjuvant and advanced disease, with an expanding armamentarium that includes newer tyrosine kinase inhibitors, bispecific antibodies, and antibody–drug conjugates. Collectively, improved screening, more precise staging, and increasingly personalized systemic therapy have transformed NSCLC into a disease where outcomes are steadily improving.

Reference: Jeon H, Wang S, Song J, Gill H, Cheng H. Update 2025: Management of Non‑Small-Cell Lung Cancer. Lung. 2025;203(1):53. doi: 10.1007/s00408-025-00801-x.