Clinical research advances in thoracic surgery and thoracic oncology in 2025: a panoramic narrative review

Our plain-English summary of Clinical research advances in thoracic surgery and thoracic oncology in 2025: a panoramic narrative review, by Z. Sun, X. Li, Z. Hao, et al (Journal of Thoracic Disease, 2026).

The study

• Authors: Z. Sun, X. Li, Z. Hao, H. Zhang, D. Ou, W. Zhou, H. Liang, F. Cui
• Journal: Journal of Thoracic Disease
• Published: 2026;18(4):424
• Type of article: Review
• Read it: PubMed · Publisher · Free full text

Abstract

Background And Objective: The year 2025 brought important refinements in thoracic surgery and thoracic oncology, particularly in risk-adapted screening, biomarker-guided perioperative therapy, minimally invasive surgery, and perioperative recovery. This narrative review summarizes clinically relevant evidence reported in 2025 and discusses how these updates may influence multidisciplinary practice.

Methods: We conducted a narrative review of literature and conference reports published or presented between January 1 and December 31, 2025. PubMed, Google Scholar, and the official abstract proceedings/websites of the American Society of Clinical Oncology (ASCO), the World Conference on Lung Cancer (WCLC), and the European Society for Medical Oncology (ESMO) were searched using combinations of disease-, treatment-, and surgery-related keywords. Earlier pivotal trials were cited selectively to provide background context where needed.

Key Content And Findings: The National Comprehensive Cancer Network (NCCN) updated lung cancer screening criteria toward broader risk inclusion. In resectable non-small cell lung cancer (NSCLC), 2025 data further refined perioperative strategies for molecularly selected and driver-negative populations, including long-term outcomes from immunotherapy trials and phase III evidence for neoadjuvant targeted therapy. Robot-assisted thoracic surgery (RATS) continued to show advantages in selected complex settings, especially after induction treatment. Progress in mesothelioma, esophageal cancer, perioperative rehabilitation, and digital symptom monitoring also underscored the increasing importance of whole-patient care. However, several emerging tools, including circulating tumor DNA (ctDNA) and artificial intelligence (AI)-assisted models, still require prospective validation, standardization, and broader accessibility before routine implementation.

Conclusions: Recent advances in thoracic oncology increasingly support a more precise, multidisciplinary, and patient-centered model of care. The most meaningful progress in 2025 lay not only in new treatments, but also in better integration of molecular stratification, surgical decision-making, and perioperative management.

© AME Publishing Company.

In plain English

This article was a narrative review, not a new study. The authors searched PubMed, Google Scholar and the abstract records of three cancer conferences (ASCO, WCLC and ESMO) for clinical research on chest cancers and chest surgery published or presented in 2025. They stated that the review was centered on lung cancer and did not aim to capture every study. For malignant pleural mesothelioma, the review described other researchers' findings. A review article noted that the drugs nivolumab plus ipilimumab had become the cornerstone of treatment when the cancer cannot be removed by surgery. That article also cited observational studies finding that pleurectomy/decortication gave better function than extrapleural pneumonectomy, with similar survival. A phase II trial gave nivolumab plus ipilimumab before surgery and reported a median overall survival of 28.6 months, against 18 months in a historical comparison group. The review does not discuss asbestos. The authors concluded that lung cancer produced most of the new evidence, but that mesothelioma, esophageal cancer and thymic tumors also showed progress toward more tailored management.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Narrative review of literature and conference reports from 2025
• Who was studied: Published studies, guidelines and conference abstracts on thoracic cancers and thoracic surgery from January 1 to December 31, 2025, found through PubMed, Google Scholar and the ASCO, WCLC and ESMO proceedings. Earlier studies were cited selectively for background. Mainly lung cancer, with sections on malignant pleural mesothelioma, esophageal cancer and thymic tumors.
• Exposure: Not an exposure study. The review covered screening, diagnostic tests, drug treatments, surgical methods and recovery care. Asbestos and asbestos fiber types are not mentioned.
• Main results:
  • A review article cited by the authors noted that nivolumab plus ipilimumab became the cornerstone of systemic treatment for unresectable malignant pleural mesothelioma. It also noted that observational studies showed lung-sparing pleurectomy/decortication improved functional outcomes compared with extrapleural pneumonectomy, with similar survival.
  • A retrospective analysis cited by the authors limited surgery to patients with epithelioid histology, no lymph node involvement and complete gross resection. In those patients, pleurectomy/decortication combined with systemic treatment showed greater survival benefit than in the non-surgical group.
  • A phase II study cited by the authors used neoadjuvant nivolumab plus ipilimumab in mesothelioma. It reported a median overall survival of 28.6 months, compared with 18 months in a historical control group, and more than 80% of patients completed surgery within the planned window.
  • In the cited mesothelioma work, patients whose circulating tumor DNA cleared or fell by more than 95% after neoadjuvant immunotherapy had significantly longer survival. Continued positivity indicated a risk of early progression.
  • A genomic profiling platform study cited by the authors (EORTC-SPECTRA Arcagen) identified actionable mutations in about 30% of rare thoracic tumors, including malignant pleural mesothelioma.
  • For lung cancer, the cited 5-year follow-up of CheckMate 816 reported 65% overall survival in the nivolumab group versus 55% in the chemotherapy group.
• The authors' conclusion: The authors concluded that lung cancer remained the main source of new evidence in 2025, but that mesothelioma, esophageal cancer and thymic tumors also showed meaningful progress toward more tailored management. In their view, tools such as circulating tumor DNA testing and AI-assisted models remain in transition from research to routine practice.
• Limitations the authors state:
  • The review did not aim to capture every study; it selected evidence the authors judged clinically influential.
  • The review was centered on lung cancer because most 2025 evidence concerned lung cancer. Other thoracic cancers, including mesothelioma, were covered only selectively.

Topics

Medical terms in this study, explained in our Lexicon: Thoracic Surgery, Biomarker, Lung Cancer, Low-Dose CT Screening, Non-Small Cell Lung Cancer, Immunotherapy, Targeted Therapy, Mesothelioma.

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