ArticleNPJ primary care respiratory medicine2026
The "Asian Paradox" in multiple primary lung cancer: a geographic monopole driven by phenotypic divergence.
Article in NPJ primary care respiratory medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The global clinical trial landscape for multiple primary lung cancer (MPLC) exhibits a striking geographic anomaly. Through a systematic analysis of 8212 lung cancer registrations (2015-2024), we identified a cohort of 17 trials explicitly targeting MPLC. Analysis revealed an absolute geographic monopole: 100% of these trials were investigator-initiated in China, with a complete absence of active protocols in Western registries. We argue that this segregation is not accidental but driven by the "Asian phenotype",which is characterized by indolent, multifocal ground-glass nodules (GGNs), demands lung-sparing local strategies distinct from the systemic paradigms favored in the West. We urge the international community to transition from universal guidelines to phenotype-stratified management frameworks.
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