{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:18:50Z","timestamp":1786115930318,"version":"build-2736575974"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"AEEC \u201cClinico Junior en Territorio Nacional 2023\u201d"},{"name":"Acci\u00f3n Estrat\u00e9gica en Salud programme of the Instituto de Salud Carlos III"},{"name":"FIS 2024","award":["PI24\/00982"],"award-info":[{"award-number":["PI24\/00982"]}]},{"name":"CRIS Translational Physician Talent Programme"},{"name":"Fundaci\u00f3 La Marat\u00f3 TV3"},{"name":"LAPIN Consortium","award":["EU4H-2024-PJ-04-01"],"award-info":[{"award-number":["EU4H-2024-PJ-04-01"]}]},{"name":"EU\u2013USA cooperation on lung cancer, 2025"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Med Oncol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>Lung cancer remains the leading cause of cancer-related mortality worldwide, accounting for approximately 1.8 million deaths annually. Beyond this universal burden, lung cancer is profoundly heterogeneous, shaped by geography, environmental exposures, genetic ancestry, and unequal access to molecular diagnostics and modern therapies. Compelling evidence indicates that non-small cell lung cancer (NSCLC) is not a single entity but a constellation of molecularly distinct subtypes whose distribution reflects regional carcinogens and population-specific susceptibilities. This Special Collection of Therapeutic Advances in Medical Oncology assembles five complementary studies that address the geographical heterogeneity of NSCLC. A comprehensive review by Laguna and colleagues maps the worldwide distribution of risk factors and molecular subtypes, illustrating how tobacco, indoor radon, air pollution, arsenic, biomass smoke, and genetic ancestry converge to produce distinct molecular landscapes across continents. Garc\u00eda-Pardo and colleagues extend this framework with the RADON EUROPE study, the first ecological analysis to link estimated indoor radon exposure with ALK fusion prevalence across 21 European countries. Marjanski and colleagues expose critical gaps in real-world perioperative assessment in Poland, where limited preoperative biomarker testing and prolonged surgical intervals may exclude patients from neoadjuvant chemoimmunotherapy. Mo and colleagues describe an emerging consequence of therapeutic progress: a temporal rise in cardiovascular and pulmonary diseasespecific mortality in NSCLC, coinciding with the expanded use of targeted therapies and immune checkpoint inhibitors. Pham and colleagues demonstrate, in a Vietnamese cohort with EGFR-mutant NSCLC, that flexible, individualized afatinib dosing improves outcomes and underscores the persistent underrepresentation of non-European populations in pivotal trials. Taken together, these articles illustrate that the geographic distribution of carcinogens shapes molecular subtypes; molecular subtypes dictate treatment options; treatment options generate toxicities that must be managed within local healthcare systems; and those systems, in turn, determine equitable access to diagnostic and therapeutic innovation. Bridging these gaps will require integration of exposome-informed approaches, more diverse clinical trial populations, cardio-oncology surveillance, and pharmacological individualization. This editorial advocates for a geographically informed and globally equitable approach to thoracic oncology.<\/jats:p>","DOI":"10.1177\/17588359261473571","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T11:34:27Z","timestamp":1785756867000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lung cancer across borders: From molecular epidemiology to precision treatment strategies"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6339-8501","authenticated-orcid":false,"given":"Miguel","family":"Garc\u00eda-Pardo","sequence":"first","affiliation":[{"name":"Hospital Universitario Ram\u00f3n y Cajal"},{"name":"Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s Felipe","family":"Cardona","sequence":"additional","affiliation":[{"name":"Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center, CTIC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6607-1106","authenticated-orcid":false,"given":"Herbert H.","family":"Loong","sequence":"additional","affiliation":[{"name":"The Chinese University of Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0936-7338","authenticated-orcid":false,"given":"Laura","family":"Mezquita","sequence":"additional","affiliation":[{"name":"Hospital Clinic of Barcelona"},{"name":"IDIBAPS"},{"name":"University of Barcelona"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.01626"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/17588359241231260"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/17588359251351449"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2019.04.009"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2021.01.122"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14133142"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-023-05874-3"},{"key":"e_1_3_3_10_2","doi-asserted-by":"crossref","first-page":"S849","DOI":"10.1016\/j.annonc.2023.09.2539","article-title":"1508TiP The 1920-EORTC-BIORADON study: Molecular characterization of non-small cell lung cancer (NSCLC) and indoor radon exposure in Europe","volume":"34","author":"Mezquita L","year":"2023","unstructured":"Mezquita L, Turrisi F, Mauer ME, et al. 1508TiP The 1920-EORTC-BIORADON study: Molecular characterization of non-small cell lung cancer (NSCLC) and indoor radon exposure in Europe. 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