MINI REVIEW article
Front. Oncol.
Sec. Thoracic Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1642062
This article is part of the Research TopicPrecision Oncology: Integrating Molecular Mechanisms, Organoid Models, and Omics Technologies for Personalized Cancer CareView all articles
Mapping the clinical trial landscape of multiple primary lung cancer in the era of precision oncology：Persistent exclusion and design limitations hamper evidence-based treatment development
Provisionally accepted
- 1University of Oxford, Bee Research Laboratory, Oxford, United Kingdom
- 2Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China
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Multiple primary lung cancer (MPLC) is increasingly recognized for its clinical and biological significance, yet remains strikingly underrepresented in clinical trials. We systematically analysed 8,212 lung cancer trials registered between 2015 and 2024 across four major international registries, finding only 18 (0.22%) explicitly included MPLC patients. Most of these trials were early-phase, observational, and surgery-focused, with minimal incorporation of biomarker-driven or precision strategies. This underrepresentation reflects a structural exclusion rooted in traditional single-lesion trial paradigms. It is further exacerbated by limited engagement from industry and government sponsors, due to high trial complexity and low commercial incentive. Inclusion-oriented frameworks are urgently needed to align research with MPLC’s clinical reality.
Keywords: Multiple primary lung cancer (MPLC), clinical trial design, Patient underrepresentation, precision oncology, tumour heterogeneity
Received: 19 Jun 2025; Accepted: 17 Jul 2025.
Copyright: © 2025 Shi, Liang and Gao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yushun Gao, Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China
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