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Curation log — lung-adenocarcinoma

2026-08-28 — Seed session

  • What changed: Condition seeded: INDEX.md (portrait + 18-page proposed canonical list, sibling cross-reference to lung-squamous-cell-carcinoma), wiki/overview.md (draft, 25 PMID-verified references incl. full driver-therapy table), OPEN-QUESTIONS.md (8 seed questions), this log.
  • What was searched: Live PubMed queries on: NLST, NELSON, USPSTF 2021, population-mortality analysis (Howlader 2020), IASLC/ATS/ERS 2011 classification, TCGA 2014, Sherlock-Lung never-smoker genomics (Díaz-Gay 2025), CAP/IASLC/AMP testing guideline, IPASS, FLAURA, ADAURA (+network meta-analysis), ALEX, CROWN, ROS1 crizotinib, CodeBreaK100 sotorasib, BRAF dabrafenib–trametinib, LIBRETTO selpercatinib, GEOMETRY capmatinib, DESTINY-Lung01 T-DXd, KEYNOTE-024, KEYNOTE-189, CheckMate 816, pemetrexed histology interaction. All PMIDs verified via search + metadata retrieval this session.
  • Check next time: (1) FLAURA2 (osimertinib+chemo) and MARIPOSA (amivantamab–lazertinib) first-line EGFR trials — deliberately omitted pending verification; (2) ADAURA overall-survival publication; (3) KRYSTAL/adagrasib and G12C combination data; (4) TNM-9 staging edition for the shared staging page; (5) ALINA (adjuvant alectinib); (6) driver-frequency-by-ancestry table sources for molecular-landscape page.

2026-08-29 — Full build

  • What changed: Completed all 18 canonical wiki pages. Preserved and extended the 8 seeded pages; added alk-ros1-and-fusion-drivers.md, kras-braf-met-her2.md, immunotherapy.md, early-stage-and-perioperative-therapy.md, systemic-therapy.md, biomarkers.md, guidelines.md, clinical-trials-landscape.md, patient-experience-and-advocacy.md, and red-flags-and-safety-concerns.md. Every page is 150–400 lines, has current frontmatter, TL;DR, dense cited sections/tables, open questions, canonical related links, and references. Status remains draft pending the separate audit session required by the playbook.
  • Literature layer: Built BIBLIOGRAPHY.md with 262 unique PubMed records and every citing page; six landmark notes (IPASS, TCGA, FLAURA, ADAURA, CheckMate 816, Sherlock-Lung); a worldwide/current guideline registry with supersession chains, disagreements and watch list; a quantitative statistics/effect-size ledger; and a four-file patient-voice layer with method/ethics, 12 live-fetched organizations, aggregate themes, and annotated sources.
  • Research agenda: Replaced the 8-question seed with 30 stable questions: 18 Tier 1 practice-changing designs and 12 Tier 2 enabling questions. Added 12 “Dots not yet connected” junctions linking screening, pollution, pathology, MRD, CNS therapy, evolution, immunobiology, ADC safety, perioperative therapy, plasma/tissue, survivorship, and trial access.
  • PubMed searches: Live E-utilities searches covered existing condition citations plus shared NSCLC evidence and targeted queries for ALK inhibitors/ALEX/CROWN/ALINA; ROS1 crizotinib/entrectinib/repotrectinib; RET selpercatinib/pralsetinib/LIBRETTO-431; NTRK/larotrectinib; KRAS G12C/CodeBreaK/KRYSTAL; BRAF V600E doublets; MET exon-14 capmatinib/tepotinib and resistance; HER2/T-DXd/zongertinib; driver-positive immunotherapy; STK11/KEAP1; perioperative chemo-immunotherapy; ctDNA/MRD; stigma, caregivers, financial toxicity, trial access and supportive care. Final whole-condition validation resolved all 265 unique PMIDs present anywhere in the condition in two ESummary batches (150 + 115); the wiki bibliography contains the 262 unique PMIDs cited by canonical pages.
  • ClinicalTrials.gov searches: Live API v2 queries covered Non-Small Cell Lung Cancer, Lung Adenocarcinoma, osimertinib, amivantamab, lorlatinib/ALK, repotrectinib/ROS1, KRAS G12C, HER2-mutant, MET exon-14, RET fusion, ctDNA/MRD, and perioperative NSCLC. Snapshot counts: 490 active and 578 completed records indexed to lung adenocarcinoma; 2,429 active and 3,247 completed indexed to NSCLC. Final record-by-record validation resolved all 42 unique NCT identifiers used in this condition; no failed NCT remained.
  • Public-source verification: Live HTTP fetches returned 200 for NICE NG122/NG12, the ESMO early/local living guideline, the IASLC molecular-testing resource, CAP cancer protocols, USPSTF screening, and 12 patient/advocacy organization sites. The ASCO living-guideline URL returned HTTP 403 to automated retrieval but its URL and archived PMID were verified; the registry labels this access limitation. NCCN professional guidance remains authenticated-access-only and is explicitly flagged for point-of-use version checking. A direct CAP PD-L1/TMB page URL tested returned 404, so the registry cites the live-resolved PMID rather than that stale URL.
  • Validation performed: 18 wiki pages; 2,939 lines; all page frontmatter dates/statuses and required sections present; all local Markdown links resolve; no unresolved citation flags remain; every wiki PMID appears in the bibliography; 265/265 unique condition PMIDs resolve live; 42/42 unique NCT IDs resolve live. No files under the excluded thoracic-aortic-aneurysm, fibromyalgia, tools, or frontend paths were modified, and no Git command was used.
  • Check in the separate audit session: Re-fetch each claim→PMID pair and compare titles, author/year/journal, numerical values, and abstract support; correct bibliographic abbreviations where needed; re-run absence claims; verify current ASCO/NCCN/ESMO versions with human/authenticated access; inspect ClinicalTrials.gov site-level recruitment rather than sponsor-level status; then promote only pages that pass to curated and change the roadmap from built to audited.

2026-08-29 — Full AUDIT pass

  • Scope completed: Audited all 18 canonical wiki pages and all 13 literature artifacts: the 270-record bibliography, guideline registry, statistics ledger, six landmark notes, and four patient-voice files. The wiki contains 2,961 lines, 1,086 PMID occurrences representing 268 unique page-cited records, and 42 unique NCT identifiers. The literature layer contains 474 PMID occurrences representing 270 unique records; two records are registry-only context rather than wiki citations.
  • Live citation verification: Re-fetched all 270/270 unique condition PMIDs through PubMed E-utilities in this audit session and compared identifiers, titles, authorship/year/journal metadata, numerical claims, and abstract support. Re-fetched all 42/42 unique NCT records through ClinicalTrials.gov API v2 and checked study identity, recruitment status, phase, and enrollment fields. No unresolved PMID or NCT identifier remains.
  • Absence and currency searches: Re-ran live PubMed searches for randomized repotrectinib-versus-entrectinib evidence, direct alectinib-versus-lorlatinib comparisons, ctDNA/MRD-guided adjuvant intervention results, never-smoker LDCT mortality trials, EGFR oligoprogression randomized evidence, and STK11/KEAP1-directed immunotherapy evidence. Re-ran ClinicalTrials.gov disease-level and topic-level searches; the dated 2026-08-29 snapshots remain 490 active and 578 completed records indexed to lung adenocarcinoma and 2,429 active and 3,247 completed records indexed to NSCLC.
  • Errors found and fixed: 50 discrete defects were corrected: 19 incorrect first-author attributions in the patient-voice source ledger; 2 incorrect or stale ASCO living-guideline records/version fields; 7 ClinicalTrials.gov phase fields; 1 misspelled central-airway registry author; 1 superseded ROS1 organization URL in 2 local locations; 3 stale or overbroad evidence statements (STK11/KEAP1, MRD-guided treatment, and first-line EGFR intensification); and 17 PMID entries cited in page bodies but omitted from 3 page reference lists. Current ASCO records were replaced with live-verified PMIDs 42607282, 42190143, and 42190141; the emerging CTLA-4/STK11-KEAP1 evidence was added with PMID 39385035; and active MRD protocols were added with PMIDs 39659920 and 41628935.
  • Claims corrected or softened: The STK11/KEAP1 discussion now distinguishes adverse prognosis and PD-(L)1 resistance from the subgroup/translational evidence supporting a CTLA-4-containing strategy, without claiming validated biomarker-directed selection. MRD language now states the dated positive gap—interventional protocols exist, but mature randomized survival evidence for changing therapy from postoperative ctDNA was not identified. EGFR intensification language now separates proven aggregate PFS benefit from the unresolved patient-selection question. Trial tables now use registry-reported phase and actual-versus-estimated enrollment labels.
  • Structural validation: All 18 pages remain within the required 150–400-line range (150–202 lines), contain the required frontmatter and sections, have every body PMID represented in the page reference list, and resolve all local Markdown links. The bibliography covers every PMID used anywhere in the condition. There are zero unresolved verification markers and zero unresolved substantive audit issues.
  • External-source limitations retained explicitly: NCCN professional guidance remains authenticated-access-only and requires point-of-use version checking. ASCO living-guideline web pages returned HTTP 403 to automated retrieval, so current recommendations are anchored to their live PubMed records and the access limitation remains recorded. These are access/version-control cautions, not unresolved claim-to-citation failures.
  • Promotion: All 18 wiki pages passed and were promoted from draft to curated. INDEX.md, the literature status labels, and CONDITIONS-ROADMAP.md were updated to audited.

2026-10-16 — Literature sweep (author: Claude; window 2026-08-28 → 2026-10-16)

  • Sources actually queried:
  • PubMed E-utilities: 19 topic queries on Entrez date [edat], about 600 hits. Topics: RCT/phase 3, systematic reviews, Cochrane, guidelines, EGFR, fusions, KRAS/BRAF/MET/HER2, immunotherapy, perioperative, ADCs, ctDNA/MRD, screening, epidemiology, histology/staging, molecular testing, never-smoker/pollution, brain metastases/SABR, patient experience, and retraction notices (0 hits).
  • PubMed, second pass: the same queries on publication date [dp], excluding the edat window, to catch records entered before the window but dated inside it (about 220 more). Plus targeted title/journal searches for trial OS papers.
  • Cochrane: "Cochrane Database Syst Rev"[jour]. 54 CDSR records were entered in the window and none concerns lung cancer, screening or lung-cancer therapy, so no new or updated Cochrane review was found in PubMed.
  • Europe PMC: three queries (non-MEDLINE, preprints SRC:PPR, phase 3 NSCLC), 395/111/240 hits. Nothing of practice-changing weight survived triage: mostly unreviewed preprints and PMC copies of records already seen.
  • Crossref: updated-by checked for every added DOI. The two CMA DOIs returned 404 (not Crossref-registered); the PubMed publication types were clean.
  • ClinicalTrials.gov API v2: all 42 tracked NCT IDs re-fetched, plus 7 newly cited trials and the disease-level snapshot counts.
  • WHO ICTRP: the ChiCTR2000040590 record was retrieved (status still "Pending"). The ChiCTR site itself returned HTTP 405.
  • Patient-organisation sites: 12 probed.
  • Not searched: Cochrane CENTRAL and SciELO/LILACS (HTTP 403); Embase/Scopus/WoS (no credentials); Unpaywall (LIFEBANK_CONTACT_EMAIL unset, so skipped per SOURCES.md, and no email was sent to any API). Every absence below is an absence in PubMed and Europe PMC only.
  • Full query strings, translations, IDs, registry fields and per-record retraction results are in the manifest literature/sweeps/2026-10-16.json.
  • Most important finding: the 2026-08-29 build was stale on EGFR first-line therapy. The final OS papers for FLAURA2 (Jänne 2026, PMID 41104938: OS HR 0.77, 47.5 vs 37.6 mo) and MARIPOSA (Yang 2025, PMID 40923797: OS HR 0.75) were published before the build but not cited. The wiki and OQ-1 said intensification improved PFS with "mature OS" unresolved. The build also missed:
  • LAURA's primary report (PMID 38828946), although the wiki said genotype-specific stage III evidence was "required";
  • STARLET (PMID 41534788), the first randomized evidence on deferring SRS for EGFR brain metastases, which bears directly on OQ-6;
  • the CROWN 7-year update (PMID 42217582).

The 2026-08-29 audit's currency claim therefore did not hold for these records. - Other records that survived triage and changed pages: - Early-stage: S1914 (SABR ± atezolizumab: OS HR 1.04, futility; PMID 42702214), AEGEAN updated OS HR 0.89 (PMID 42664473), ADAURA 8-year landmark (PMID 42732874), ICWIP (PMID 42660909), LAURA subsequent therapy/OS IA2 (PMID 42714840), ADVANCE (ChiCTR2000040590; PMID 42764281), ALINA HRQoL (PMID 42636834), the CheckMate 77T biomarker paper (PMID 42587156), the postoperative IO absolute-DFS reconstruction (PMID 42843316), and the EVIDENCE and stage III MRD cohorts (PMIDs 42706268, 42336205). - Advanced disease: the EGFR/TP53 osimertinib ± chemo phase 3 (PMID 42574006), HARMONi (PMID 42636833; has a published correction, PMID 42805208, whose content could not be retrieved — the auditor must check whether it alters the figures cited), AMAZE-lung (PMID 42833236), MARIPOSA resistance (PMID 42061572), FLAURA2 long-term safety (PMID 42728193), the Japanese long-term-benefit score (PMID 42767607), envonalkib (PMID 42830869), cabozantinib after ROS1 TKIs (PMID 42832369), daraxonrasib (PMID 42685317), GFH375 (PMID 42745055), ifebemtinib + garsorasib (PMID 42413526), and SKYSCRAPER-01 (PMID 42507968). - Risk and screening: germline EGFR T790M (PMID 42752144), PM2.5 constituents in never-smokers (PMID 42828982), wildfire PM2.5 and survival (PMID 42743939), CPH-Lung (PMID 42863103), BioMILD (PMID 42777510), and the JAMA cessation RCT (PMID 42832220). - Pathology: histologic descriptors added to TNM-9 (PMID 42055159), ECTOP-1014 frozen-section grading (PMID 42119754), and STAS genomics (PMID 42760303). - Patient experience: SYMPRO-Lung (PMID 42727592), the ALK survey (PMID 42823962), EGFR shared decision-making (PMID 42799215), and the financial-toxicity meta-analysis (PMID 42661720). - Literature layer: - Registry: added AATS 2026 (PMID 42790620), STS 2026 sublobar (42320552), ESTRO reirradiation (42468604), ACR indolent lung cancer (42573542), the CMA 2026 guideline (42764215; parallel 42763208), the Chinese molecular-testing guideline 2026 (42851192; no abstract, so content unverified), Korean PE/BALF ctDNA (42844226), the Vietnamese consensus (42870861), and the Austrian screening position paper (42758313). Added the ASCO driver-alteration 2026.3.2 record (42372216) to the supersession chain (3.3 remains current). - Statistics: about 30 rows added, including US Hispanic statistics 2026 (42831778), AYA incidence by histology (42873587), and real-world NGS/matched-therapy use (42804730, 42679379). - Patient voice: four studies and Lung Cancer Europe's "Get Checked! 2026" campaign (primary-care focus) added. - Bibliography: 57 new PMIDs, tagged sweep-2026-10-16; 327 unique in total. - Triaged out: three in-window records were relevant but not cited because the ledger rule admits only cited PMIDs: ADC brain-metastasis meta-analysis (42815252), lorlatinib phase 2 final (42749050) and MARIPOSA time to symptomatic progression (42492306). The large majority of the ~800 PubMed hits (real-world series, single-centre retrospectives, bioinformatic signatures, case reports, cost-effectiveness models, narrative reviews) deserved nothing. No landmark note was written. FLAURA2/MARIPOSA OS is a candidate for a note once audited. - Trial registry changes: - NCT06524427 (RAVAR) went from Recruiting to Active, not recruiting. No tracked trial newly posted results. - Primary completion passed without results: NCT05132075, NCT04819100, NCT05650879, and NCT03175224 (still listed Recruiting). - Probably stale records: NCT06156527, NCT06854939, NCT06682884, NCT05965024. - Results published but not posted to the registry: NCT05601973 (AMAZE-lung), NCT03769103 (LUOSICNS/STARLET). - Snapshot counts: NSCLC 2,437 active / 3,265 completed; LUAD 497 / 584. - Pages changed, all demoted to status: draft with last-curated: 2026-10-16: egfr-disease, early-stage-and-perioperative-therapy, alk-ros1-and-fusion-drivers, kras-braf-met-her2, screening-and-early-detection, epidemiology-and-risk-factors, immunotherapy, histology-and-classification, patient-experience-and-advocacy, clinical-trials-landscape, systemic-therapy. STATISTICS.md was also set to draft. Numbers were taken from PubMed abstracts. Full texts were not opened: Europe PMC reports most cited records as not open access, and Unpaywall was skipped. Per FAILURE-MODES.md, any claim the auditor considers load-bearing should be checked against full-text tables. - Open questions: OQ-1 rewritten (OS now proven in aggregate; selection is the whole question) and sweep notes added to OQ-2, 5, 6 (partly addressed by STARLET; not retired), 7, 8, 12, 13, 14, 15, 20, 21, 22 and 28. D5 updated. None retired. - Issues found but not fixed (pre-existing, outside this sweep's edits): - Body PMIDs missing from the page's own References list: guidelines.md (36780674, 35461558) and systemic-therapy.md (37270692, 34740862, 29773717, 31838015, 37694347). All are in the bibliography. - Four patient organisations (ALK Positive, LCRF, GLCC, Lung Foundation Australia) returned HTTP 403 to automated probes. This is likely bot blocking; rows left unchanged. - The bibliography's "Unique PMIDs: 262" line was stale (the actual count was 270); it has been corrected to 327. - The abstracts disagree on whether STAS is part of TNM-9 (Saw 2026 vs Abolfathi 2026). This is recorded in OQ-22 for the auditor. - Next sweep / audit should chase: 1. A different-engine audit of the 11 draft pages, STATISTICS.md and the 57 new bibliography lines. 2. The HARMONi correction (PMID 42805208). 3. The MARIPOSA and FLAURA2 OS full texts, for subgroup and PRO tables relevant to OQ-1. 4. A currency re-search for other pre-window primary papers the build may have missed (e.g., ALINA OS, CheckMate 77T/KEYNOTE-671 OS updates, TROPION-Lung, Beamion/zongertinib randomized data, KRYSTAL-7, NeoADAURA). 5. NCT05132075 and NCT04819100 results. 6. The ESMO 2026 and WCLC 2026 full publications. 7. Lung Cancer Awareness Month (November) patient-organisation material. 8. Continue to qualify regional-evidence absences while SciELO/LILACS and CENTRAL remain unreachable.

2026-10-23 — Literature sweep (author: Codex; window 2026-08-28 → 2026-10-23; independent audit pending)

  • Sources actually queried:
  • PubMed E-utilities: 18 main topic searches, each explicitly restricted to publication dates 2026-08-28 through 2026-10-23: epidemiology/risk; screening; histology/staging; molecular landscape; molecular testing; EGFR; fusion drivers; KRAS/BRAF/MET/HER2; immunotherapy; perioperative/local treatment; biomarkers/MRD; systemic therapy/ADCs; CNS/oligoprogression; patient experience; safety; guidelines; randomized/phase-3 trials; systematic reviews. These returned 1,862 distinct IDs; metadata/abstracts were fetched for these plus the prior HARMONi correction follow-up (1,863 records). Triage prioritized systematic reviews, randomized trials, guideline/version changes, and the prior sweep's follow-ups; retrieval alone is not an evidence addition.
  • Supplementary PubMed: a broader lung-neoplasm burden query returned 1,617 IDs, from which the Annual Report to the Nation was selected for metadata retrieval. Pan-Asian guideline publication/electronic-date searches and direct record retrieval checked a newly indexed guideline with inconsistent dates. Two existing ASCO anchors were re-fetched. These supplementary search counts overlap the main searches and are not summed as a unique-paper count.
  • Cochrane through PubMed: the CDSR journal restriction was run separately for all 18 topics (zero hits in each); a broader lung-cancer/CDSR query returned one updated menopause hormone-therapy review, triaged outside this condition's existing assertions. No new review warranting a change to the lung-adenocarcinoma synthesis was identified in these PubMed searches. Cochrane Library/CENTRAL was not searched.
  • Europe PMC: 18 date-restricted topic queries returned 1,398 distinct source/record pairs, including 234 without a PMID. Core metadata included open-access/full-text availability. No non-PMID record survived triage for citation: the candidates were preprints, secondary analyses, protocols or small studies. The 29 Europe PMC PMIDs outside the main fetched set were independently fetched through PubMed E-utilities; no PMID was introduced on Europe PMC authority alone.
  • Crossref: checked the new burden report, the held Pan-Asian guideline, the HARMONi report/correction and the broad Cochrane hit. The added burden report has clean PubMed publication types and an empty Crossref updated-by field. HARMONi's updated-by identifies an erratum. The Pan-Asian DOI returned HTTP 404, so its Crossref retraction status remains unverified and the paper was withheld from the bibliography and recommendation synthesis.
  • ClinicalTrials.gov API v2: all 50 distinct NCT IDs in the condition's Markdown resolved live. The old manifest has saved comparison fields for 42; the other eight are current snapshots only, so no interval change is inferred for them. Among the comparable 42 there was no overall-status or results-availability change. NCT06162221 has a newer last-update-posted date (2026-10-19 versus 2026-06-30), remains Recruiting, and has no posted results. The requested priority records NCT05132075 and NCT04819100 still have no posted results. Across all 50 current snapshots, NCT04214262 (S1914) has a results-first-posted date within the requested 2026-08-28 onward window (2026-10-06); the previous sweep already noted posted results for it, so this is not a new posting since 2026-10-16. No disease-level counts were recalculated.
  • Non-US registries: WHO ICTRP was requested for the previously cited ADVANCE registration and returned HTTP 502 on both attempts. Direct ChiCTR search served an anti-bot script, not a usable record. ISRCTN search served a JavaScript/cookie wall and the attempted API route returned HTTP 404. These are unsuccessful registry attempts, not a completed non-US trial search; no current registry status was inferred from the prior WHO snapshot or from ClinicalTrials.gov.
  • Official guideline sources: NICE NG122 was retrieved directly and still displays update 2024-03-08/review 2026-02-10. Direct ASCO living pages returned HTTP 403. Official search-indexed metadata advertises without-driver v2026.3.3 (updated 2026-07-24), while its archived PMID identifies v2026.3.1; these are now distinguished. ESMO's direct pages served only a site shell, while its official search-indexed listing identifies early/local living v1.3 (August 2026) and a Pan-Asian notice dated 2026-09-29. NCCN authenticated content was not retrieved.
  • Burden portals: CDC's Annual Report page and NCI/SEER's lung-cancer special topic were read through web retrieval; SEER Cancer Stat Facts was also directly fetched. The CDC direct HTTP client route was blocked, but web retrieval returned its full page. The new numerical rows cite the open government portals themselves.
  • Patient-organisation material: directly fetched Lung Cancer Europe news, the existing Get Checked campaign launch, three additional news/education articles, LUNGevity newsletters, GO2's blog, The ROS1ders and EGFR Resisters. Added only the patient-navigation education source. The Get Checked /home route returned HTTP 404, while its LuCE launch page remained available. No private patient material or identifying details were retained.
  • Unavailable/not searched: CENTRAL and SciELO/LILACS (documented HTTP 403 limitations), Embase/Scopus/Web of Science (no credentials), and Unpaywall (LIFEBANK_CONTACT_EMAIL unset). No owner email was read or transmitted. Regional-literature absences cannot be inferred from this sweep.
  • What survived triage and changed:
  • Added one bibliography record: Henley et al., Annual Report to the Nation (PMID 42770880), with both required retraction checks. Bibliography total is now 328. Its journal full text was not retrieved; the entry catalogs metadata, and the statistics rows use retrieved government pages.
  • Added two explicitly all-histology US statistics rows: lung-cancer mortality-rate change during 2004–2023 and screening uptake in eligible adults in 2024. Kept periods, populations, sources and transport limits; did not combine differing historical screening baselines across portals.
  • Corrected ASCO archive-versus-dynamic version labeling in the guideline registry and wiki. Added ESMO version/access notes and a pending-source alert for the Pan-Asian adaptation. Its PubMed record currently gives 2027-12-31 despite October 2026 indexing; Crossref DOI lookup and publisher access failed. Date, Crossref retraction status and recommendation content are explicitly [unverified]; no clinical recommendation was imported.
  • Updated the trial landscape to the actual 50-ID Markdown corpus, recorded the 42-record comparison boundary and the RAS(ON) update, and retained the outstanding results follow-ups.
  • Rechecked the HARMONi correction linkage live (PMIDs: 42636833, 42805208). Publisher correction full text remains HTTP 403; the impact on previously quoted numerical results is now explicitly [unverified] in wiki/egfr-disease.md.
  • Added LuCE's public patient-navigation education page to the patient-voice source ledger. Sharpened OQ-30's proposed access cascade to distinguish non-offer from refusal and record navigator involvement and handoff/travel/time burdens. This is a design refinement, not an intervention-effect claim. No question was retired.
  • Updated INDEX counts/statuses and the changed pages' last-curated dates; all edited pages remain draft. The wiki now has 6 curated and 12 draft pages. The prior 2026-10-16 additions still await their independent audit.
  • Triage boundary: no newly retrieved treatment result warranted a new treatment recommendation or landmark deep note in this pass. Most retrieved records were not added. The new Pan-Asian document was held for verification rather than promoted from its abstract. No claim that a clinical evidence gap is resolved or that regional trials are absent is made.
  • Reproducibility: exact queries, PubMed translations/IDs, compact Europe PMC metadata and full-text flags, per-NCT current/previous fields, retraction checks, source attempts and limitations are preserved only at the permitted path literature/sweeps/2026-10-23.json.
  • Validation: the added bibliography PMID was fetched in-session and passed both retraction checks; all NCT IDs on new/changed lines match live API records; changed Markdown local links resolve; the bibliography count and 6/12 wiki status split reconcile; frontmatter dates/statuses were checked. The pre-existing wiki/guidelines.md body/reference omissions noted by the previous sweep remain outside these version-metadata edits. This is authoring validation, not an independent audit. No git, publishing, deployment, frontend regeneration or site-wide build was run, and only this condition's paths were written.
  • Next sweep / separate auditor should chase: (1) obtain the HARMONi correction full text and verify the existing figures against it; (2) resolve the Pan-Asian date/DOI discrepancy and complete both retraction and full-document recommendation checks; (3) verify the full dynamic ASCO without-driver v2026.3.3 recommendations and current with-driver version; (4) recheck NCT05132075, NCT04819100, NCT05650879 and NCT03175224 for posted results, and use today's 50-record manifest as the next complete baseline; (5) obtain a usable WHO/ChiCTR/ISRCTN response and preserve regional-coverage qualifications; (6) continue the prior sweep's full-text/audit follow-ups for the 57 earlier additions and ESMO/WCLC publications; (7) revisit November awareness material and navigation evidence, distinguishing advocacy resources from empirical outcomes.

2026-10-30 — Literature sweep (author: Grok; window 2026-08-28 → 2026-10-30; independent audit pending)

  • Sources actually queried:
  • PubMed E-utilities: 18 topic searches on publication date [dp] 2026-08-28 to 2026-10-30 (2,141 unique IDs) and the same 18 topics on Entrez date [edat] 2026-10-23 to 2026-10-30 to catch newly indexed records (289 unique IDs). Union 2,169. Cochrane-per-topic CDSR searches on [dp] (all zero). Follow-up title/PMID searches for HARMONi, Pan-Asian, ASCO living guidelines, ALINA OS, CheckMate 77T, KEYNOTE-671, TROPION, zongertinib/Beamion, KRYSTAL-7, NeoADAURA, FLAURA2/MARIPOSA, ESMO/WCLC, retractions, and the Annual Report. Metadata fetched for 400 records and abstracts for 166.
  • Cochrane through PubMed: every topic plus a broader lung/CDSR query. Topic searches returned zero. The broader query returned PMID 42695385 (updated menopause hormone-therapy review), already triaged outside this condition by the 2026-10-23 sweep. No new or updated Cochrane review of lung cancer, screening, or lung-cancer therapy was found in PubMed. Cochrane Library/CENTRAL was not searched (HTTP 403).
  • Europe PMC: eight queries (RCT/phase 3, guidelines, EGFR, perioperative, preprints, non-MEDLINE, Cochrane journal, new-since-last). Hit counts 329 / 213 / 584 / 344 / 132 / 132 / 0 / 53. No non-PMID record survived triage for citation. Key added records were reported isOpenAccess: N.
  • Crossref: updated-by checked for every added DOI. All returned HTTP 200 with empty updated-by except HARMONi (PMID 42636833), whose updated-by is an erratum (DOI 10.1016/s1470-2045(26)00473-0), already recorded. No retraction.
  • ClinicalTrials.gov API v2: all 50 previously tracked NCT IDs re-fetched, plus 9 newly cited IDs (59 total). Disease-level counts: NSCLC 2,463 active / 3,274 completed; LUAD 500 / 586.
  • Non-US registries: WHO ICTRP served ChiCTR2000040590 (HTTP 200); recruitment still listed Pending, last refreshed 15 March 2021. Direct ChiCTR HTML was a shell. ISRCTN API HTTP 200 but no ADVANCE match extracted. CTRI timed out. EudraCT search HTTP 200 (JS portal). These are incomplete non-US registry attempts.
  • Guidelines / burden / patient orgs: NICE NG122/NG12 HTTP 200; ASCO living pages HTTP 403; ESMO early living and news HTTP 200 (JS shell); USPSTF HTTP 200; SEER Stat Facts and Annual Report HTTP 200; CDC annual-report URL HTTP 403 this session. Patient-org homepages: IASLC, GLCC, LuCE, GO2, LUNGevity, LCRF, EGFR Resisters, ROS1ders, Roy Castle, Lung Cancer Canada, Lung Foundation Australia HTTP 200; ALK Positive HTTP 403; LuCE Lung Cancer Awareness Month URL HTTP 404. No new campaign content was imported.
  • Unavailable/not searched: CENTRAL and SciELO/LILACS (HTTP 403), Embase/Scopus/Web of Science (no credentials), Unpaywall (LIFEBANK_CONTACT_EMAIL unset). No owner email was read or transmitted. Absences below are absences in PubMed and Europe PMC only.
  • What survived triage and changed:
  • Krascendo 1 (Skoulidis 2026, PMID 42929675, NCT06497556): divarasib vs sotorasib/adagrasib in previously treated KRAS G12C NSCLC, n=338. PFS 9.8 vs 5.7 mo, HR 0.58; OS 17.7 vs 12.0 mo, HR 0.56; ORR 58.4% vs 32.3%; grade 3–4 TRAEs 24.6% vs 34.5%. First randomized OS advantage of a next-generation G12C inhibitor over first-generation G12C inhibitors. Later-line; does not close first-line OQ-8.
  • KEYNOTE-867 (Jabbour 2026, PMID 42950173, NCT03924869): SBRT ± pembrolizumab in unresected stage I–II, n=448. EFS HR 0.92; stopped early; five treatment-related deaths, all on pembrolizumab. Second independent negative phase 3 after S1914.
  • PANKU-Lung01 (Hong 2026, PMID 42933461, NCT06382116) and HERON-Lung01 (Xu 2026, PMID 42933457, NCT06671379): China-only post-third-generation-EGFR ADC versus chemotherapy. PFS HR 0.40 and 0.47. Grade ≥3 TRAEs 79% vs 62% (iza-bren) and 41% vs 39% (ruzaltatug). OS numbers for PANKU not in the abstract.
  • Dalmelitinib + aumolertinib (Li 2026, PMID 42928710, NCT06110663): EGFR-mutant MET-amplified after EGFR-TKI vs chemotherapy, n=314. PFS HR 0.60; OS immature. Registry record UNKNOWN since 2023-11-01.
  • PERSEE (Descourt 2026, PMID 42927854, NCT04547504): pembrolizumab + chemo vs pembrolizumab in PD-L1 ≥50%, n=321. PFS HR 0.56; OS HR 0.77 (0.56–1.05); grade ≥3 TRAEs 54% vs 19%. Mixed histology.
  • R-ALPS (Ji 2026, PMID 42955021, NCT04325763): benmelstobart ± anlotinib vs placebo after CRT, China, n=553. PFS vs placebo significant; anlotinib add-on not significant (HR 0.82) and more fatal TRAEs. 89.5% male; placebo, not durvalumab, control. Registry UNKNOWN since 2022-03-31.
  • ASCO living guideline 2026.3.4 (Reuss 2026, PMID 42956324): new indexed driver-alteration version. Abstract is boilerplate; dynamic page HTTP 403; recommendation content unverified.
  • LAT meta-analysis (Xu 2026, PMID 42955614): 16 RCTs, OS HR 0.68 overall and 0.52 in EGFR-mutant TKI subgroups. Abstract-sourced; does not close OQ-17.
  • Pre-window follow-ups the prior sweeps asked to chase: HARMONi-A final OS (Fang 2026, PMID 42307937, published 2026-07-28; China-only, OS HR 0.74 significant, distinct from global HARMONi OS not met) and ELEVATE (Yue 2026, PMID 42418775, published 2026-07-09; adjuvant ensartinib vs placebo after chemo, 24-month DFS HR 0.20). Both live-fetched this session.
  • UK frailty consensus (Gomes 2026, PMID 42956446): 22 of 23 statements reached agreement. Registry-only; statement text not imported.
  • Literature layer: bibliography now 340 unique PMIDs (+12, tagged sweep-2026-10-30). Statistics rows added for the trials above. Guideline registry: ASCO driver-alteration chain extended to 2026.3.4; UK consensus row added. No patient-voice addition. No landmark note. Krascendo 1 is a candidate once full text is audited.
  • Triaged out: OASIS adjuvant osimertinib 40 vs 80 mg protocol; PIONEER qualitative feasibility; PET-BOOST negative phase 2; VITaL protocol; NeoADAURA plain-language summary (primary is 2025 PMID 40454705, outside this window and not in the bibliography — next sweep/auditor should decide whether to add it); KEYNOTE-671 Japanese subgroup; MARIPOSA-2 Asian subgroup; FLAURA2 long-term safety and MARIPOSA TTSP (already triaged 2026-10-16); HARMONi-6 (squamous); Cochrane menopause HT; IMRT SR; ADC-after-EGFR SR; TCM-plus-EGFR SR; almonertinib SR; osimertinib prognostic-factor SR; zongertinib case reports; in-window retractions of papers not in this corpus. The large majority of ~2,100 PubMed hits deserved nothing.
  • Trial registry: no overall-status or results-posting change among the 50 previously tracked IDs. Last-update-posted moved for NCT04214262 (2026-10-27) and NCT04538664 (2026-10-29). Priority follow-ups NCT05132075, NCT04819100, NCT05650879, NCT03175224 still have no posted results. HARMONi correction full text remains unretrieved (PMID 42805208).
  • Pages changed, all remaining status: draft with last-curated: 2026-10-30: egfr-disease, kras-braf-met-her2, immunotherapy, early-stage-and-perioperative-therapy, systemic-therapy, alk-ros1-and-fusion-drivers, guidelines, clinical-trials-landscape, plus INDEX, OPEN-QUESTIONS, BIBLIOGRAPHY, REGISTRY, STATISTICS. Numbers were taken from PubMed abstracts. Full texts were not opened. Per FAILURE-MODES.md, load-bearing claims should be checked against full-text tables.
  • Open questions: sweep notes added to OQ-4, 8, 12, 16, 17, 18, 30. None retired.
  • Decision noted: HARMONi-A and ELEVATE were published before 2026-08-28. They were added because prior sweeps explicitly asked to chase HARMONi OS and adjuvant ALK evidence, and both records were live-fetched in this session.
  • Reproducibility: queries, translations, IDs, NCT snapshots, Crossref updated-by, source probes, and limitations are at literature/sweeps/2026-10-30.json.
  • Next sweep / separate auditor should chase: (1) open Krascendo 1, PANKU, HERON, PERSEE, KEYNOTE-867, R-ALPS, ELEVATE, and HARMONi-A full texts and verify the abstract numbers cited here; (2) HARMONi correction full text (PMID 42805208) still outstanding; (3) ASCO 2026.3.4 recommendation content (dynamic page still 403); (4) Pan-Asian early/locally advanced NSCLC adaptation still unverified; (5) NeoADAURA primary (PMID 40454705, 2025) is still absent from the bibliography; (6) NCT05132075, NCT04819100, NCT05650879, NCT03175224 results; (7) November Lung Cancer Awareness Month material; (8) PANKU interim OS numbers not in the abstract; (9) preserve SciELO/LILACS/CENTRAL qualifications. Use today's 59-ID NCT set as the next baseline.