A new Northwestern Medicine study has been published in JAMA. It suggested that lung transplantation can be extended to some patients with stage 4 lung cancer. The study was conducted as a part of Northwestern’s Double Lung Transplant Registry for Lung-Limited Malignancies program. The program tested whether lung transplantation can be extended to patients at advanced stages of lung cancer who are at risk of dying from the disease.
Study Design and Patient Groups
The researchers from Chicago-based Northwestern Medicine analysed data from 404 adult patients. These include 98 with stage 4 lung cancer patients as well, between September 2021 and June 2025 to access outcomes associated with lung transplant. Of these 98 patients with stage 4 lung cancer, 17 received lung transplant and 81 got medical therapy alone. After completion of study period, all transplant patients were alive but fewer than half of similar patients receiving medical therapy alone were alive.
Lung Transplant Shows Improved Early Survival
The primary outcome of the study was overall survival of patients with NSCLC. The study challenged the long-held guidance that patients with stage IV lung cancer should not be eligible for lung transplants. Doctors found that transplantation was associated with substantially better early survival than medical management alone. A year later of the study, all 17 transplanted patients were still alive. While at Stage IV, the cancer usually spreads beyond the lungs but patients in this study where those whose cancer remains confined to both lungs even as it progressed to respiratory failure.
Study Limitations and Future Research
Among selected lung cancer patients, stage IV NSCLC who underwent lung transplant, early survival was favorable although long-term follow-up and quality of life assessment are needed to be done.
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FAQ
Can stage 4 lung cancer patients receive a lung transplant?
Yes. This study suggests that carefully selected stage 4 NSCLC patients whose cancer remains confined to the lungs may benefit from a lung transplant.
What did the study find?
All 17 stage 4 lung cancer patients who received a lung transplant were alive after one year, while fewer than half of similar patients receiving medical therapy alone survived.
Does this apply to all stage 4 lung cancer patients?
No. The findings apply only to a highly selected group of patients with cancer limited to both lungs.
Does this study change current lung cancer treatment guidelines?
The study challenges previous assumptions, but more long-term research is needed before treatment guidelines change.
What are the limitations of this study?
Researchers noted that longer follow-up and quality-of-life assessments are still needed to confirm the long-term benefits of lung transplantation in stage 4 NSCLC patients.