Cancers

Research

9 pages, 674 KiB

Open AccessArticle

Real-World Survival Impact of New Treatment Strategies for Lung Cancer: A 2000–2020 French Cohort

by Clemence Basse, Matthieu Carton, Maud Milder, Romain Geiss, Pauline Du Rusquec, Catherine Daniel, Marie-Ange Massiani, Alain Livartowski and Nicolas Girard

Cancers 2024, 16(15), 2768; https://doi.org/10.3390/cancers16152768 - 5 Aug 2024

Cited by 2 | Viewed by 1438

Abstract

Over the past 20 years, several innovative therapies have been implemented in the treatment of lung cancer that have had reported survival benefits in clinical trials. Whether these improvements translate into the clinic setting has not been studied yet. We retrospectively analyzed all [...] Read more.

Over the past 20 years, several innovative therapies have been implemented in the treatment of lung cancer that have had reported survival benefits in clinical trials. Whether these improvements translate into the clinic setting has not been studied yet. We retrospectively analyzed all patients consecutively treated at Institute Curie for metastatic lung cancer. Diagnosis date was used to define three periods, based on the approvals of novel treatment strategies in the first-line setting, including targeted therapies in 2010 and immunotherapy in 2018. Endpoints included Overall survival (OS), survival rate of 2 years and 5 years, and a conditional survival rate of 2 years (if still alive at 6 months from treatment initiation). A total of 673 patients were identified for Period 1—2000 to 2009, 752 for Period 2—2010 to 2017, and 768 for Period 3—2018 to 2020. Median OS in the whole cohort was 11.1, 15.5, and 16.2 months, respectively. Median OS for patients with NSCLC or SCLC was 11.2, 17.2, and 18.2 months, or 10.9, 11.7, and 11.2 months, respectively. The two-year conditional survival was more favorable for NSCLC than SCLC patients. Outcomes were statistically higher for women as compared to men in all periods and all subgroups. Survival of patients with metastatic lung cancer has improved over the past 20 years, mostly in NSCLC, along with the implementation of novel treatment strategies. Full article

(This article belongs to the Special Issue Recent Advances in Trachea, Bronchus and Lung Cancer Management)

► Show Figures

Graphical abstract

11 pages, 657 KiB

Open AccessArticle

Efficacy and Safety of Tinzaparin Thromboprophylaxis in Lung Cancer Patients with High Thromboembolic Risk: A Prospective, Observational, Single-Center Cohort Study

by Marousa Kouvela, Maria Effrosyni Livanou, Dimitra T. Stefanou, Ioannis A. Vathiotis, Fotini Sarropoulou, Maria Grammoustianou, Evangelos Dimakakos and Nikolaos Syrigos

Cancers 2024, 16(7), 1442; https://doi.org/10.3390/cancers16071442 - 8 Apr 2024

Viewed by 1060

Abstract

Background: The aim of this study was to record and assess the efficacy and safety ofthromboprophylaxis with an intermediate dose of Tinzaparin in lung cancer patients with high thrombotic risk. Methods: This was a non-interventional, single-arm, prospective cohort study of lung cancer patients [...] Read more.

Background: The aim of this study was to record and assess the efficacy and safety ofthromboprophylaxis with an intermediate dose of Tinzaparin in lung cancer patients with high thrombotic risk. Methods: This was a non-interventional, single-arm, prospective cohort study of lung cancer patients who received thromboprophylaxis with Tinzaparin 10.000 Anti-Xa IU in 0.5 mL, OD, used in current clinical practice. Enrolled ambulatory patients signed informed consent. Anti-Xa levels were tested. Results: In total, 140 patients were included in the study, of which 81.4% were males. The histology of the tumor was mainly adenocarcinoma. Lung cancer patients with high thrombotic risk based on tumor, patient, treatment, and laboratory-related factors were enrolled. Only one patient experienced a thrombotic event (0.7%), and 10 patients had bleeding events (7.1%), including only one major event. Anti-Xa levels measured at 10 days and 3 months did not differ significantly between patients who developed hemorrhagic events and those who did not (p = 0.26 and p = 0.32, respectively). Conclusion: Thromboprophylaxis with an intermediate Tinzaparin dose in high thrombotic-risk lung cancer patients is a safe and effective choice for the prevention of VTE. Full article

(This article belongs to the Special Issue Recent Advances in Trachea, Bronchus and Lung Cancer Management)

► Show Figures

Figure 1

Review

Jump to: Research, Other

22 pages, 6056 KiB

Open AccessReview

On the Way to Accounting for Lung Modulation Effects in Particle Therapy of Lung Cancer Patients—A Review

by Matthias Witt, Uli Weber, Veronika Flatten, Jessica Stolzenberg, Rita Engenhart-Cabillic, Klemens Zink and Kilian-Simon Baumann

Cancers 2024, 16(21), 3598; https://doi.org/10.3390/cancers16213598 - 25 Oct 2024

Viewed by 454

Abstract

Particle therapy presents a promising alternative to conventional photon therapy for treating non-small cell lung cancer (NSCLC). However, the heterogeneous structure of lung tissue leads to the degradation of the Bragg peak and thereby to the degradation of the dose distribution. This review [...] Read more.

Particle therapy presents a promising alternative to conventional photon therapy for treating non-small cell lung cancer (NSCLC). However, the heterogeneous structure of lung tissue leads to the degradation of the Bragg peak and thereby to the degradation of the dose distribution. This review offers a comprehensive overview of the models developed to account for these modulation effects. It summarizes studies focused on determining modulation power as a predictor of this so-called lung modulation. In addition, the review covers early investigations on dose uncertainties caused by lung modulation in CT-based lung phantoms and patient anatomies and discusses future challenges in integrating these solutions into clinical treatment planning routines. Full article

(This article belongs to the Special Issue Recent Advances in Trachea, Bronchus and Lung Cancer Management)

► Show Figures

Figure 1

25 pages, 3913 KiB

Open AccessReview

Lung Cancer and Interstitial Lung Diseases

by Fotios Drakopanagiotakis, Ekaterina Krauss, Ira Michailidou, Vasileios Drosos, Stavros Anevlavis, Andreas Günther and Paschalis Steiropoulos

Cancers 2024, 16(16), 2837; https://doi.org/10.3390/cancers16162837 - 13 Aug 2024

Viewed by 1885

Abstract

Lung cancer continues to be one of the leading causes of cancer-related death worldwide. There is evidence of a complex interplay between lung cancer and interstitial lung disease (ILD), affecting disease progression, management strategies, and patient outcomes. Both conditions develop as the result [...] Read more.

Lung cancer continues to be one of the leading causes of cancer-related death worldwide. There is evidence of a complex interplay between lung cancer and interstitial lung disease (ILD), affecting disease progression, management strategies, and patient outcomes. Both conditions develop as the result of common risk factors such as smoking, environmental exposures, and genetic predispositions. The presence of ILD poses diagnostic and therapeutic challenges in lung cancer management, including difficulties in interpreting radiological findings and increased susceptibility to treatment-related toxicities, such as acute exacerbation of ILD after surgery and pneumonitis after radiation therapy and immunotherapy. Moreover, due to the lack of large, phase III randomized controlled trials, the evidence-based therapeutic options for patients with ILDs and lung cancer remain limited. Antifibrotic treatment may help prevent pulmonary toxicity due to lung cancer treatment, but its effect is still unclear. Emerging diagnostic modalities and biomarkers and optimizing personalized treatment strategies are essential to improve outcomes in this patient population. Full article

(This article belongs to the Special Issue Recent Advances in Trachea, Bronchus and Lung Cancer Management)

► Show Figures

Figure 1

12 pages, 565 KiB

Open AccessReview

The Role of Biomarkers in Lung Cancer Screening

by Efimia Boutsikou, Georgia Hardavella, Eleni Fili, Aikaterini Bakiri, Stylianos Gaitanakis, Alexandra Kote, Konstantinos Samitas and Ioannis Gkiozos

Cancers 2024, 16(11), 1980; https://doi.org/10.3390/cancers16111980 - 23 May 2024

Cited by 2 | Viewed by 1191

Abstract

Background: Lung Cancer Screening (LCS) is an evolving field with variations in its implementation in various countries. There are only scarce data from National LCS programs. Aim: We aim to provide an up-to-date overview of the current evidence regarding the use of biomarkers [...] Read more.

Background: Lung Cancer Screening (LCS) is an evolving field with variations in its implementation in various countries. There are only scarce data from National LCS programs. Aim: We aim to provide an up-to-date overview of the current evidence regarding the use of biomarkers in LCS. Materials and Methods: A multidisciplinary Task Force experts’ panel collaborated and conducted a systematic literature search, followed by screening, review and synthesis of available evidence. Results: Biomarkers in LCS could be used to improve risk stratification in high-risk participants, improve clarification regarding indeterminate lung nodules and avoid overdiagnosis in suspicious lung findings. Currently, there seem to be promising biomarkers (blood/serum/breath) that have been studied in various trials; however, there is still a lack of solid evidence in clinical validation that would pave the way for their integration into LCS programs. Conclusions: Biomarkers are the next logical step in improving the LCS pathway and its efficiency by playing an adjuvant role in a minimally invasive way. National LCS programs and pilot studies should integrate biomarkers to validate their accuracy in real-life LCS participants. Full article

(This article belongs to the Special Issue Recent Advances in Trachea, Bronchus and Lung Cancer Management)

► Show Figures

Figure 1

19 pages, 966 KiB

Open AccessReview

Neoadjuvant and Adjuvant Immunotherapy in Resectable NSCLC

by Evangelia Bogatsa, George Lazaridis, Chrysoula Stivanaki and Eleni Timotheadou

Cancers 2024, 16(9), 1619; https://doi.org/10.3390/cancers16091619 - 23 Apr 2024

Cited by 1 | Viewed by 2594

Abstract

Non-small cell lung cancer, even when diagnosed in early stages, has been linked with poor survival rates and distant recurrence patterns. Novel therapeutic approaches harnessing the immune system have been implemented in early stages, following the designated steps of advanced NSCLC treatment strategies. [...] Read more.

Non-small cell lung cancer, even when diagnosed in early stages, has been linked with poor survival rates and distant recurrence patterns. Novel therapeutic approaches harnessing the immune system have been implemented in early stages, following the designated steps of advanced NSCLC treatment strategies. Immune-checkpoint inhibitor (ICI) regimens as monotherapy, combinational, or alongside chemotherapy have been intensely investigated as adjuvant, neoadjuvant, and, more recently, perioperative therapeutic strategies, representing pivotal milestones in the evolution of early lung cancer management while holding great potential for the future. The subject of current ongoing research is optimizing treatment outcomes for patient subsets with different needs and identifying biomarkers that could be predictive of response while translating the trials’ endpoints to survival rates. The aim of this review is to discuss all current treatment options with the pros and cons of each, persistent challenges, and future perspectives on immunotherapy as illuminating the path to a new era for resectable NSCLC. Full article

(This article belongs to the Special Issue Recent Advances in Trachea, Bronchus and Lung Cancer Management)

► Show Figures

Figure 1

19 pages, 614 KiB

Open AccessReview

Emerging Therapies in Kirsten Rat Sarcoma Virus (+) Non-Small-Cell Lung Cancer

by Anastasia Karachaliou, Elias Kotteas, Oraianthi Fiste and Konstantinos Syrigos

Cancers 2024, 16(8), 1447; https://doi.org/10.3390/cancers16081447 - 9 Apr 2024

Viewed by 2002

Abstract

Kirsten rat sarcoma virus (KRAS) is the most frequently found oncogene in human cancers, including non-small-cell lung cancer (NSCLC). For many years, KRAS was considered “undruggable” due to its structure and difficult targeting. However, the discovery of the switch II region in the [...] Read more.

Kirsten rat sarcoma virus (KRAS) is the most frequently found oncogene in human cancers, including non-small-cell lung cancer (NSCLC). For many years, KRAS was considered “undruggable” due to its structure and difficult targeting. However, the discovery of the switch II region in the KRAS-G12C-mutated protein has changed the therapeutic landscape with the design and development of novel direct KRAS-G12C inhibitors. Sotorasib and adagrasib are FDA-approved targeted agents for pre-treated patients with KRAS-G12C-mutated NSCLC. Despite promising results, the efficacy of these novel inhibitors is limited by mechanisms of resistance. Ongoing studies are evaluating combination strategies for overcoming resistance. In this review, we summarize the biology of the KRAS protein and the characteristics of KRAS mutations. We then present current and emerging therapeutic approaches for targeting KRAS mutation subtypes intending to provide individualized treatment for lung cancer harboring this challenging driver mutation. Full article

(This article belongs to the Special Issue Recent Advances in Trachea, Bronchus and Lung Cancer Management)

► Show Figures

Figure 1

13 pages, 868 KiB

Open AccessReview

Real-World Data and Evidence in Lung Cancer: A Review of Recent Developments

by Eleni Kokkotou, Maximilian Anagnostakis, Georgios Evangelou, Nikolaos K. Syrigos and Ioannis Gkiozos

Cancers 2024, 16(7), 1414; https://doi.org/10.3390/cancers16071414 - 4 Apr 2024

Cited by 3 | Viewed by 3333

Abstract

Conventional cancer clinical trials can be time-consuming and expensive, often yielding results with limited applicability to real-world scenarios and presenting challenges for patient participation. Real-world data (RWD) studies offer a promising solution to address evidence gaps and provide essential information about the effects [...] Read more.

Conventional cancer clinical trials can be time-consuming and expensive, often yielding results with limited applicability to real-world scenarios and presenting challenges for patient participation. Real-world data (RWD) studies offer a promising solution to address evidence gaps and provide essential information about the effects of cancer treatments in real-world settings. The distinction between RWD and data derived from randomized clinical trials lies in the method of data collection, as RWD by definition are obtained at the point of care. Experimental designs resembling those used in traditional clinical trials can be utilized to generate RWD, thus offering multiple benefits including increased efficiency and a more equitable balance between internal and external validity. Real-world data can be utilized in the field of pharmacovigilance to facilitate the understanding of disease progression and to formulate external control groups. By utilizing prospectively collected RWD, it is feasible to conduct pragmatic clinical trials (PCTs) that can provide evidence to support randomized study designs and extend clinical research to the patient’s point of care. To ensure the quality of real-world studies, it is crucial to implement auditable data abstraction methods and develop new incentives to capture clinically relevant data electronically at the point of care. The treatment landscape is constantly evolving, with the integration of front-line immune checkpoint inhibitors (ICIs), either alone or in combination with chemotherapy, affecting subsequent treatment lines. Real-world effectiveness and safety in underrepresented populations, such as the elderly and patients with poor performance status (PS), hepatitis, or human immunodeficiency virus, are still largely unexplored. Similarly, the cost-effectiveness and sustainability of these innovative agents are important considerations in the real world. Full article

(This article belongs to the Special Issue Recent Advances in Trachea, Bronchus and Lung Cancer Management)

► Show Figures

Figure 1

19 pages, 274 KiB

Open AccessReview

Efficacy of NSCLC Rechallenge with Immune Checkpoint Inhibitors following Disease Progression or Relapse

by Maria Effrosyni Livanou, Vasiliki Nikolaidou, Vasileios Skouras, Oraianthi Fiste and Elias Kotteas

Cancers 2024, 16(6), 1196; https://doi.org/10.3390/cancers16061196 - 18 Mar 2024

Cited by 2 | Viewed by 2125

Abstract

Immune checkpoint inhibitors (ICIs) are at the forefront of advanced non-small-cell lung cancer (NSCLC) treatment. Still, only 27–46% of patients respond to initial therapy with ICIs, and of those, up to 65% develop resistance within four years. After disease progression (PD), treatment options [...] Read more.

Immune checkpoint inhibitors (ICIs) are at the forefront of advanced non-small-cell lung cancer (NSCLC) treatment. Still, only 27–46% of patients respond to initial therapy with ICIs, and of those, up to 65% develop resistance within four years. After disease progression (PD), treatment options are limited, with 10% Objective Response Rate (ORR) to second or third-line chemotherapy. In this context, ICI rechallenge is an appealing option for NSCLC. Most data on the efficacy of ICI rechallenge are based on retrospective real-world studies of small, heavily pretreated, and heterogeneous patient groups. Despite these limitations, these studies suggest that ICI monotherapy rechallenge in unselected NSCLC patient populations who discontinued initial ICI due to PD is generally ineffective, with a median Progression-Free Survival (PFS) of 1.6–3.1 months and a Disease Control Rate (DCR) of 21.4–41.6%. However, there is a subpopulation that benefits from this strategy, and further characterization of this subgroup is essential. Furthermore, immunotherapy rechallenge in patients who discontinued initial immunotherapy following treatment protocol completion and progressed after an immunotherapy-free interval showed promising efficacy, with a DCR of 75–81%, according to post hoc analyses of several clinical trials. Future research on ICI rechallenge for NSCLC should focus on better patient stratification to reflect the underlying biology of immunotherapy resistance more accurately. In this review, we summarize evidence regarding rechallenge immunotherapy efficacy following NSCLC disease progression or relapse, as well as ongoing trials on immunotherapy rechallenge. Full article

(This article belongs to the Special Issue Recent Advances in Trachea, Bronchus and Lung Cancer Management)

12 pages, 1362 KiB

Open AccessReview

Robotic Bronchoscopy in Lung Cancer Diagnosis

by Vasileios S. Skouras, Ioannis Gkiozos, Andriani G. Charpidou and Konstantinos N. Syrigos

Cancers 2024, 16(6), 1179; https://doi.org/10.3390/cancers16061179 - 17 Mar 2024

Viewed by 1900

Abstract

Background: The widespread use of chest CT has increased the number of detected pulmonary nodules. Nodules with intermediate risk of malignancy warrant further evaluation with PET-CT or sampling. Although sampling with conventional bronchoscopy presents lower complication rates compared to transthoracic needle biopsy (TTNB), [...] Read more.

Background: The widespread use of chest CT has increased the number of detected pulmonary nodules. Nodules with intermediate risk of malignancy warrant further evaluation with PET-CT or sampling. Although sampling with conventional bronchoscopy presents lower complication rates compared to transthoracic needle biopsy (TTNB), it is limited by the inability to reach distal airways. To overcome this shortcoming, a new bronchoscopic technique named robotic bronchoscopy (RB) has emerged. Methods: A literature review was used to clarify the rationale behind RB emergence, describe RB procedure, and summarize data regarding its efficacy and safety. Results: The FDA has approved three RB platforms for clinical use. RB is safe, presenting a mortality and complication rate of 0% and 0–8.1%, respectively. Common complications include pneumothorax (0–5.7%) and minor bleeding (0–3.2%). However, its diagnostic yield remains lower than that of TTNB. Conclusions: RB is a promising bronchoscopic technique that aims to overcome the limitations of conventional bronchoscopy and improve upon the current techniques of guided bronchoscopy for the investigation of pulmonary nodules. Despite the lower complication rate, current evidence suggests a lower diagnostic yield compared to TTNB. Additional studies are required to adequately evaluate the role of RB in the diagnosis of pulmonary nodules. Full article

(This article belongs to the Special Issue Recent Advances in Trachea, Bronchus and Lung Cancer Management)

► Show Figures

Figure 1

16 pages, 295 KiB

Open AccessReview

Lung NETs and GEPNETs: One Cancer with Different Origins or Two Distinct Cancers?

by Georgios Evangelou, Ioannis Vamvakaris, Anastasia Papafili, Maximilian Anagnostakis and Melpomeni Peppa

Cancers 2024, 16(6), 1177; https://doi.org/10.3390/cancers16061177 - 17 Mar 2024

Cited by 1 | Viewed by 2055

Abstract

Lung neuroendocrine tumors (LNETs) and gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are two distinct types of neuroendocrine tumors (NETs) that have traditionally been treated as a single entity despite originating from different sources. Although they share certain phenotypic characteristics and the expression of neuroendocrine markers, [...] Read more.

Lung neuroendocrine tumors (LNETs) and gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are two distinct types of neuroendocrine tumors (NETs) that have traditionally been treated as a single entity despite originating from different sources. Although they share certain phenotypic characteristics and the expression of neuroendocrine markers, they exhibit differences in their microenvironment, molecular mutations, and responses to various therapeutic regimens. Recent research has explored the genetic alterations in these tumors, revealing dissimilarities in the frequently mutated genes, the role of EGFR in carcinogenesis, the presence of transcription factors, and the immunogenicity of the tumor and its microenvironment. Spread Through Air Spaces (STAS), a phenomenon unique to lung carcinomas, appears to play a crucial role in LNET prognosis. These distinctions are also evident in the cascade response of lung and GI tract neuroendocrine tumors to somatostatin analogs, Peptide Receptor Radionuclide Therapy (PRRT), chemotherapy, and immunotherapy. Identifying similarities and differences between the two groups may improve our understanding of the underlying mechanisms and facilitate the development of more effective treatment strategies. Full article

(This article belongs to the Special Issue Recent Advances in Trachea, Bronchus and Lung Cancer Management)

16 pages, 1258 KiB

Open AccessReview

The Gap of Health Inequalities Amongst Lung Cancer Patients of Different Socioeconomic Status: A Brief Reference to the Greek Reality

by Amalia Sofianidi, Alexandra Karadimou, Andriani Charpidou and Konstantinos N. Syrigos

Cancers 2024, 16(5), 906; https://doi.org/10.3390/cancers16050906 - 23 Feb 2024

Viewed by 2608

Abstract

Lung cancer treatment and patient care are constantly improving, but it remains doubtful whether this applies equally to all socioeconomic groups. It is nowadays well established that there are socioeconomic inequalities regarding lung cancer incidence, screening, effective treatment, overall survival, and prognosis. One [...] Read more.

Lung cancer treatment and patient care are constantly improving, but it remains doubtful whether this applies equally to all socioeconomic groups. It is nowadays well established that there are socioeconomic inequalities regarding lung cancer incidence, screening, effective treatment, overall survival, and prognosis. One of the key contributing factors to low socioeconomic status is low education. Low educational level is correlated with several factors, such as smoking habits, bad lifestyle behaviors, lower paid and unhealthier occupations, polluted neighborhoods, and genetic-familial risk, that lead to increased lung cancer incidence. The disparities regarding lung cancer care are further enhanced by stigma. On this basis and inspired by the gap in health equality among the Greek population, the Greek Society of Lung Cancer initiated a campaign, “MIND THE GAP”, to help increase awareness and minimize the gap associated with lung cancer, both in Greece and across Europe. The aim of this review is to explore the gap of health inequalities regarding lung cancer incidence and prognosis between patients of different SES and its root of causality. Key pivotal actions towards bridging this gap are reviewed as well. Full article

(This article belongs to the Special Issue Recent Advances in Trachea, Bronchus and Lung Cancer Management)

► Show Figures

Figure 1

15 pages, 286 KiB

Open AccessReview

Artificial Intelligence-Based Treatment Decisions: A New Era for NSCLC

by Oraianthi Fiste, Ioannis Gkiozos, Andriani Charpidou and Nikolaos K. Syrigos

Cancers 2024, 16(4), 831; https://doi.org/10.3390/cancers16040831 - 19 Feb 2024

Cited by 7 | Viewed by 3746

Abstract

Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related mortality among women and men, in developed countries, despite the public health interventions including tobacco-free campaigns, screening and early detection methods, recent therapeutic advances, and ongoing intense research on novel antineoplastic modalities. [...] Read more.

Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related mortality among women and men, in developed countries, despite the public health interventions including tobacco-free campaigns, screening and early detection methods, recent therapeutic advances, and ongoing intense research on novel antineoplastic modalities. Targeting oncogenic driver mutations and immune checkpoint inhibition has indeed revolutionized NSCLC treatment, yet there still remains the unmet need for robust and standardized predictive biomarkers to accurately inform clinical decisions. Artificial intelligence (AI) represents the computer-based science concerned with large datasets for complex problem-solving. Its concept has brought a paradigm shift in oncology considering its immense potential for improved diagnosis, treatment guidance, and prognosis. In this review, we present the current state of AI-driven applications on NSCLC management, with a particular focus on radiomics and pathomics, and critically discuss both the existing limitations and future directions in this field. The thoracic oncology community should not be discouraged by the likely long road of AI implementation into daily clinical practice, as its transformative impact on personalized treatment approaches is undeniable. Full article

(This article belongs to the Special Issue Recent Advances in Trachea, Bronchus and Lung Cancer Management)

Other

Jump to: Research, Review

8 pages, 237 KiB

Open AccessCommentary

Uncommon and Rare EGFR Mutations in Non-Small Cell Lung Cancer Patients with a Focus on Exon 20 Insertions and the Phase 3 PAPILLON Trial: The State of the Art

by Federico Pio Fabrizio, Ilaria Attili and Filippo de Marinis

Cancers 2024, 16(7), 1331; https://doi.org/10.3390/cancers16071331 - 29 Mar 2024

Viewed by 2033

Abstract

Uncommon (ucEGFRmuts) and rare epidermal growth factor receptor (EGFR) mutations account for 10–15% of diagnosed cases and consist of a heterogeneous group represented by several clusters within exons 18–21 (e.g., exon 18 point mutations, exon 21 L861X, exon 20 S768I), as [...] Read more.

Uncommon (ucEGFRmuts) and rare epidermal growth factor receptor (EGFR) mutations account for 10–15% of diagnosed cases and consist of a heterogeneous group represented by several clusters within exons 18–21 (e.g., exon 18 point mutations, exon 21 L861X, exon 20 S768I), as well as exon 20 insertions (Ex20ins). Their incidence is under molecular and clinical investigation following recent findings that reported an increase of sensitivity and specificity of next-generation sequencing (NGS) methods. Consequently, their detection allows for the selection of emerging treatment options to significantly improve patients’ outcomes in these particular subgroups of EGFR-mutated advanced non-small cell lung cancer (NSCLC). Specifically, this commentary is focused on the notable progress of the Phase 3 PAPILLON study that showed primary efficacy results from amivantamab, a bispecific antibody with specific binding and affinity to extracellular domains of EGFR and MET, plus chemotherapy in the first-line setting for EGFR exon 20 insertion–mutated advanced or metastatic NSCLC patients, as compared with chemotherapy alone, thus becoming the new standard of care in this group of patients. Full article

(This article belongs to the Special Issue Recent Advances in Trachea, Bronchus and Lung Cancer Management)

18 pages, 2985 KiB

Open AccessSystematic Review

AI-Driven Models for Diagnosing and Predicting Outcomes in Lung Cancer: A Systematic Review and Meta-Analysis

by Mohammed Kanan, Hajar Alharbi, Nawaf Alotaibi, Lubna Almasuood, Shahad Aljoaid, Tuqa Alharbi, Leen Albraik, Wojod Alothman, Hadeel Aljohani, Aghnar Alzahrani, Sadeem Alqahtani, Razan Kalantan, Raghad Althomali, Maram Alameen and Ahdab Mufti

Cancers 2024, 16(3), 674; https://doi.org/10.3390/cancers16030674 - 5 Feb 2024

Cited by 5 | Viewed by 8865

Abstract

(1) Background: Lung cancer’s high mortality due to late diagnosis highlights a need for early detection strategies. Artificial intelligence (AI) in healthcare, particularly for lung cancer, offers promise by analyzing medical data for early identification and personalized treatment. This systematic review evaluates AI’s [...] Read more.

(1) Background: Lung cancer’s high mortality due to late diagnosis highlights a need for early detection strategies. Artificial intelligence (AI) in healthcare, particularly for lung cancer, offers promise by analyzing medical data for early identification and personalized treatment. This systematic review evaluates AI’s performance in early lung cancer detection, analyzing its techniques, strengths, limitations, and comparative edge over traditional methods. (2) Methods: This systematic review and meta-analysis followed the PRISMA guidelines rigorously, outlining a comprehensive protocol and employing tailored search strategies across diverse databases. Two reviewers independently screened studies based on predefined criteria, ensuring the selection of high-quality data relevant to AI’s role in lung cancer detection. The extraction of key study details and performance metrics, followed by quality assessment, facilitated a robust analysis using R software (Version 4.3.0). The process, depicted via a PRISMA flow diagram, allowed for the meticulous evaluation and synthesis of the findings in this review. (3) Results: From 1024 records, 39 studies met the inclusion criteria, showcasing diverse AI model applications for lung cancer detection, emphasizing varying strengths among the studies. These findings underscore AI’s potential for early lung cancer diagnosis but highlight the need for standardization amidst study variations. The results demonstrate promising pooled sensitivity and specificity of 0.87, signifying AI’s accuracy in identifying true positives and negatives, despite the observed heterogeneity attributed to diverse study parameters. (4) Conclusions: AI demonstrates promise in early lung cancer detection, showing high accuracy levels in this systematic review. However, study variations underline the need for standardized protocols to fully leverage AI’s potential in revolutionizing early diagnosis, ultimately benefiting patients and healthcare professionals. As the field progresses, validated AI models from large-scale perspective studies will greatly benefit clinical practice and patient care in the future. Full article

(This article belongs to the Special Issue Recent Advances in Trachea, Bronchus and Lung Cancer Management)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Recent Advances in Trachea, Bronchus and Lung Cancer Management

Share This Special Issue

Special Issue Editors

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (15 papers)

Research

Review

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI