Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
8.0
4.5
Journals
Cancers
Special Issues
Advances in Lung Cancer Imaging and Therapy
share announcement

Advances in Lung Cancer Imaging and Therapy

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (31 January 2021) | Viewed by 30969

Special Issue Editors

Dr. Egesta Lopci

E-Mail Website
Guest Editor
Department of Nuclear Medicine, IRCCS Humanitas Research Hospital, 20089 Milan, Italy
Interests: molecular imaging; positron emission tomography; cancer imaging; immunotherapy; treatment response assessment
Special Issues, Collections and Topics in MDPI journals
Dr. Silvia Morbelli

E-Mail Website
Guest Editor
Department of Health Sciences, University of Genoa, Genova, Italy
Interests: imaging biomarkers; positron emission tomography; oncological imaging; brain imaging
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

The treatment algorithm for lung cancer has experienced in the last several years a rapid evolution, mostly as a result of the availability in clinical practice of checkpoint inhibitors that aim to disrupt the immunosuppressive pathway of programmed death-1 (PD-1) and its ligands (PD-Ls). In non-small-cell lung cancer (NSCLC) in particular, immunotherapy with checkpoint inhibitors has gradually replaced “old” chemotherapeutic agents. The amazing results obtained so far have prompted the investigation of combination therapy regimens using either different checkpoint inhibitors, such as CTLA-4 or Cytotoxic T-Lymphocyte Antigen 4, or different treatment types.

While patient selection in a first-line setting essentially relies on high levels of PD-L1 expression, the therapeutic choice in pretreated patients is more challenging and, although clinical and biological characteristics might be of help, there is an urgent need for novel tools to better identify responsive and resistant patients. In this context, integration of molecular markers and imaging might represent an effective potential strategy for refining patient selection.

The aim of the present Special Issue, entitled “Advances in Lung Cancer Imaging and Therapy”, is to provide an overview of the state-of-the-art in therapeutic strategies for lung cancer, while reserving a proper place for validated imaging techniques and future biomarkers for predicting response to therapy.

Dr. Egesta Lopci
Assoc. Prof. Dr. Silvia Morbelli
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • lung cancer
  • NSCLC
  • immunotherapy
  • combination therapy
  • radiotherapy
  • molecular imaging
  • radiomics
  • response assessment

Benefits of Publishing in a Special Issue

  • Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
  • Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
  • External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
  • e-Book format: Special Issues with more than 10 articles can be published as dedicated e-books, ensuring wide and rapid dissemination.

Further information on MDPI's Special Issue polices can be found here.

Published Papers (9 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Editorial

Jump to: Research, Review

3 pages, 183 KiB  
Editorial
Advances in Lung Cancer Imaging and Therapy
by Egesta Lopci and Silvia Morbelli
Cancers 2022, 14(1), 58; https://doi.org/10.3390/cancers14010058 - 23 Dec 2021
Viewed by 2572
Abstract
This series of eight papers (five original articles, two reviews and one meta-analysis) is presented by international leaders covering various aspects of lung cancer management, starting with diagnostic imaging and analyzing the novel perspectives of therapy [...] Full article
(This article belongs to the Special Issue Advances in Lung Cancer Imaging and Therapy)

Research

Jump to: Editorial, Review

12 pages, 2523 KiB  
Article
Blinded Independent Central Review (BICR) in New Therapeutic Lung Cancer Trials
by Hubert Beaumont, Antoine Iannessi, Yi Wang, Charles M. Voyton, Jennifer Cillario and Yan Liu
Cancers 2021, 13(18), 4533; https://doi.org/10.3390/cancers13184533 - 9 Sep 2021
Cited by 7 | Viewed by 3562
Abstract
Background: Double reads in blinded independent central reviews (BICRs) are recommended to control the quality of trials but they are prone to discordances. We analyzed inter-reader discordances in a pool of lung cancer trials using RECIST 1.1. Methods: We analyzed six lung cancer [...] Read more.
Background: Double reads in blinded independent central reviews (BICRs) are recommended to control the quality of trials but they are prone to discordances. We analyzed inter-reader discordances in a pool of lung cancer trials using RECIST 1.1. Methods: We analyzed six lung cancer BICR trials that included 1833 patients (10,684 time points) involving 17 radiologists. We analyzed the rate of discrepancy of each trial at the time-point and patient levels as well as testing inter-trial differences. The analysis of adjudication made it possible to compute the readers’ endorsement rates, the root causes of adjudications, and the proportions of “errors” versus “medically justifiable differences”. Results: The trials had significantly different discrepancy rates both at the time-point (average = 34.3%) and patient (average = 59.2%) levels. When considering only discrepancies for progressive disease, homogeneous discrepancy rates were found with an average of 32.9%, while readers’ endorsement rates ranged between 27.7% and 77.8%. Major causes of adjudication were different per trial, with medically justifiable differences being the most common, triggering 74.2% of total adjudications. Conclusions: We provide baseline performances for monitoring reader performance in trials with double reads. Intelligent reading system implementation along with appropriate reader training and monitoring are solutions that could mitigate a large portion of the commonly encountered reading errors. Full article
(This article belongs to the Special Issue Advances in Lung Cancer Imaging and Therapy)
►▼ Show Figures

Figure 1

15 pages, 934 KiB  
Article
The Role of the Immune Metabolic Prognostic Index in Patients with Non-Small Cell Lung Cancer (NSCLC) in Radiological Progression during Treatment with Nivolumab
by Matteo Bauckneht, Carlo Genova, Giovanni Rossi, Erika Rijavec, Maria Giovanna Dal Bello, Giulia Ferrarazzo, Marco Tagliamento, Maria Isabella Donegani, Federica Biello, Silvia Chiola, Lodovica Zullo, Stefano Raffa, Francesco Lanfranchi, Giuseppe Cittadini, Cecilia Marini, Egesta Lopci, Gianmario Sambuceti, Francesco Grossi and Silvia Morbelli
Cancers 2021, 13(13), 3117; https://doi.org/10.3390/cancers13133117 - 22 Jun 2021
Cited by 18 | Viewed by 4343
Abstract
An emerging clinical need is represented by identifying reliable biomarkers able to discriminate between responders and non-responders among patients showing imaging progression during the administration of immune checkpoints inhibitors for advanced non-small cell lung cancer (NSCLC). In the present study, we analyzed the [...] Read more.
An emerging clinical need is represented by identifying reliable biomarkers able to discriminate between responders and non-responders among patients showing imaging progression during the administration of immune checkpoints inhibitors for advanced non-small cell lung cancer (NSCLC). In the present study, we analyzed the prognostic power of peripheral-blood systemic inflammation indexes and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in this clinical setting. In 45 patients showing radiological progression (defined as RECIST 1.1 progressive disease) during Nivolumab administration, the following lab and imaging parameters were collected: neutrophil-to-lymphocyte ratio (NLR), derived-NLR (dNLR), lymphocyte-to-monocyte ratio (LMR), platelets-to-lymphocyte ratio (PLR), systemic inflammation index (SII), maximum standardized uptake value, metabolic tumor volume (MTV), and total lesion glycolysis (TLG). MTV and SII independently predicted OS. Their combination in the immune metabolic prognostic index (IMPI) allowed the identification of patients who might benefit from immunotherapy continuation, despite radiological progression. The combination of FDG PET/CT volumetric data with SII also approximates the immune-metabolic response with respect to baseline, providing additional independent prognostic insights. In conclusion, the degree of systemic inflammation, the quantification of the metabolically active tumor burden, and their combination might disclose the radiological progression in NSCLC patients receiving Nivolumab. Full article
(This article belongs to the Special Issue Advances in Lung Cancer Imaging and Therapy)
►▼ Show Figures

Figure 1

11 pages, 1356 KiB  
Article
Whole-Lesion Apparent Diffusion Coefficient Histogram Analysis: Significance for Discriminating Lung Cancer from Pulmonary Abscess and Mycobacterial Infection
by Katsuo Usuda, Shun Iwai, Aika Yamagata, Yoshihito Iijima, Nozomu Motono, Munetaka Matoba, Mariko Doai, Keiya Hirata and Hidetaka Uramoto
Cancers 2021, 13(11), 2720; https://doi.org/10.3390/cancers13112720 - 31 May 2021
Cited by 7 | Viewed by 2743
Abstract
Diffusion-weighted magnetic resonance imaging (DWI) can differentiate malignant from benign pulmonary nodules. However, it is difficult to differentiate pulmonary abscesses and mycobacterial infections (PAMIs) from lung cancers because PAMIs show restricted diffusion in DWI. The study purpose is to establish the role of [...] Read more.
Diffusion-weighted magnetic resonance imaging (DWI) can differentiate malignant from benign pulmonary nodules. However, it is difficult to differentiate pulmonary abscesses and mycobacterial infections (PAMIs) from lung cancers because PAMIs show restricted diffusion in DWI. The study purpose is to establish the role of ADC histogram for differentiating lung cancer from PAMI. There were 41 lung cancers (25 adenocarcinomas, 16 squamous cell carcinomas), and 19 PAMIs (9 pulmonary abscesses, 10 mycobacterial infections). Parameters more than 60% of the area under the ROC curve (AUC) were ADC, maximal ADC, mean ADC, median ADC, most frequency ADC, kurtosis of ADC, and volume of lesion. There were significant differences between lung cancer and PAMI in ADC, mean ADC, median ADC, and most frequency ADC. The ADC (1.19 ± 0.29 × 10−3 mm2/s) of lung cancer obtained from a single slice was significantly lower than that (1.44 ± 0.54) of PAMI (p = 0.0262). In contrast, mean, median, or most frequency ADC of lung cancer which was obtained in the ADC histogram was significantly higher than the value of each parameter of PAMI. ADC histogram could discriminate PAMIs from lung cancers by showing that AUCs of several parameters were more than 60%, and that several parameters of ADC of PAMI were significantly lower than those of lung cancer. ADC histogram has the potential to be a valuable tool to differentiate PAMI from lung cancer. Full article
(This article belongs to the Special Issue Advances in Lung Cancer Imaging and Therapy)
►▼ Show Figures

Graphical abstract

16 pages, 4005 KiB  
Article
Beyond Abscopal Effect: A Meta-Analysis of Immune Checkpoint Inhibitors and Radiotherapy in Advanced Non-Small Cell Lung Cancer
by Francesco Fiorica, Umberto Tebano, Milena Gabbani, Mariasole Perrone, Sonia Missiroli, Massimiliano Berretta, Jacopo Giuliani, Andrea Bonetti, Andrea Remo, Eva Pigozzi, Andrea Tontini, Giuseppe Napoli, Nicoletta Luca, Daniela Grigolato, Paolo Pinton and Carlotta Giorgi
Cancers 2021, 13(10), 2352; https://doi.org/10.3390/cancers13102352 - 13 May 2021
Cited by 17 | Viewed by 3171
Abstract
Background: Immune checkpoint inhibitors (ICI) plus radiotherapy (RT) have been suggested as an emerging combination in non-small cell lung cancer (NSCLC) patients. However, little is known about the magnitude of its benefits and potential clinical predictors. Objective: To assess the effects of this [...] Read more.
Background: Immune checkpoint inhibitors (ICI) plus radiotherapy (RT) have been suggested as an emerging combination in non-small cell lung cancer (NSCLC) patients. However, little is known about the magnitude of its benefits and potential clinical predictors. Objective: To assess the effects of this combination on the increase in overall and progression-free survival. Data sources: The MEDLINE and CANCERLIT (1970–2020) electronic databases were searched, and the reference lists of included studies were manually searched. Study selection: Studies were included if they were comparative studies between combination ICI-RT and ICI or RT alone in advanced or metastatic NSCLC patients. Overall survival (OS) was analyzed according to the treatment strategy. Data extraction: Data on population, intervention, and outcomes were extracted from each study, in accordance with the intention-to-treat method, by two independent observers and combined using the DerSimonian method and Laird method. Results: Compared to ICI or RT alone, ICI-RT significantly increased the 1-year and 3-year OS RR by 0.75 (95% CI 0.64–0.88; p = 0.0003) and 0.85 (95% CI 0.78–0.93; p = 0.0006), respectively. Furthermore, there was a statistically significant benefit on 1- and 3-year progression-free survival (RR 0.73 (95% CI, 0.61–0.87; p = 0.0005) and RR 0.82 (95% CI 0.67–0.99; p = 0.04), respectively). Conclusions: In patients with advanced or metastatic NSCLC, combination ICI-RT increases 1- and 3-year OS and progression-free survival compared to ICI or RT alone. Full article
(This article belongs to the Special Issue Advances in Lung Cancer Imaging and Therapy)
►▼ Show Figures

Figure 1

11 pages, 1177 KiB  
Article
Metabolic Parameters as Biomarkers of Response to Immunotherapy and Prognosis in Non-Small Cell Lung Cancer (NSCLC): A Real World Experience
by Lavinia Monaco, Maria Gemelli, Irene Gotuzzo, Matteo Bauckneht, Cinzia Crivellaro, Carlo Genova, Diego Cortinovis, Lodovica Zullo, Luca Carlofrancesco Ammoni, Davide Paolo Bernasconi, Giovanni Rossi, Silvia Morbelli and Luca Guerra
Cancers 2021, 13(7), 1634; https://doi.org/10.3390/cancers13071634 - 1 Apr 2021
Cited by 24 | Viewed by 3353
Abstract
Immune-checkpoint inhibitors (ICIs) have been proven to have great efficacy in non-small cell lung cancer (NSCLC) as single agents or in combination therapy, being capable to induce deep and durable remission. However, severe adverse events may occur and about 40% of patients do [...] Read more.
Immune-checkpoint inhibitors (ICIs) have been proven to have great efficacy in non-small cell lung cancer (NSCLC) as single agents or in combination therapy, being capable to induce deep and durable remission. However, severe adverse events may occur and about 40% of patients do not benefit from the treatment. Predictive factors of response to ICIs are needed in order to customize treatment. The aim of this study is to evaluate the correlation between quantitative positron emission tomography (PET) parameters defined before starting ICI therapy and responses to treatment and patient outcome. We retrospectively analyzed 92 NSCLC patients treated with nivolumab, pembrolizumab or atezolizumab. Basal PET/computed tomography (CT) scan parameters (whole-body metabolic tumor volume—wMTV, total lesion glycolysis—wTLG, higher standardized uptake volume maximum and mean—SUVmax and SUVmean) were calculated for each patient and correlated with outcomes. Patients who achieved disease control (complete response + partial response + stable disease) had significantly lower MTV median values than patients who had not (progressive disease) (77 vs. 160.2, p = 0.039). Furthermore, patients with MTV and TLG values lower than the median values had improved OS compared to patients with higher MTV and TLG (p = 0.03 and 0.05, respectively). No relation was found between the other parameters and outcome. In conclusion, baseline metabolic tumor burden, measured with MTV, might be an independent predictor of treatment response to ICI and a prognostic biomarker in NSCLC patients. Full article
(This article belongs to the Special Issue Advances in Lung Cancer Imaging and Therapy)
►▼ Show Figures

Figure 1

8 pages, 234 KiB  
Article
Impact of Low-Dose Irradiation of the Lung and Heart on Toxicity and Pulmonary Function Parameters after Thoracic Radiotherapy
by Christina Schröder, André Buchali, Paul Windisch, Erwin Vu, Lucas Basler, Daniel R. Zwahlen and Robert Förster
Cancers 2021, 13(1), 22; https://doi.org/10.3390/cancers13010022 - 23 Dec 2020
Cited by 7 | Viewed by 2118
Abstract
Objective: To assess the impact of (low) dose irradiation to the lungs and heart on the incidence of pneumonitis and pulmonary function changes after thoracic radiotherapy (RT). Methods/Material: Data of 62 patients treated with curative thoracic radiotherapy were analyzed. Toxicity data and pulmonary [...] Read more.
Objective: To assess the impact of (low) dose irradiation to the lungs and heart on the incidence of pneumonitis and pulmonary function changes after thoracic radiotherapy (RT). Methods/Material: Data of 62 patients treated with curative thoracic radiotherapy were analyzed. Toxicity data and pulmonary function tests (PFTs) were obtained before RT and at 6 weeks, at 12 weeks, and at 6 months after RT. PFTs included ventilation (e.g., vital capacity) and diffusion parameters (e.g., diffusion capacity for carbon monoxide (DLCO)). Dosimetric data of the lung and heart were extracted to assess the impact of dose on PFT changes and radiation pneumonitis (RP). Results: No statistically significant correlations between dose parameters and changes in ventilation parameters were found. There were statistically significant correlations between DLCO and low-dose parameters of the lungs (V5Gy–V30Gy (%)) and irradiation of the heart during the follow-up up to 6 months after RT, as well as a temporary correlation of the V60Gy (%) on the blood gas parameters at 12 weeks after RT. On multivariate analysis, both heart and lung parameters had a significant impact on DLCO. There was no statistically significant influence of any patient or treatment-related (including dose parameters) factors on the incidence of ≥G2 pneumonitis. Conclusion: There seems to be a lasting impact of low dose irradiation to the lung as well as irradiation to the heart on the DLCO after thoracic radiotherapy. No influence on RP was found in this analysis. Full article
(This article belongs to the Special Issue Advances in Lung Cancer Imaging and Therapy)
14 pages, 1845 KiB  
Article
Association of the Metabolic Score Using Baseline FDG-PET/CT and dNLR with Immunotherapy Outcomes in Advanced NSCLC Patients Treated with First-Line Pembrolizumab
by Romain-David Seban, Jean-Baptiste Assié, Etienne Giroux-Leprieur, Marie-Ange Massiani, Michael Soussan, Gérald Bonardel, Christos Chouaid, Margot Playe, Lucas Goldfarb, Boris Duchemann, Laura Mezquita, Nicolas Girard and Laurence Champion
Cancers 2020, 12(8), 2234; https://doi.org/10.3390/cancers12082234 - 10 Aug 2020
Cited by 34 | Viewed by 3044
Abstract
Background: We aimed to assess the clinical utility of a previously published score combining the total metabolic tumor volume (TMTV) on baseline FDG-PET/CT and pretreatment derived from the neutrophils to lymphocytes ratio (dNLR) for prognostication in NSCLC patients undergoing first-line immunotherapy (IT). [...] Read more.
Background: We aimed to assess the clinical utility of a previously published score combining the total metabolic tumor volume (TMTV) on baseline FDG-PET/CT and pretreatment derived from the neutrophils to lymphocytes ratio (dNLR) for prognostication in NSCLC patients undergoing first-line immunotherapy (IT). Methods: In this multicenter retrospective study, 63 advanced NSCLC patients with a PD-L1 tumor proportion score (TPS) ≥50%, who underwent FDG-PET/CT before first-line IT, treated from January 2017 to September 2019, were enrolled. Associations between this score and the progression-free survival (PFS), overall survival (OS), disease control rate (DCR), and overall response rate (ORR) were evaluated. Results: The median (m) PFS and mOS were 7.7 (95% CI 4.9–10.6) and 12.1 (8.6–15.6) months, respectively, and DCR and ORR were 65% and 58%, respectively. mOS was 17.9 months (14.6 not reached) for the good group versus 13.8 (95%CI 8.4–18.9) and 6.6 (CI 2.0–11.2) months for the intermediate and poor groups, respectively. mPFS was 15.1 (95%CI 12.1–20.0) months for the good group versus 5.2 (1.9–8.5) and 1.9 (95%CI 1.3–2.5) months for the intermediate and poor groups, respectively. The poor prognosis group was associated with DCR and ORR (p < 0.05). Conclusions: The metabolic score combining TMTV on the baseline FDG-PET/CT scan and pretreatment dNLR was associated with the survival and response in a cohort of advanced NSCLC patients with ≥50% PD-L1 receiving frontline IT. Full article
(This article belongs to the Special Issue Advances in Lung Cancer Imaging and Therapy)
►▼ Show Figures

Figure 1

Review

Jump to: Editorial, Research

17 pages, 712 KiB  
Review
Non-Small-Cell Lung Cancer: New Rare Targets—New Targeted Therapies—State of The Art and Future Directions
by Katarzyna Stencel, Izabela Chmielewska, Janusz Milanowski and Rodryg Ramlau
Cancers 2021, 13(8), 1829; https://doi.org/10.3390/cancers13081829 - 12 Apr 2021
Cited by 17 | Viewed by 4678
Abstract
Lung cancer is the most common cause of cancer-related death worldwide, and the prognosis for stage IV remains poor. The presence of genetic alterations in tumor cells, such as EGFR and BRAF gene mutations, as well as ALK and ROS1 gene rearrangements, are [...] Read more.
Lung cancer is the most common cause of cancer-related death worldwide, and the prognosis for stage IV remains poor. The presence of genetic alterations in tumor cells, such as EGFR and BRAF gene mutations, as well as ALK and ROS1 gene rearrangements, are indications for targeted therapies. Many such treatments are already registered and used on a wide scale. In comparison to standard chemotherapy, they can prolong not only progression-free survival but also overall survival. Moreover, they are able to provide excellent quality of life and rapid improvement of cancer-related symptoms such as dyspnea, cough and pain. Recent years have witnessed great advances in both molecular diagnostics and new molecular therapies for non-small-cell lung cancer. This review presents new therapeutic targets in NSCLC, as well as drugs of which the activity against NTRK, RET, MET or HER2 gene alterations (including EGFR exon 20 insertions) has either been confirmed or is currently being evaluated. Although these particular genetic alterations in NSCLC are generally rare, each accounting for 1–2% of patients, in total about half of all patients have molecular alterations and may ultimately receive targeted therapies. Full article
(This article belongs to the Special Issue Advances in Lung Cancer Imaging and Therapy)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-9
Back to TopTop