Advances in the Diagnosis and Treatment of Lung Adenocarcinoma

Dear Colleagues,

Lung cancer is one of the most frequently diagnosed cancers and the leading cause of cancer-related death worldwide, with an estimated 2.2 million new cases and 1.8 million deaths in 2020. The histological pattern of lung cancer changed significantly over a period of only a few decades, with a decrease in squamous cell carcinoma and a sharp rise in adenocarcinoma. Currently, adenocarcinoma represents the most common histologic type of pulmonary tumors, accounting for more than 65% of all lung cancers. Of interest, it is also the most common form of lung cancer in never smokers. With the recent introduction of lung cancer screening programs and the increasing detection of adenocarcinoma spectrum lesions (e.g., adenocarcinoma in situ, minimally invasive adenocarcinoma), the number of newly diagnosed cases is expected to further rise.

Apart from changes in the epidemiology and biology of lung cancer, significant advances have recently occurred in the diagnosis and treatment of the disease. The discovery of treatable oncogenic alterations has led to the routine implementation of molecular testing in the diagnostic evaluation of patients with lung adenocarcinoma. Indeed, an increasing number of targetable gene alterations has been recently identified, allowing individualized therapies that have demonstrated remarkable responses in selected patients. Targeted therapies were initially used for the management of advanced lung adenocarcinoma, but they have also recently shown promising results in early disease as part of multimodality treatments. The success of targeted therapies has resulted in ongoing efforts to identify and therapeutically target other driver mutations. Furthermore, important progress has been achieved in the development of immunotherapies, which now constitute the first-line treatment of advanced wild-type lung adenocarcinomas. Moreover, a paradigm shift in the surgical management of small, peripheral adenocarcinomas, which may radiologically manifest as subsolid lung nodules, has been recently observed. Sublobar resections in the form of segmentectomy or even wedge resection have been increasingly adopted by thoracic surgeons as a valid alternative to the traditional lobectomy. Such lesions may also be successfully treated with stereotactic ablative radiotherapy, which is currently being investigated as an alternative to surgical resection.

It is evident that the landscape of lung adenocarcinoma is transforming rapidly. This has created great opportunities for research in diagnosis and treatment; however, it has also provided challenges for clinicians, who are often presented with an excessive amount of new information. This Special Issue on the “Advances in the Diagnosis and Treatment of Lung Adenocarcinoma” aims to provide the readers of the Journal of Clinical Medicine with concise, high-quality, and up-to-date knowledge, as well as to present unpublished evidence on this topic. It therefore welcomes both reviews and original articles. By discussing the advances in the diagnosis and treatment of lung adenocarcinoma and identifying avenues for future research, this Special Issue will be a valuable resource for researchers, clinicians, and patients alike.

Dr. Marco Scarci
Dr. Savvas Lampridis
Guest Editors

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• biomarkers
• chemotherapy
• immunotherapy
• lung adenocarcinoma
• lung surgery
• molecular targeted therapy
• non-small cell lung cancer
• radiotherapy
• screening

• Advances in the Diagnosis and Treatment of Lung Adenocarcinoma–Part II in Journal of Clinical Medicine (1 article)