Cancer Research and Treatment

Original Articles

Factors Associated with Smoking Cessation of Participants in the National Lung Cancer Screening Program in Korea: Na-Young Yoon, Minji Seo, Nayoung Lee, Yeol Kim; Received July 16, 2024 Accepted January 10, 2025 Published online January 10, 2025; DOI: https://doi.org/10.4143/crt.2024.653 [Accepted]

Abstract PDF: Purpose
Smoking cessation interventions for participants in lung cancer screening are essential for increasing the effectiveness of screening to reduce lung cancer mortality. This study aimed to investigate the factors that lead to smoking cessation after lung cancer screening.
Materials and Methods
The Korean National Lung Cancer Screening (KNLCS) Satisfaction Survey was conducted from 2021 to 2022 with 1,000 samples per year among participants in KNLCS targets 30 or more pack-year smokers. Factors associated with smoking cessation were analyzed based on the survey.
Results
Among 1,525 current smokers in the survey participants, 728 (47.7%) received screening result counseling from physician after screening and showed significantly higher smoking cessation rate than non-counselling participants [OR 2.17, 95% CI 1.27–3.70]. The participants who considered the counseling helpful were more likely to quit smoking [OR 3.53, 95% CI 2.00–6.22] and to reduce smoking amount [OR 2.05, 95% CI 1.54–2.71]. Similarly, those who received physicians’ active recommendations to quit smoking were likely to quit smoking [OR 2.20, 95% CI 1.25–3.87] and to decrease smoking amount [OR 1.30, 95% CI 1.00-1.68]. In contrast, participants who had no abnormal findings from screening tended to have no significant change in smoking status despite the physicians’ active recommendations to quit smoking.
Conclusion
Physicians’ active recommendations and effective counseling to quit smoking could be a key factor in increasing smoking cessation among lung cancer screening participants. Further research should be conducted to develop more effective strategies for smoking cessation to participants without abnormal findings in lung cancer screening.

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Long-Term Survival Outcomes of Surgical Resection for Lung Adenocarcinoma with Intraoperatively Diagnosed Pleural Metastasis: Target Treatment Era: Yelee Kwon, Jae Kwang Yun, Geun Dong Lee, Se Hoon Choi, Yong-Hee Kim, Hyeong Ryul Kim; Received October 15, 2024 Accepted December 27, 2024 Published online December 30, 2024; DOI: https://doi.org/10.4143/crt.2024.993 [Accepted]

Abstract PDF: Purpose
This study aimed to evaluate the clinical impact of main tumor resection on long-term survival compared with pleural biopsy alone in patients with lung adenocarcinoma who were intraoperatively diagnosed with pleural metastasis.
Materials and Methods
A total of 176 patients with adenocarcinoma who had unexpected pleural metastasis detected during surgery from 2002 to 2021 were retrospectively analyzed. Each surgeon decided whether to perform main tumor resection or pleural biopsy alone.
Results
The patients were grouped based on the surgical approaches: main tumor resection (Resection group; n=83) and pleural biopsy only (O&C group; n=93). The Resection group had better overall survival (OS, 10-year survival: 27.9% vs. 9.4%; median survival: 68.3 vs. 36.6 months; p<0.01) and locoregional progression-free survival (10-year survival: 12.5% vs. 7.1%; median survival: 19.6 vs. 10.6 months; p<0.01) than the O&C group. Similar results were found for OS in patients who received tyrosine kinase inhibitors (TKIs) as first-line therapy (10-year survival: 49.2% vs. 15.0%; median survival: 72.2 vs. 45.4 months; p=0.03), patients who did not undergo TKIs treatment (10-year survival: 29.4% vs. 9.2%; median survival: 82.4 vs. 23.8 months; p<0.01), and patients with positive target gene mutation (10-year survival: 31.7% vs. 10.1%; median survival: 72.2 vs. 33.7 months; p<0.01). In multivariate analysis, pleural biopsy only (hazard ratio, 1.73; p=0.04) was a significant predictor of OS.
Conclusion
Main tumor resection can improve survival in patients with lung adenocarcinoma who had unexpected pleural metastasis during operation.

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Review Article

The Era of Antibody Drug Conjugates in Lung Cancer: Trick or Threat?: Mariona Riudavets, David Planchard; Received July 26, 2024 Accepted November 27, 2024 Published online November 28, 2024; DOI: https://doi.org/10.4143/crt.2024.714 [Epub ahead of print]

Abstract PDF: Antibody drug conjugates (ADCs) are a novel class of therapeutics that structurally are composed by an antibody directed to a tumor epitope connected via a linker to a cytotoxic payload, and that have shown significant antitumor activity across a range of malignancies including lung cancer. In this article we review the pharmacology and design of ADCs, as well as we describe the results of different studies evaluating ADCs in lung cancer directed to several targets including HER2, HER3, TROP2, MET, CEACAM5 and DLL3.

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Original Articles

Association of Shorter Time to Recurrence and Recurrence-Free Survival with Transthoracic Lung Biopsy in Stage I Lung Cancer: Kum Ju Chae, Hyunsook Hong, Hyungin Park, Soon Ho Yoon; Received June 15, 2024 Accepted August 30, 2024 Published online September 2, 2024; DOI: https://doi.org/10.4143/crt.2024.560 [Epub ahead of print]

Abstract PDF Supplementary Material: Purpose
We aim to determine whether preoperative percutaneous needle aspiration or biopsy (PCNA/Bx) increases recurrence risk and reduces survival in stage I lung cancer patients, using a nationwide lung cancer registry.
Materials and Methods
We retrospectively included 3,452 patients diagnosed with stage I lung cancer who underwent curative surgery between 2014 and 2019, as recorded in the Korean Association of Lung Cancer Registry. To balance the characteristics of patients with and without PCNA/Bx, we applied inverse probability of treatment weighting. We used cumulative incidence plots and a weighted subdistribution hazard model to analyze time to recurrence. Recurrence-free survival and overall survival were analyzed using Kaplan-Meier curves and weighted Cox proportional hazard ratio models.
Results
In patients with adenocarcinoma, the use of PCNA/Bx was associated with a 1.9-fold increase (95% confidence interval [CI], 1.5 to 2.4) in the risk of recurrence and a 1.7-fold decrease (95% CI, 1.3 to 2.2) in recurrence-free survival. Subgroup analysis based on pathologic pleural invasion revealed that the risk of recurrence increased when PCNA/Bx was performed, with 2.1-fold (95% CI, 1.5 to 2.8) in patients without pleural invasion and 1.6-fold (95% CI, 1.0 to 2.4) in those with pleural invasion. No association was found between the use of PCNA/Bx and overall survival.
Conclusion
Preoperative PCNA/Bx was associated with increased recurrence risks in stage I adenocarcinoma, regardless of pathologic pleural invasion status. In early lung cancer cases where adenocarcinoma is strongly suspected and curative surgery is feasible, the use of transthoracic biopsy should be approached with caution.

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Lung and Thoracic cancer

Association of TP53 Mutation Status and Sex with Clinical Outcome in Non–Small Cell Lung Cancer Treated with Immune Checkpoint Inhibitors: A Retrospective Cohort Study: Songji Choi, Se Hyun Kim, Sejoon Lee, Jeongmin Seo, Minsu Kang, Eun Hee Jung, Sang-A Kim, Koung Jin Suh, Ji Yun Lee, Ji-Won Kim, Jin Won Kim, Jeong-Ok Lee, Yu Jung Kim, Keun-Wook Lee, Jee Hyun Kim, Soo-Mee Bang, Jong Seok Lee; Cancer Res Treat. 2025;57(1):70-82. Published online August 7, 2024; DOI: https://doi.org/10.4143/crt.2024.046

Abstract PDF Supplementary Material PubReader ePub: Purpose
Some studies suggest that TP53 mutations are associated with the response to immune checkpoint inhibitors (ICI) in patients with non–small cell lung cancer (NSCLC) and also contribute to sex disparities in several cancers. Thus, we hypothesized that TP53 mutations might serve as sex-dependent genomic biomarkers of ICI treatment response in patients with NSCLC.
Materials and Methods
Clinical data of 100 patients with metastatic NSCLC treated with ICI monotherapy at Seoul National University Bundang Hospital (SNUBH) were retrospectively reviewed. Genomic and clinical datasets of The Cancer Genome Atlas and an ICI-treated lung cancer cohort (cBioPortal) were also analyzed.
Results
In SNUBH cohort, no statistically significant difference was observed in the median progression-free survival (PFS) according to TP53 mutation status (p=0.930); however, female patients with TP53 mutations (MT) had a significantly prolonged median PFS compared to wild-type (WT) (6.1 months in TP53 MT vs. 2.6 months in TP53 WT; p=0.021). Programmed death-ligand 1 (PD-L1) high (≥ 50%) expression was significantly enriched in female patients with TP53 MT (p=0.005). The analysis from publicly available dataset also revealed that females with NSCLC with TP53 MT showed significantly longer PFS than those with TP53 WT (p < 0.001). In The Cancer Genome Atlas analysis, expression of immune-related genes, and tumor mutation burden score in TP53 MT females were higher than in males without TP53 MT.
Conclusion
Female patients with NSCLC with TP53 mutations had high PD-L1 expression and showed favorable clinical outcomes following ICI therapy, suggesting a need for further research to explore the role of TP53 mutations for sex disparities in response to ICI therapy.

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Special Article

Trends in Cancer-Screening Rates in Korea: Findings from the National Cancer Screening Survey, 2004-2023: EunKyo Kang, Kui Son Choi, Jae Kwan Jun, Yeol Kim, Hyeon Ji Lee, Chang Kyun Choi, Tae Hee Kim, Sun Hwa Lee, Mina Suh; Cancer Res Treat. 2025;57(1):28-38. Published online August 2, 2024; DOI: https://doi.org/10.4143/crt.2024.325

Abstract PDF Supplementary Material PubReader ePub: Purpose
This study aimed to report the overall national trends in the rates of cancer screening based on recommendations and provide insights into the changing trends of these rates across different demographics.
Materials and Methods
This study used data from the Korean National Cancer Screening Survey (KNCSS), which surveys nationwide cancer-screening rates and includes 4,500 individuals meeting the Korean National Cancer Screening Program (NCSP) protocol age criteria. Cancer-screening rates were assessed using structured questionnaires; yearly trends were analyzed for both lifetime cancer-screening rates and rates of screening based on recommendations, and subgroup analyses were performed based on age and sex.
Results
The rates of cancer screening based on recommendations showed significant increments: the stomach cancer-screening rate increased from 39.2% in 2004 to 77.5% in 2023 (3.50% per year), the liver cancer-screening rate increased from 20.0% to 48.8% (4.30% per year), and the colorectal cancer, increased from 19.9% to 70.7% (5.15% per year). The breast cancer-screening rate increased from 33.2% to 72.7% (2.88% per year), and the cervical cancer, increased from 58.3% to 70.2% (1.08% per year). Despite some differences, particularly in relation to sociodemographic factors, screening rates increased significantly for all cancer types.
Conclusion
Cancer-screening rates in Korea increased consistently from 2004 to 2023, demonstrating the effectiveness of the national cancer-screening program. However, the increments in breast, cervical and lung cancer-screening rates were relatively lower, indicating the need for additional efforts and strategies.

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Original Articles

Lung and Thoracic cancer

Recurrence Dynamics of Pathological N2 Non–Small Cell Lung Cancer Based on IASLC Residual Tumor Descriptor: In Ha Kim, Geun Dong Lee, Sehoon Choi, Hyeong Ryul Kim, Yong-Hee Kim, Dong Kwan Kim, Seung-Il Park, Jae Kwang Yun; Cancer Res Treat. 2025;57(1):105-115. Published online July 23, 2024; DOI: https://doi.org/10.4143/crt.2024.150

Abstract PDF Supplementary Material PubReader ePub: Purpose
This study investigated the recurrence patterns and timing in patients with pathologic N2 (pN2) non-small cell lung cancer (NSCLC) according to the residual tumor (R) descriptor proposed by the International Association for the Study of Lung Cancer (IASLC).
Materials and Methods
From 2004 to 2021, patients with pN2 NSCLC who underwent anatomical resection were analyzed according to the IASLC R criteria using medical records from a single center. Survival analysis was performed using Cox proportional hazards models. Recurrence patterns between complete (R0) and uncertain resections (R[un]) were compared.
Results
In total, 1,373 patients were enrolled in this study: 576 (42.0%) in R0, 286 (20.8%) in R(un), and 511 (37.2%) in R1/R2 according to the IASLC R criteria. The most common reason for R(un) classification was positivity for the highest lymph node (88.8%). In multivariable analysis, the hazard ratios for recurrence in R(un) and R1/R2 compared to R0 were 1.18 (95% confidence interval [CI], 0.96–1.46) and 1.58 (1.31–1.90), respectively. The hazard rate curves displayed similar patterns among groups, peaking at approximately 12 months after surgery. There was a significant difference in distant recurrence patterns between R0 and R(un). Further analysis after stratification with the IASLC N2 descriptor showed significant differences in distant recurrence patterns between R0 and R(un) in patients pN2a1 and pN2a2 disease, but not in those with pN2b disease.
Conclusion
The IASLC R criteria has prognostic relevance in patients with pN2 NSCLC. R(un) is a highly heterogeneous group, and the involvement of the highest mediastinal lymph node can affect distant recurrence patterns.

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Differences in the Prognostic Impact between Single-Zone and Multi-Zone N2 Node Metastasis in Patients with Station-Based Multiple N2 Non–Small Cell Lung Cancer: Shia Kim, Geun Dong Lee, SeHoon Choi, Hyeong Ryul Kim, Yong-Hee Kim, Dong Kwan Kim, Seung-Il Park, Jae Kwang Yun; Cancer Res Treat. 2025;57(1):95-104. Published online July 22, 2024; DOI: https://doi.org/10.4143/crt.2024.120

Abstract PDF Supplementary Material PubReader ePub: Purpose
The International Association for the Study of Lung Cancer suggests further subdivision of pathologic N (pN) category in non–small-cell lung cancer (NSCLC) by incorporating the location and number of involved lymph node (LN) stations. We reclassified patients with the station-based N2b disease into single-zone and multi-zone N2b groups and compared survival outcomes between the groups.
Materials and Methods
This retrospective study included patients with pN2 NSCLC who underwent lobectomy from 2006 to 2019. The N2 disease was subdivided into four categories: single-station N2 without N1 (N2a1), single-station N2 with N1 (N2a2), multiple-station N2 with single zone involvement (single-zone N2b), and multiple-station N2 with multiple zone involvement (multi-zone N2b). LN zones included in the subdivision of N2 disease were upper mediastinal, lower mediastinal, aortopulmonary, and subcarinal.
Results
Among 996 eligible patients, 211 (21.2%), 394 (39.6%), and 391 (39.3%) were confirmed to have pN2a1, pN2a2, and pN2b disease, respectively. In multivariable analysis after adjustment for sex, age, pT category, and adjuvant chemotherapy, overall survival was significantly better with single-zone N2b disease (n=125, 12.6%) than with multi-zone N2b disease (n=266, 26.7%) (hazard ratio [HR], 0.67; 95% confidence interval [CI], 0.49 to 0.90; p=0.009) and was comparable to that of N2a2 disease (HR, 1.12; 95% CI, 0.83 to 1.49; p=0.46).
Conclusion
Prognosis of single-zone LN metastasis was better than that of multiple-zone LN metastasis in patients with N2b NSCLC. Along with the station-based N descriptors, zone-based descriptors might ensure optimal staging, enabling the most appropriate decision-making on adjuvant therapy for patients with pN2 NSCLC.

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Enhancing Identification of High-Risk cN0 Lung Adenocarcinoma Patients Using MRI-Based Radiomic Features: Harim Kim, Jonghoon Kim, Soohyun Hwang, You Jin Oh, Joong Hyun Ahn, Min-Ji Kim, Tae Hee Hong, Sung Goo Park, Joon Young Choi, Hong Kwan Kim, Jhingook Kim, Sumin Shin, Ho Yun Lee; Cancer Res Treat. 2025;57(1):57-69. Published online June 26, 2024; DOI: https://doi.org/10.4143/crt.2024.251

Abstract PDF Supplementary Material PubReader ePub: Purpose
This study aimed to develop a magnetic resonance imaging (MRI)–based radiomics model to predict high-risk pathologic features for lung adenocarcinoma: micropapillary and solid pattern (MPsol), spread through air space, and poorly differentiated patterns.
Materials and Methods
As a prospective study, we screened clinical N0 lung cancer patients who were surgical candidates and had undergone both ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography–computed tomography (PET/CT) and chest CT from August 2018 to January 2020. We recruited patients meeting our proposed imaging criteria indicating high-risk, that is, poorer prognosis of lung adenocarcinoma, using CT and FDG PET/CT. If possible, these patients underwent an MRI examination from which we extracted 77 radiomics features from T1-contrast-enhanced and T2-weighted images. Additionally, patient demographics, maximum standardized uptake value on FDG PET/CT, and the mean apparent diffusion coefficient value on diffusion-weighted image, were considered together to build prediction models for high-risk pathologic features.
Results
Among 616 patients, 72 patients met the imaging criteria for high-risk lung cancer and underwent lung MRI. The magnetic resonance (MR)–eligible group showed a higher prevalence of nodal upstaging (29.2% vs. 4.2%, p < 0.001), vascular invasion (6.5% vs. 2.1%, p=0.011), high-grade pathologic features (p < 0.001), worse 4-year disease-free survival (p < 0.001) compared with non-MR-eligible group. The prediction power for MR-based radiomics model predicting high-risk pathologic features was good, with mean area under the receiver operating curve (AUC) value measuring 0.751-0.886 in test sets. Adding clinical variables increased the predictive performance for MPsol and the poorly differentiated pattern using the 2021 grading system (AUC, 0.860 and 0.907, respectively).
Conclusion
Our imaging criteria can effectively screen high-risk lung cancer patients and predict high-risk pathologic features by our MR-based prediction model using radiomics.

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Development of the Korean Association for Lung Cancer Clinical Practice Guidelines: Recommendations on Radial Probe Endobronchial Ultrasound for Diagnosing Lung Cancer - An Updated Meta-Analysis: Soo Han Kim, Hyun Sung Chung, Jinmi Kim, Mi-Hyun Kim, Min Ki Lee, Insu Kim, Jung Seop Eom; Cancer Res Treat. 2024;56(2):464-483. Published online November 29, 2023; DOI: https://doi.org/10.4143/crt.2023.749

Abstract PDF Supplementary Material PubReader ePub: Purpose
Radial probe endobronchial ultrasound (RP-EBUS) accurately locates peripheral lung lesions (PLLs) during transbronchial biopsy (TBB). We performed an updated meta-analysis of the diagnostic yield of TBB for PLLs using RP-EBUS to generate recommendations for the development of the Korean Association of Lung Cancer guidelines.
Materials and Methods
We systematically searched MEDLINE and EMBASE (from January 2013 to December 2022), and performed a meta-analysis using R software. The diagnostic yield was evaluated by dividing the number of successful diagnoses by the total lesion number. Subgroup analysis was performed to identify related factors.
Results
Forty-one studies with a total of 13,133 PLLs were included. The pooled diagnostic yield of RP-EBUS was 0.72 (95% confidence interval [CI], 0.70 to 0.75). Significant heterogeneity was observed among studies (χ²=292.38, p < 0.01, I²=86.4%). In a subgroup analysis, there was a significant difference in diagnostic yield based on RP-EBUS findings (within, adjacent to, invisible), with a risk ratio of 1.45 (95% CI, 1.23 to 1.72) between within and adjacent to, 4.20 (95% CI, 1.89 to 9.32) between within and invisible, and 2.59 (95% CI, 1.32 to 5.01) between adjacent to and invisible. There was a significant difference in diagnostic yield based on lesion size, histologic diagnosis, computed tomography (CT) bronchus sign, lesion character, and location from the hilum. The overall complication rate of TBB with RP-EBUS was 6.8% (bleeding, 4.5%; pneumothorax, 1.4%).
Conclusion
Our study showed that TBB with RP-EBUS is an accurate diagnostic tool for PLLs with good safety profiles, especially for PLLs with within orientation on RP-EBUS or positive CT bronchus sign.

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Aggressive Local Ablative Radiotherapy Mitigates Progression Risk in Oligometastatic Lung Adenocarcinoma: Gowoon Yang, Kyung Hwan Kim, Chang Geol Lee, Min Hee Hong, Hye Ryun Kim, Yeona Cho, Hong In Yoon; Cancer Res Treat. 2024;56(1):115-124. Published online August 29, 2023; DOI: https://doi.org/10.4143/crt.2023.600

Abstract PDF Supplementary Material PubReader ePub: Purpose
This study aimed to determine the role of local ablative radiotherapy (LART) in oligometastatic/oligoprogressive lung adenocarcinoma.
Materials and Methods
Patients (n=176) with oligometastatic lung adenocarcinoma treated with LART were identified, and those treated with LART at the initial diagnosis of synchronous oligometastatic disease (OMD group) or treated with LART when they presented with repeat oligoprogression (OPD group) were included.
Results
In the OMD group (n=54), the 1- and 3-year progression-free survival (PFS) were 50.9% and 22.5%, respectively, whereas the 1- and 3-year overall survival in the OPD group were 75.9% and 58.1%, respectively. Forty-one patients (75.9%) received LART at all gross disease sites. Tyrosine kinase inhibitor (TKI) use and all-metastatic site LART were significant predictors of higher PFS (p=0.018 and p=0.046, respectively). In patients treated with TKIs at the time of LART (n=23) and those treated with all-metastatic site LART, the 1-year PFS was 86.7%, while that of patients not treated with all-metastatic site LART was 37.5% (p=0.006). In the OPD group (n=122), 67.2% of the patients (n=82) maintained a systemic therapy regimen after LART. The cumulative incidence of changing systemic therapy was 39.6%, 62.9%, and 78.5% at 6 months, 1 year, and 2 years after LART, respectively.
Conclusion
Aggressive LART can be an option to improve survival in patients with oligometastatic disease. Patients with synchronous oligometastatic disease receiving TKI and all-metastatic site LART may have improved PFS. In patients with repeat oligoprogression, LART might potentially extend survival by delaying the need to change the systemic treatment regimen.

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Strategies to Improve Smoking Cessation for Participants in Lung Cancer Screening Program: Analysis of Factors Associated with Smoking Cessation in Korean Lung Cancer Screening Project (K-LUCAS): Yeol Kim, Jaeho Lee, Eunju Lee, Juntae Lim, Yonghyun Kim, Choon-Taek Lee, Seung Hun Jang, Yu-Jin Paek, Won-Chul Lee, Chan Wha Lee, Hyae Young Kim, Jin Mo Goo, Kui Son Choi, Boyoung Park, Duk Hyoung Lee, Hong Gwan Seo; Cancer Res Treat. 2024;56(1):92-103. Published online August 7, 2023; DOI: https://doi.org/10.4143/crt.2022.1598

Abstract PDF PubReader ePub

Purpose
Smoking cessation intervention is one of the key components of successful lung cancer screening program. We investigated the effectiveness and related factors of smoking cessation services provided to the participants in a population-based lung cancer screening trial.
Materials and Methods
The Korean Lung Cancer Screening Project (K-LUCAS) is a nationwide, multi-center lung cancer screening trial that evaluates the feasibility of implementing population-based lung cancer screening. All 5,144 current smokers who participated in the K-LUCAS received a mandatory smoking cessation counseling. Changes in smoking status were followed up using a telephone survey in 6 months after lung cancer screening participation. The lung cancer screening’s impact on smoking cessation is analyzed by variations in the smoking cessation interventions provided in screening units.
Results
Among 4,136 survey responders, participant’s motivation to quit smoking increased by 9.4% on average after lung cancer screening. After 6 months from the initial screening, 24.3% of participants stopped smoking, and 10.6% of participants had not smoked continuously for at least 6 months after screening. Over 80% of quitters stated that participation in lung cancer screening motivated them to quit smoking. Low-cost public smoking cessation program combined with lung cancer screening increased the abstinence rates. The smokers were three times more likely to quit smoking when the smoking cessation counseling was provided simultaneously with low-dose computed tomography screening results than when provided separately.
Conclusion
A mandatory smoking cessation intervention integrated with screening result counselling by a physician after participation in lung cancer screening could be effective for increasing smoking cessation attempts.

Citations

Citations to this article as recorded by

p53 Genetics and Biology in Lung Carcinomas: Insights, Implications and Clinical Applications
Dixan A. Benitez, Guadalupe Cumplido-Laso, Marcos Olivera-Gómez, Nuria Del Valle-Del Pino, Alba Díaz-Pizarro, Sonia Mulero-Navarro, Angel Román-García, Jose Maria Carvajal-Gonzalez
Biomedicines.2024; 12(7): 1453. CrossRef
Problems and Alternatives for Korea National Lung Cancer Screening Program for Smoking Cessation: Analysis of a Survey Involving Experts
Cheol Min Lee, Sil Vi Han Park, Jinri Kim, Bumjo Oh, Kiheon Lee, Yeol Kim, Yu-Jin Paek
Journal of the Korean Society for Research on Nicotine and Tobacco.2024; 15(2): 49. CrossRef
The pros and cons of lung cancer screening
Roberta Eufrasia Ledda, Georg-Christian Funk, Nicola Sverzellati
European Radiology.2024; 35(1): 267. CrossRef
Effective Smoking Cessation Counseling for Participants in a Lung Cancer Screening
Choon-Young Kim, Yeol Kim, Cheol Min Lee
Journal of the Korean Society for Research on Nicotine and Tobacco.2024; 15(3): 88. CrossRef

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Should We Perform Repeated Re-biopsy for the Detection of T790M Mutation?: Saerom Kim, Soo Han Kim, Jinmi Kim, Mi-Hyun Kim, Min Ki Lee, Jung Seop Eom; Cancer Res Treat. 2023;55(4):1190-1197. Published online April 17, 2023; DOI: https://doi.org/10.4143/crt.2023.320

Abstract PDF PubReader ePub

Purpose
Epidermal growth factor receptor (EGFR) T790M mutations have been detected in the second or third rebiopsy, even if the T790M mutation was not identified in the first rebiopsy. This meta-analysis investigated the EGFR T790M mutation detection rates and its additional advantages with repeated rebiopsies.
Materials and Methods
We searched through the PubMed and EMBASE databases up to June 2022. Studies reporting rebiopsy to identify the EGFR T790M mutation in case of disease progression among patients with advanced non-small cell lung cancer and multiple rebiopsies were included. The quality of the included studies was checked using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool.
Results
Eight studies meeting the eligibility criteria, reporting 1,031 EGFR mutation–positive patients were selected. The pooled EGFR T790M mutation detection rate of the first and repeated rebiopsies were 0.442 (95% confidence interval [CI], 0.411 to 0.473; I²=84%; p < 0.01) and 0.465 (95% CI, 0.400 to 0.530; I²=69%; p < 0.01), respectively. Overall, the pooled detection rate of EGFR T790M mutation was 0.545 (95% CI, 0.513 to 0.576), which increased by 10.3% with repeated rebiopsies.
Conclusion
This meta-analysis identified that repeated rebiopsy increases the detection rate of EGFR T790M mutation by 10.3%, even if EGFR T790M mutation is not detected in the first rebiopsy. Our results indicate that the spatiotemporal T790M heterogeneity can be overcome with repeated rebiopsy.

Citations

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Clinical utility of repeated rebiopsy for EGFR T790M mutation detection in non-small cell lung cancer
Eun Hye Lee, Se Hyun Kwak, Kyeong Yeon Kim, Chi Young Kim, Sang Hoon Lee, Seok-Jae Heo, Yoon Soo Chang, Eun Young Kim
Frontiers in Oncology.2024;[Epub] CrossRef
Repeated rebiopsy for detection of EGFR T790M mutation in patients with advanced-stage lung adenocarcinoma: Associated factors and treatment outcomes of Osimertinib
Taeyun Kim, Junsu Choe, Sun Hye Shin, Byeong-Ho Jeong, Kyungjong Lee, Hojoong Kim, Se-Hoon Lee, Sang-Won Um, Hamidreza Montazeri Aliabadi
PLOS ONE.2024; 19(9): e0310079. CrossRef
Rebiopsie tumorale : quand ? pour qui ? pourquoi ? comment ?
V. Fallet
Revue des Maladies Respiratoires Actualités.2023; 15(2): 2S121. CrossRef

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Clinical Outcome of Stereotactic Body Radiotherapy in Patients with Early-Stage Lung Cancer with Ground-Glass Opacity Predominant Lesions: A Single Institution Experience: Jeong Yun Jang, Su Ssan Kim, Si Yeol Song, Young Seob Shin, Sei Won Lee, Wonjun Ji, Chang-Min Choi, Eun Kyung Choi; Cancer Res Treat. 2023;55(4):1181-1189. Published online March 21, 2023; DOI: https://doi.org/10.4143/crt.2022.1656

Abstract PDF Supplementary Material PubReader ePub

Purpose
The detection rate of early-stage lung cancer with ground-glass opacity (GGO) has increased, and stereotactic body radiotherapy (SBRT) has been suggested as an alternative to surgery in inoperable patients. However, reports on treatment results are limited. Therefore, we performed a retrospective study to investigate the clinical outcome after SBRT in patients with early-stage lung cancer with GGO-predominant tumor lesions at a single institution.
Materials and Methods
This study included 89 patients with 99 lesions who were treated with SBRT for lung cancer with GGO-predominant lesions that had a consolidation-to-tumor ratio of ≤0.5 at Asan Medical Center between July 2016 and July 2021. A median total dose of 56.0 Gy (range, 48.0–60.0) was delivered using 10.0–15.0 Gy per fraction.
Results
The overall follow-up period for the study was median 33.0 months (range, 9.9 to 65.9 months). There was 100% local control with no recurrences in any of the 99 treated lesions. Three patients had regional recurrences outside of the radiation field, and three had distant metastasis. The 1-year, 3-year, and 5-year overall survival rates were 100.0%, 91.6%, and 82.8%, respectively. Univariate analysis revealed that advanced age and a low level of diffusing capacity of the lungs for carbon monoxide were significantly associated with overall survival. There were no patients with grade ≥3 toxicity.
Conclusion
SBRT is a safe and effective treatment for patients with GGO-predominant lung cancer lesions and is likely to be considered as an alternative to surgery.

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Recent Advancements in Minimally Invasive Surgery for Early Stage Non-Small Cell Lung Cancer: A Narrative Review
Jibran Ahmad Khan, Ibrahem Albalkhi, Sarah Garatli, Marcello Migliore
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The clinical effect of thoracoscopic segmentectomy in the treatment of lung malignancies less than 2CM in diameter
Yafeng Zhang, Renzhong Shi, Xiaoming Xia, Kaiyao Zhang
Journal of Cardiothoracic Surgery.2024;[Epub] CrossRef
Impact of ground-glass component on prognosis in early-stage lung cancer treated with stereotactic body radiotherapy via Helical Tomotherapy
Jintao Ma, Shaonan Fan, Wenhan Huang, Xiaohong Xu, Yong Hu, Jian He
Radiation Oncology.2024;[Epub] CrossRef

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Predictors of Post-chemoradiotherapy Pulmonary Complication in Locally Advanced Non–Small Cell Lung Cancer: Tae Hoon Lee, Byung-Hee Kang, Hak Jae Kim, Hong-Gyun Wu, Joo Ho Lee; Cancer Res Treat. 2023;55(3):865-874. Published online January 19, 2023; DOI: https://doi.org/10.4143/crt.2022.1538

Abstract PDF PubReader ePub

Purpose
We investigated the clinical effects and predictive factors of severe post-chemoradiotherapy pulmonary complications (PCPC) in locally advanced non–small cell lung cancer (LA-NSCLC).
Materials and Methods
Medical records of 317 patients who underwent definitive concurrent chemoradiation (CCRT) for LA-NSCLC were reviewed retrospectively. PCPC was defined as an event of admission or emergency department visit for acute or subacute pulmonary inflammatory complications, including pneumonitis and pneumonia, within 6 months after CCRT initiation. Patient characteristics, baseline lung function tests, radiation dosimetric parameters, and laboratory tests were analyzed to investigate their association with PCPC. Prognostic endpoints were disease progression rate (DPR) and overall survival (OS).
Results
PCPC was reported in 53 patients (16.7%). The OS of patients with PCPC was significantly worse (35.0% in 2 years) than that of patients without PCPC (67.0% in 2 years, p < 0.001). However, 2-year DPRs were 77.0% and 70.7% in patients with and without PCPC, respectively, which were not significantly different (p=0.087). In multivariate logistic regression, PCPC was independently associated with grade ≥ 1 hypoalbuminemia during CCRT (odds ratio [OR], 5.670; 95% confidence interval [CI], 2.487 to 13.40; p < 0.001), lower diffusing capacity of carbon monoxide (DLCO) (per mL/min/mmHg; OR, 0.855; 95% CI, 0.743 to 0.974; p=0.022), and higher lung V5 (per 10%; OR, 1.872; 95% CI, 1.336 to 2.699; p < 0.001).
Conclusion
PCPC might be a clinical endpoint to evaluate complications and predict the survival of patients subjected to CCRT for LA-NSCLC. Hypoalbuminaemia, DLCO, and lung V5 might predict PCPC in LA-NSCLC.

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Pneumonitis Risk After Chemoradiotherapy With and Without Immunotherapy in Patients With Locally Advanced Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis
Chong Han, Jingping Qiu, Lu Bai, Tingting Liu, Jun Chen, He Wang, Jun Dang
International Journal of Radiation Oncology*Biology*Physics.2024; 119(4): 1179. CrossRef
Prognostic Biomarkers of Systemic Inflammation in Non-Small Cell Lung Cancer: A Narrative Review of Challenges and Opportunities
Mark Stares, Leo R. Brown, Dhruv Abhi, Iain Phillips
Cancers.2024; 16(8): 1508. CrossRef
Comparison of post-chemoradiotherapy pneumonitis between Asian and non-Asian patients with locally advanced non-small cell lung cancer: a systematic review and meta-analysis
Tingting Liu, Sihan Li, Silu Ding, Jingping Qiu, Chengbo Ren, Jun Chen, He Wang, Xiaoling Wang, Guang Li, Zheng He, Jun Dang
eClinicalMedicine.2023; 64: 102246. CrossRef

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The Incidence and Risk Factors of Chronic Pulmonary Infection after Radiotherapy in Patients with Lung Cancer: Yeonseok Choi, Jae Myoung Noh, Sun Hye Shin, Kyungjong Lee, Sang-Won Um, Hojoong Kim, Hongryull Pyo, Yong Chan Ahn, Byeong-Ho Jeong; Cancer Res Treat. 2023;55(3):804-813. Published online January 3, 2023; DOI: https://doi.org/10.4143/crt.2022.1305

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to investigate cumulative incidence and risk factors associated with chronic pulmonary infection (CPI) development after radiotherapy for lung cancer.
Materials and Methods
We retrospectively analyzed 1,872 patients with lung cancer who received radiotherapy for lung cancer from 2010-2014, had a follow-up period of ≥ 3 months after radiotherapy, and did not have CPI at the time of radiotherapy. CPI was defined as pulmonary tuberculosis, non-tuberculous mycobacterial pulmonary disease, chronic pulmonary aspergillosis, or pulmonary actinomycosis. The cumulative incidence of CPI and overall survival (OS) were estimated using the Kaplan-Meier method, and a multivariable Cox proportional hazards analysis was performed to identify risk factors associated with CPI development.
Results
The median follow-up period was 2.3 years with OS rates of 55.6% and 37.6% at 2 and 5 years, respectively. CPI developed in 59 patients at a median of 1.8 years after radiotherapy, with cumulative incidence rates of 1.1%, 3.4%, 5.0%, and 6.8% at 1, 3, 5, and 7 years, respectively. A lower body mass index, interstitial lung disease, prior pulmonary tuberculosis, larger clinical target volume, history of lung cancer surgery or radiation pneumonitis, and use of inhaled corticosteroids were independent risk factors for CPI development.
Conclusion
The long-term survival rate of lung cancer patients receiving radiotherapy was not low, but the cumulative incidence of CPI gradually increased to 6.8% at 7 years after radiotherapy. Therefore, close monitoring of CPI development is required in surviving patients with risk factors.

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Invasive aspergillosis complicated in a patient with non-small cell lung cancer harboring RET fusion during treatment with RET-TKIs: a case report and literature review
Kaidiriye Setiwalidi, Yimeng Li, Yuyan Ma, Zhanpeng Hao, Yujia Zhao, Yuxin Zhang, Xuan Liang, Tao Tian, Zhiping Ruan, Yu Yao, Xiao Fu
Frontiers in Oncology.2024;[Epub] CrossRef

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Optimal Definition of Oligometastasis Showing Survival Benefits of Local Therapies during Tyrosine Kinase Inhibitor Treatment: Yoon Jung Jang, Dong-gon Hyun, Wonjun Ji, Chang-Min Choi, Shinkyo Yoon, Dae Ho Lee, Sang-We Kim, Jae Cheol Lee; Cancer Res Treat. 2023;55(2):468-478. Published online November 28, 2022; DOI: https://doi.org/10.4143/crt.2022.1342

Abstract PDF Supplementary Material PubReader ePub: Purpose
We aimed to investigate the feasibility of four criteria on oligometastasis (OM) concerning clear survival benefits of local therapy (LT) during tyrosine kinase inhibitor (TKI) treatment in non–small cell lung cancer (NSCLC).
Materials and Methods
This single-center, retrospective study included patients with advanced NSCLC who received LT because of OM during TKI treatment at Asan Medical Center from January 2011 to December 2020. At the application of LT OM was classified according to four criteria: TNM, European Organization for Research and Treatment of Cancer Lung Cancer Group (EORTC-LCG), National Comprehensive Network (NCCN), and ORGAN. We compared survival outcomes between patients with and without OM.
Results
The median overall survival of the 117 patients included in the analysis was 70.8 months (95% confidence interval [CI], 56.6 to 85.1). The patients with OM meeting all four criteria (hazard ratio [HR] with 95% CI of TNM criteria 0.24 with 0.10-0.57; p=0.001, EORTC-LCG criteria 0.34 with 0.17-0.67; p=0.002, NCCN criteria 0.41 with 0.20-0.86; p=0.018 and ORGAN criteria 0.33 with 0.18-0.60; p < 0.001) had significantly longer survival compared with patients who did not after adjusting for confounding factors. Furthermore, increasing the number of extra-thoracic metastatic organs to two or more were independent predictive factors for worse survival outcomes (2 organs: HR, 3.51; 95% CI, 1.01 to 12.14; p=0.048; 3 organs: HR, 4.31; 95% CI, 0.94 to 19.73; p=0.060; 4 organs: HR, 24.47; 95% CI, 5.08 to 117.80; p < 0.001).
Conclusion
Patients with OM defined by all four criteria showed prognostic benefits from LT during TKI therapy.

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Real World Characteristics and Clinical Outcomes of HER2-Mutant Non–Small Cell Lung Cancer Patients Detected by Next-Generation Sequencing: Beung-Chul Ahn, Ye-Jeong Han, Hye Ryun Kim, Min Hee Hong, Byoung Chul Cho, Sun Min Lim; Cancer Res Treat. 2023;55(2):488-497. Published online November 9, 2022; DOI: https://doi.org/10.4143/crt.2022.359

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study was conducted to investigate the clinical characteristics of patients with advanced non–small cell lung cancer (NSCLC) harboring human epidermal growth factor receptor 2 (HER2) mutations and to evaluate response to standard treatment and HER2-targeted agents.
Materials and Methods
Using tissue and/or blood next-generation sequencing, we identified 44 patients with NSCLC harboring HER2 mutations who were treated at Severance Hospital between December 2016 and February 2021. Clinical data, including patient characteristics, mutation status, incidence of metastasis for distant lesions, and response to chemotherapy, were retrospectively analyzed.
Results
The median age was 58 years, and 61% of the patients were female. Most patients (64%) were never-smokers. Adenocarcinoma was the most predominant subtype (98%). A total of 66% of the patients had extrathoracic metastatic lesions, and 32% had intracranial lesions at initial presentation. The median time to the development of brain metastasis was 15.6 months (range, 2.4 to 43.7). The most common type of HER2 mutation was 12 base pair in-frame insertion in exon 20, A775_G776insYVMA. Of the 44 patients, two had concomitant driver mutations, one with epidermal growth factor receptor (EGFR) mutation (V769M), and one with BRAF mutation (V600E). Patients treated with pemetrexed-based chemotherapy (75%) had an overall response rate (ORR) and progression-free survival (PFS) of 30% and 8.3 months (95% confidence interval [CI], 3.9 to 12.7), respectively. The ORR and PFS of HER2-targeted agent treated patients (14%) were 0.0% and 1.9 months (95% CI, 0.1 to 2.8), respectively.
Conclusion
Given its distinct characteristics and treatment responses, novel treatment strategies for HER2-mutant NSCLC should be developed promptly to improve survival outcomes of patients.

Citations

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Prognostic factors in non-metastatic HER2 ‘low’ and HER2 ‘negative’ breast cancer: single institute experience
Alper Türkel, Mutlu Doğan, Elif Sertesen, Cengiz Karaçin, Sultan Çiğdem Irkkan, Öztürk Ateş
Wiener klinische Wochenschrift.2024; 136(11-12): 340. CrossRef
Clinicopathologic and Molecular Characteristics of HER2 (ERBB2)-Altered Non–Small Cell Lung Cancer: Implications for Precision Medicine
Yurimi Lee, Boram Lee, Yoon-La Choi, Dong-Wook Kang, Joungho Han
Modern Pathology.2024; 37(6): 100490. CrossRef
Current status and breakthroughs in treating advanced non-small cell lung cancer with EGFR exon 20 insertion mutations
Meng Hu, Congying Zhong, Jiabing Wang, JinQin Chen, Tao Zhou
Frontiers in Immunology.2024;[Epub] CrossRef
Efficacy of chemotherapy plus immune checkpoint inhibitors in patients with non-small cell lung cancer who have rare oncogenic driver mutations: a retrospective analysis
Teppei Yamaguchi, Junichi Shimizu, Reiko Matsuzawa, Naohiro Watanabe, Yoshitsugu Horio, Yutaka Fujiwara
BMC Cancer.2024;[Epub] CrossRef
Antibody–Drug Conjugates for the Treatment of Non-Small Cell Lung Cancer with Central Nervous System Metastases
David J. H. Bian, Sara F. Cohen, Anna-Maria Lazaratos, Nathaniel Bouganim, Matthew Dankner
Current Oncology.2024; 31(10): 6314. CrossRef
Real-World Clinical Outcomes for Patients with EGFR and HER2 Exon 20 Insertion-Mutated Non-Small-Cell Lung Cancer
Kelly Li, Ian Bosdet, Stephen Yip, Cheryl Ho, Janessa Laskin, Barbara Melosky, Ying Wang, Sophie Sun
Current Oncology.2023; 30(8): 7099. CrossRef

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The Additive Impact of Transbronchial Cryobiopsy Using a 1.1-mm Diameter Cryoprobe on Conventional Biopsy for Peripheral Lung Nodules: Soo Han Kim, Jeongha Mok, Eun-Jung Jo, Mi-Hyun Kim, Kwangha Lee, Ki Uk Kim, Hye-Kyung Park, Min Ki Lee, Jung Seop Eom; Cancer Res Treat. 2023;55(2):506-512. Published online November 1, 2022; DOI: https://doi.org/10.4143/crt.2022.1008

Abstract PDF Supplementary Material PubReader ePub

Purpose
The diagnostic yield of transbronchial biopsy (TBB) using radial probe endobronchial ultrasound (RP-EBUS) is 71%, which is lower than that of transthoracic needle biopsy. We investigated the performance and safety of sequential transbronchial cryobiopsy (TBC) using a novel 1.1-mm diameter cryoprobe, after conventional TBB using RP-EBUS for the diagnosis of peripheral lung lesions (PLLs).
Materials and Methods
From April 2021 to November 2021, 110 patients who underwent bronchoscopy using RP-EBUS for the diagnosis of PLL ≤ 30 mm were retrospectively included in our study. All records were followed until June 2022.
Results
The overall diagnostic yield of combined TBB and TBC was 79.1%, which was higher than 60.9% of TBB alone (p=0.005). The diagnostic yield of sequential TBC was 65.5%, which increased the overall diagnostic yield by 18.2%. The surface area of tissues by TBC (mean area, 18.5 mm²) was significantly larger than those of TBB by 1.5-mm forceps (3.4 mm², p < 0.001) and 1.9-mm forceps (3.7 mm², p=0.011). In the multivariate analysis, PLLs with the longest diameter of ≤ 22 mm were found to be related to additional diagnostic benefits from sequential TBC (odds ratio, 3.51; 95% confidence interval, 1.043 to 11.775; p=0.042). Complications were found in 10.5% of the patients: pneumothorax (1.0%), infection (1.0%), and significant bleeding (8.6%). None of the patients developed any life-threatening complications.
Conclusion
Sequential TBC with a 1.1-mm cryoprobe improved the performance of conventional TBB using RP-EBUS without serious complications.

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Transbronchial lung cryobiopsy for peripheral pulmonary lesions. A narrative review
Y. Tang, S. Tian, H. Chen, X. Li, X. Pu, X. Zhang, Y. Zheng, Y. Li, H. Huang, C. Bai
Pulmonology.2024; 30(5): 475. CrossRef
Transbronchial Tumor Ablation
Russell Miller, George Cheng
Current Pulmonology Reports.2024; 13(1): 103. CrossRef
Using cryoprobes of different sizes combined with cone-beam computed tomography-derived augmented fluoroscopy and endobronchial ultrasound to diagnose peripheral pulmonary lesions: a propensity-matched study
Ching-Kai Lin, Sheng-Yuan Ruan, Hung-Jen Fan, Hao-Chun Chang, Yen-Ting Lin, Chao-Chi Ho
Respiratory Research.2024;[Epub] CrossRef
Next‐generation sequencing using tissue specimen collected with a 1.1 mm‐diameter cryoprobe in patients with lung cancer
Mi‐Hyun Kim, Soo Han Kim, Geewon Lee, Jeongha Mok, Min Ki Lee, Ju Sun Song, Jung Seop Eom
Respirology.2024; 29(4): 333. CrossRef
Development of the Korean Association for Lung Cancer Clinical Practice Guidelines: Recommendations on Radial Probe Endobronchial Ultrasound for Diagnosing Lung Cancer - An Updated Meta-Analysis
Soo Han Kim, Hyun Sung Chung, Jinmi Kim, Mi-Hyun Kim, Min Ki Lee, Insu Kim, Jung Seop Eom
Cancer Research and Treatment.2024; 56(2): 464. CrossRef
Navigational bronchoscopy with tranbronchial cryobiopsy in differential diagnosis of peripheral pulmonary lesions
Ya.O. Chesalina, I.Yu. Shabalina, L.A. Semenova, I.V. Sivokozov
Pirogov Russian Journal of Surgery.2024; (6): 36. CrossRef
Advanced Bronchoscopic Diagnostic Techniques in Lung Cancer
Dongil Park
Tuberculosis and Respiratory Diseases.2024; 87(3): 282. CrossRef
Clinical utility of rapid on-site evaluation of brush cytology during bronchoscopy using endobronchial ultrasound with a guide sheath
Kazuhiro Nishiyama, Kei Morikawa, Shotaro Kaneko, Makoto Nishida, Aya Matsushima, Yoshihiro Nishi, Yu Numata, Yusuke Shinozaki, Hajime Tsuruoka, Hirotaka Kida, Hiroshi Handa, Naoki Shimada, Chie Okawa, Nobuyuki Ohike, Junki Koike, Masamichi Mineshita
Scientific Reports.2024;[Epub] CrossRef
Bronchial branch tracing navigation in ultrathin bronchoscopy-guided radial endobronchial ultrasound for peripheral pulmonary nodule
Sze Shyang Kho, Shirin Hui Tan, Swee Kim Chan, Chan Sin Chai, Siew Teck Tie
BMC Pulmonary Medicine.2024;[Epub] CrossRef
The diagnosis of peripheral lung lesions: transbronchial biopsy using a radial probe endobronchial ultrasound
Jung Seop Eom
Journal of the Korean Medical Association.2023; 66(3): 166. CrossRef
Clinical outcomes of transbronchial cryobiopsy using a 1.1-mm diameter cryoprobe for peripheral lung lesions - A prospective pilot study
Soo Han Kim, Jeongha Mok, Saerom Kim, Wan Ho Yoo, Eun-Jung Jo, Mi-Hyun Kim, Kwangha Lee, Ki Uk Kim, Hye-Kyung Park, Min Ki Lee, Jung Seop Eom
Respiratory Medicine.2023; 217: 107338. CrossRef

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Five-Year Overall Survival and Prognostic Factors in Patients with Lung Cancer: Results from the Korean Association of Lung Cancer Registry (KALC-R) 2015: Da Som Jeon, Ho Cheol Kim, Se Hee Kim, Tae-Jung Kim, Hong Kwan Kim, Mi Hyung Moon, Kyongmin Sarah Beck, Yang-Gun Suh, Changhoon Song, Jin Seok Ahn, Jeong Eun Lee, Jeong Uk Lim, Jae Hyun Jeon, Kyu-Won Jung, Chi Young Jung, Jeong Su Cho, Yoo-Duk Choi, Seung-Sik Hwang, Chang-Min Choi, Korean Association for Lung Cancer, Korea Central Cancer Registry; Cancer Res Treat. 2023;55(1):103-111. Published online June 20, 2022; DOI: https://doi.org/10.4143/crt.2022.264

Abstract PDF Supplementary Material PubReader ePub

Purpose
This study aimed to provide the clinical characteristics, prognostic factors, and 5-year relative survival rates of lung cancer diagnosed in 2015.
Materials and Methods
The demographic risk factors of lung cancer were calculated using the KALC-R (Korean Association of Lung Cancer Registry) cohort in 2015, with survival follow-up until December 31, 2020. The 5-year relative survival rates were estimated using Ederer II methods, and the general population data used the death rate adjusted for sex and age published by the Korea Statistical Information Service from 2015 to 2020.
Results
We enrolled 2,657 patients with lung cancer who were diagnosed in South Korea in 2015. Of all patients, 2,098 (79.0%) were diagnosed with non–small cell lung cancer (NSCLC) and 345 (13.0%) were diagnosed with small cell lung cancer (SCLC), respectively. Old age, poor performance status, and advanced clinical stage were independent risk factors for both NSCLC and SCLC. In addition, the 5-year relative survival rate declined with advanced stage in both NSCLC (82%, 59%, 16%, 10% as the stage progressed) and SCLC (16%, 4% as the stage progressed). In patients with stage IV adenocarcinoma, the 5-year relative survival rate was higher in the presence of epidermal growth factor receptor (EGFR) mutation (19% vs. 11%) or anaplastic lymphoma kinase (ALK) translocation (38% vs. 11%).
Conclusion
In this Korean nationwide survey, the 5-year relative survival rates of NSCLC were 82% at stage I, 59% at stage II, 16% at stage III, and 10% at stage IV, and the 5-year relative survival rates of SCLC were 16% in cases with limited disease, and 4% in cases with extensive disease.

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Review Article

Challenges in the Use of Targeted Therapies in Non–Small Cell Lung Cancer: Joel Rivera-Concepcion, Dipesh Uprety, Alex A. Adjei; Cancer Res Treat. 2022;54(2):315-329. Published online February 18, 2022; DOI: https://doi.org/10.4143/crt.2022.078

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Precision oncology has fundamentally changed how we diagnose and treat cancer. In recent years, there has been a significant change in the management of patients with oncogene-addicted advanced-stage NSCLC. Increasing amounts of identifiable oncogene drivers have led to the development of molecularly targeted drugs. Undoubtedly, the future of thoracic oncology is shifting toward increased molecular testing and the use of targeted therapies. For the most part, these novel drugs have proven to be safe and effective. As with all great innovations, targeted therapies pose unique challenges. Drug toxicities, resistance, access, and costs are some of the expected obstacles that will need to be addressed. This review highlights some of the major challenges in the use of targeted therapies in NSCLC and provides guidance for the future strategies.

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Original Articles

Lung and Thoracic cancer

Long-term Exposure to PM₁₀ Increases Lung Cancer Risks: A Cohort Analysis: Hyun Woo Lee, Sung-Chan Kang, Sun-Young Kim, Young-Jae Cho, Seungsik Hwang; Cancer Res Treat. 2022;54(4):1030-1037. Published online January 17, 2022; DOI: https://doi.org/10.4143/crt.2021.1030

Abstract PDF Supplementary Material PubReader ePub

Purpose
Although lung cancer incidences in female never-smokers have increased, few studies focus on explicit investigation. We aimed to investigate the relationship between long-term exposure to ambient particulate matter sized 10 μm or less in diameter (PM₁₀) and the incidence of lung cancer within different genders and smoking status populations.
Materials and Methods
We included Seoul metropolitan residents, aged between 20 and 65 years, who underwent a national health screening examination from 2005-2007 and were followed up until 2015. Individual-level long-term exposure to PM₁₀ was assessed based on subject home addresses. To assess the relationship between PM₁₀ and lung cancer, we estimated hazard ratios (HRs) for increased lung cancer incidence from a 10 µg/m³ increase in PM₁₀.
Results
Among 5,831,039 individuals, 36,225 (0.6%) developed lung cancer within the 7 years observed. In females, the majority (94.4%) of lung cancer development was found in never-smokers. In adjusted analyses, a significant relationship between lung cancer development and PM₁₀ was observed in males, regardless of smoking status (never-smoker: HR, 1.14 [95% confidence interval (CI), 1.13 to 1.15]; ex-smoker: HR, 1.16 [95% CI, 1.14 to 1.17]; current smoker: HR, 1.18 [95% CI, 1.17 to 1.19]). We also found significant associations in female never- or ex-smokers with smaller HRs (never-smoker: HR, 1.06 [95% CI, 1.05 to 1.07]; ex-smoker: HR, 1.13 [95% CI, 1.02 to 1.23]; current smoker: HR, 1.04 [95% CI, 0.99 to 1.10]).
Conclusion
Our findings suggest that long-term exposure to PM₁₀ is associated with lung cancer development. A novel approach to lung cancer screening needs to be considered depending on the exposed PM₁₀ level.

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Impact of air pollution on cardiorespiratory morbidities in Southern Thailand
Suhaimee Buya, Apiradee Lim, Rattikan Saelim, Salang Musikasuwan, Thitiworn Choosong, Nutta Taneepanichskul
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Lung cancer screening for never smokers: current evidence and future directions
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Airborne particulate matter integral assessment in Magdalena department, Colombia: Patterns, health impact, and policy management
Eliana Vergara-Vásquez, Luis M. Hernández Beleño, Tailin T. Castrillo-Borja, Tomás R. Bolaño-Ortíz, Yiniva Camargo-Caicedo, Andrés M. Vélez-Pereira
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Impact of Global Warming on Cancer Development: A Review of Environmental Carcinogens and Human Immunogenetics
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Health risk assessment for particulate matter: application of AirQ+ model in the northern Caribbean region of Colombia
Heli A. Arregocés, Roberto Rojano, Gloria Restrepo
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The dysfunctionality of hippocampal synapses may be directly related to PM-induced impairments in spatial learning and memory in juvenile rats
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Dan Wang, Yanan Wang, Qianqian Liu, Wenxin Sun, Liangkui Wei, Chengxin Ye, Rencheng Zhu
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The Role of Neutrophil-to-Lymphocyte Ratio in Predicting Pathological Response for Resectable Non–Small Cell Lung Cancer Treated with Neoadjuvant Chemotherapy Combined with PD-1 Checkpoint Inhibitors: Xiaoyan Sun, Yingnan Feng, Bin Zhang, Wuhao Huang, Xiaoliang Zhao, Hua Zhang, Dongsheng Yue, Changli Wang; Cancer Res Treat. 2022;54(4):1017-1029. Published online November 23, 2021; DOI: https://doi.org/10.4143/crt.2021.1007

Abstract PDF PubReader ePub

Purpose
The aim of our study was to investigate the value of baseline and preoperative neutrophil-to-lymphocyte ratio (NLR) in predicting the pathological response and disease-free survival (DFS) of neoadjuvant chemotherapy alone or combined with programmed cell death-1 (PD-1) checkpoint inhibitors in patients with resectable non‒small cell lung cancer (NSCLC).
Materials and Methods
Resectable NSCLC patients who underwent neoadjuvant chemotherapy alone or combined with PD-1 checkpoint inhibitors between January 2018 and January 2020 were included. Peripheral venous blood samples of the patients were collected within 3 days prior to the first neoadjuvant treatment and within 3 days prior to surgery.
Results
A total of 79 patients in neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors group and 89 patients in neoadjuvant chemotherapy alone group were included. Thirty-five point four percent of the patients achieved pathological complete response (pCR) in neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors group, whereas only 9.0% reached pCR in the group of neoadjuvant chemotherapy. High NLR level were correlated with poor pathological response and DFS in neoadjuvant chemotherapy or combined with PD-1 checkpoint inhibitors group. Multivariate analysis revealed that baseline NLR could independently predict pathological response and DFS in the neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors group.
Conclusion
High NLR level were correlated with poor pathological response and shorter DFS in patients with NSCLC undergoing neoadjuvant chemotherapy or combined with PD-1 checkpoint inhibitors. Meanwhile, baseline NLR could independently predict response to pathological response and DFS, revealing its potential as a screening tool in NSCLC patients who received neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors.

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Chaoyuan Liu, Wei Zhao, Junpeng Xie, Huashan Lin, Xingsheng Hu, Chang Li, Youlan Shang, Yapeng Wang, Yingjia Jiang, Mengge Ding, Muyun Peng, Tian Xu, Ao’ran Hu, Yuda Huang, Yuan Gao, Xianling Liu, Jun Liu, Fang Ma
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Wen-Yu Zhai, Fang-Fang Duan, Yao-Bin Lin, Yong-Bin Lin, Ze-Rui Zhao, Jun-Ye Wang, Bing-Yu Rao, Lie Zheng, Hao Long
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Xiaoqin Yin, Jian Li, Bei Chen, Kehuang Liu, Shuo Hu
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Ana Oitabén, Pablo Fonseca, María J. Villanueva, Carme García-Benito, Aida López-López, Alberto Garrido-Fernández, Clara González-Ojea, Laura Juaneda-Magdalena, Martín E. Lázaro, Mónica Martínez-Fernández
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Predictive Value of Interstitial Lung Abnormalities for Postoperative Pulmonary Complications in Elderly Patients with Early-stage Lung Cancer: Won Gi Jeong, Yun-Hyeon Kim, Jong Eun Lee, In-Jae Oh, Sang Yun Song, Kum Ju Chae, Hye Mi Park; Cancer Res Treat. 2022;54(3):744-752. Published online September 28, 2021; DOI: https://doi.org/10.4143/crt.2021.772

Abstract PDF Supplementary Material PubReader ePub

Purpose
Identifying pretreatment interstitial lung abnormalities (ILAs) is important because of their predictive value for complications after lung cancer treatment. This study aimed to assess the predictive value of ILAs for postoperative pulmonary complications (PPCs) in elderly patients undergoing curative resection for early-stage non-small cell lung cancer (NSCLC).
Materials and Methods
Elderly patients (age ≥ 70 years) who underwent curative resection for pathologic stage I or II NSCLC with normal preoperative spirometry results (pre-bronchodilator forced expiratory volume in 1 s to forced vital capacity [FVC] ratio > 0.70 and FVC ≥ 80% of the predicted value) between January 2012 and December 2019 were retrospectively identified. Univariable and multivariable regression analyses were performed to assess risk factors for PPCs. The Kaplan–Meier method and log-rank test were used to analyze the relationship between ILAs and postoperative mortality. One-way analysis of variance was performed to assess the correlation between ILAs and hospital stay duration.
Results
A total of 262 patients (median age, 73 [interquartile range, 71–76] years; 132 male) were evaluated. A multivariable logistic regression model revealed that, among several relevant risk factors, fibrotic ILAs independently predicted both overall PPCs (adjusted odds ratio [OR], 4.84; 95% confidence interval [CI], 1.35–17.38; p=0.016) and major PPCs (adjusted OR, 8.72; 95% CI, 1.71–44.38; p=0.009). Fibrotic ILAs were significantly associated with higher postoperative mortality and longer hospital stay (F=5.21, p=0.006).
Conclusion
Pretreatment fibrotic ILAs are associated with PPCs, higher postoperative mortality, and longer hospital stay.

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Hyun Jin Kim, Won Gi Jeong, Jeong Yeop Lee, Hyo-Jae Lee, Byung Chan Lee, Hyo Soon Lim, Yun-Hyeon Kim
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Yoon Joo Shin, Jeong Geun Yi, Mi Young Kim, Donghee Son, Su Yeon Ahn
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Clinical implication of interstitial lung abnormality in elderly patients with early‐stage non‐small cell lung cancer
Seong Woo Cho, Won Gi Jeong, Jong Eun Lee, In‐Jae Oh, Sang Yun Song, Hye Mi Park, Hyo‐Jae Lee, Yun‐Hyeon Kim
Thoracic Cancer.2022; 13(7): 977. CrossRef

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Histologic Changes in Non–Small Cell Lung Cancer under Various Treatments: A Comparison of Histology and Mutation Status in Serial Samples: Chang Gok Woo, Seung-Myoung Son, Ho-Chang Lee, Hye Sook Han, Ki Hyeong Lee, Dohun Kim, Eung-Gook Kim, Ok-Jun Lee; Cancer Res Treat. 2022;54(3):737-743. Published online September 24, 2021; DOI: https://doi.org/10.4143/crt.2021.773

Abstract PDF Supplementary Material PubReader ePub

Purpose
Histologic change is a resistant mechanism in lung cancer. The most common histological change is the switch from adenocarcinoma (AdenoCa) to small cell carcinoma (SCC) against to tyrosine kinase inhibitors (TKI). However, it is not clear whether other treatment modalities are involved in the histologic changes.
Materials and Methods
We investigated histological changes in eight cases, after various treatments, and compared the molecular profiles between primary tumors and changed tumors using exome sequencing where tissue was available.
Results
Three cases of AdenoCa that were changed into SCC retained the initial mutations after TKI and/or surgical treatment. After treatment with TKI and immunotherapy, an EGFR (epidermal growth factor receptor)-mutant AdenoCa changed to squamous cell carcinoma (SqCa). SqCa in a patient treated with surgery was changed into combined AdenoCa and SqCa. These two cases showed the same genetic variations between the two distinct non–small cell carcinomas (NSCC). Three patients experienced two histologic changes, which the changed tumors returned to its original subtype or changed to a combined tumor after treatments. Four cases showed combined histology in the first or second change.
Conclusion
The histology of NSCC can be changed to a single pattern or combined subtypes after various treatment modalities, and the phenotypic changes seem not fixed. Therefore, additional morphologic changes may occur regardless of their genetic status and types of treatments. To refine the new treatment strategy, consecutive repeated biopsies in progressive disease or recurrent tumor are necessary.

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Taesung Jeon, Uk Jeen Oh, Jaeyoung Min, Chungyeul Kim
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Jeong Yun Jang, Su Ssan Kim, Si Yeol Song, Young Seob Shin, Sei Won Lee, Wonjun Ji, Chang-Min Choi, Eun Kyung Choi
Cancer Research and Treatment.2023; 55(4): 1181. CrossRef
Challenges and Opportunities for Immunoprofiling Using a Spatial High-Plex Technology: The NanoString GeoMx® Digital Spatial Profiler
Sharia Hernandez, Rossana Lazcano, Alejandra Serrano, Steven Powell, Larissa Kostousov, Jay Mehta, Khaja Khan, Wei Lu, Luisa M. Solis
Frontiers in Oncology.2022;[Epub] CrossRef

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Cost Utility Analysis of a Pilot Study for the Korean Lung Cancer Screening Project: Juyoung Kim, Bogeum Cho, Seon-Ha Kim, Chang-Min Choi, Yeol Kim, Min-Woo Jo; Cancer Res Treat. 2022;54(3):728-736. Published online September 24, 2021; DOI: https://doi.org/10.4143/crt.2021.480

Abstract PDF Supplementary Material PubReader ePub

Purpose
The aim of this study was to evaluate the cost utility of a pilot study of Korean Lung Cancer Screening Project.
Materials and Methods
We constructed a Markov model consisting of 26 states based on the natural history of lung cancer according to the Surveillance, Epidemiology, and End Results summary stage (localized, regional, distant). In the base case, people aged 55-74 years were under consideration for annual screening. Costs and quality-adjusted life years were simulated to calculate the incremental cost utility ratio. Sensitivity analyses were performed on the uncertainty associated with screening target ages, stage distribution, cost, utility, mortality, screening duration, and discount rate.
Results
The base case (US$25,383 per quality-adjusted life year gained) was cost-effective compared to the scenario of no screening and acceptable considering a willingness-to-pay threshold of US$27,000 per quality-adjusted life years gained. In terms of the target age of screening, the age between 60 and 74 years was the most cost-effective. Lung cancer screening was still cost-effective in the sensitivity analyses on the cost for treatment, utility, mortality, screening duration, and less than 5% discount rates, although the result was sensitive to a rise in positive rates or variation of stage distribution.
Conclusion
Our results showed the cost-effectiveness of annual low-dose computed tomography screening for lung cancer in high-risk populations.

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Quantitative risk factor analysis of prior disease condition and socioeconomic status with the multiple myeloma development: nationwide cohort study
Suein Choi, Eunjin Kim, Jinhee Jung, Sung-Soo Park, Chang-Ki Min, Seunghoon Han
Scientific Reports.2024;[Epub] CrossRef
Survival of lung cancer patients according to screening eligibility using Korean Lung Cancer Registry 2014–2016
Sangwon Lee, Eun Hye Park, Bo Yun Jang, Ye Ji Kang, Kyu-Won Jung, Hyo Soung Cha, Kui Son Choi
Scientific Reports.2024;[Epub] CrossRef
Cost-Effectiveness Analysis of Risk Factor-Based Lung Cancer Screening Program by Low-Dose Computer Tomography in Current Smokers in China
Tiantian Zhang, Xudong Chen, Caichen Li, Xiaoqin Wen, Tengfei Lin, Jiaxing Huang, Jianxing He, Nanshan Zhong, Jie Jiang, Wenhua Liang
Cancers.2023; 15(18): 4445. CrossRef
Applying utility values in cost-effectiveness analyses of lung cancer screening: a review of methods
Preston J. Ngo, Sonya Cressman, Silvia Behar-Harpaz, Deme J. Karikios, Karen Canfell, Marianne F. Weber
Lung Cancer.2022;[Epub] CrossRef
Cost-Effectiveness Analyses of Lung Cancer Screening Using Low-Dose Computed Tomography: A Systematic Review Assessing Strategy Comparison and Risk Stratification
Matthew Fabbro, Kirah Hahn, Olivia Novaes, Mícheál Ó’Grálaigh, James F. O’Mahony
PharmacoEconomics - Open.2022; 6(6): 773. CrossRef

6,712 View
220 Download
3 Web of Science
5 Crossref

The Clinical Outcomes of Different First-Line EGFR-TKIs Plus Bevacizumab in Advanced EGFR-Mutant Lung Adenocarcinoma: Yen-Hsiang Huang, Kuo-Hsuan Hsu, Chun-Shih Chin, Jeng-Sen Tseng, Tsung-Ying Yang, Kun-Chieh Chen, Kang-Yi Su, Sung-Liang Yu, Jeremy J.W. Chen, Gee-Chen Chang; Cancer Res Treat. 2022;54(2):434-444. Published online August 2, 2021; DOI: https://doi.org/10.4143/crt.2021.671

Abstract PDF PubReader ePub

Purpose
The aim of this study was to investigate the efficacy of various epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitors (TKIs) plus bevacizumab in advanced EGFR-mutant lung adenocarcinoma patients.
Materials and Methods
From August 2016 to October 2020, we enrolled advanced lung adenocarcinoma patients harboring exon 19 deletion or L858R receiving gefitinib, erlotinib and afatinib plus bevacizumab as the first-line treatment for the purposes of analysis.
Results
A total of 36 patients were included in the final analysis. Three patients received gefitinib, 17 received erlotinib, and 16 received afatinib combined with bevacizumab as the first-line treatment. The objective response rate was 77.8%, and disease control rate was 94.4%. The overall median progression-free survival (PFS) was 16.4 months, while the median PFS was 17.1 months in patients with exon 19 deletion, and 16.2 months in patients with L858R mutation (p=0.311). Regarding the use of different EGFR-TKIs, the median PFS was 17.1 months in the erlotinib group and 21.6 months in the afatinib group (p=0.617). In patients with brain metastasis at baseline, the median PFS was 18.9 months in the erlotinib group and 16.4 months in the afatinib group (p=0.747). Amongst patients harboring exon 19 deletion, the median PFS was 16.2 months in the erlotinib group and not-reached in the afatinib group (p=0.141). In patients with L858R mutation, the median PFS was 18.9 months in the erlotinib group and 16.2 months in the afatinib group (p=0.481).
Conclusion
Our research demonstrates that not only erlotinib combined with bevacizumab, but also afatinib plus bevacizumab as first-line treatment, provides solid clinical efficacy in advanced EGFR-mutant lung adenocarcinoma patients.

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Clinical outcome of bevacizumab or ramucirumab combined with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors as the first line therapy in susceptible EGFR‐mutated advanced non‐small‐cell lung
Chia‐Yu Kuo, Ming‐Ju Tsai, Jen‐Yu Hung, Mei‐Hsuan Lee, Kuan‐Li Wu, Yu‐Chen Tsai, Cheng‐Hao Chuang, Chung‐Wen Huang, Chin‐Ling Chen, Chih‐Jen Yang, Inn‐Wen Chong
The Kaohsiung Journal of Medical Sciences.2024; 40(5): 467. CrossRef
Scorpiones, Scolopendra and Gekko Inhibit Lung Cancer Growth and Metastasis by Ameliorating Hypoxic Tumor Microenvironment via PI3K/AKT/mTOR/HIF-1α Signaling Pathway
Qi-yuan Mao, Xue-qian Wang, Fei Lin, Ming-wei Yu, Hui-ting Fan, Qi Zheng, Lan-chun Liu, Chu-chu Zhang, Dao-rui Li, Hong-sheng Lin
Chinese Journal of Integrative Medicine.2024; 30(9): 799. CrossRef
Real-world clinical efficacy of bevacizumab biosimilar in patients with advanced non-small-cell lung cancer
Wei-Fan Ou, Kuo-Hsuan Hsu, Jeng-Sen Tseng, Po-Hsin Lee, Kun-Chieh Chen, Yen-Hsiang Huang, Gee-Chen Chang, Tsung-Ying Yang
Therapeutic Advances in Medical Oncology.2024;[Epub] CrossRef
Bevacizumab plus erlotinib versus erlotinib alone for advanced EGFR-mutant non-small cell lung cancer: a meta-analysis of randomized clinical trials
Ruijian Li, Weiyi Li, Fang Zhang, Shanshan Li
European Journal of Medical Research.2023;[Epub] CrossRef
Bevacizumab versus Ramucirumab in EGFR-Mutated Metastatic Non-Small-Cell Lung Cancer Patients: A Real-World Observational Study
Wen-Chien Cheng, Yi-Cheng Shen, Chieh-Lung Chen, Wei-Chih Liao, Chia-Hung Chen, Hung-Jen Chen, Chih-Yen Tu, Te-Chun Hsia
Cancers.2023; 15(3): 642. CrossRef
Afatinib/bevacizumab/erlotinib

Reactions Weekly.2023; 1952(1): 32. CrossRef
Comprehensive analysis of prediction of the EGFR mutation and subtypes based on the spinal metastasis from primary lung adenocarcinoma
Ran Cao, Huanhuan Chen, Huan Wang, Yan Wang, E-Nuo Cui, Wenyan Jiang
Frontiers in Oncology.2023;[Epub] CrossRef
When to add anti-angiogenesis drugs to EGFR-mutated metastatic non–small cell lung cancer patients: a real-world study from Taiwan
Chieh-Lung Chen, Sing-Ting Wang, Wei-Chih Liao, Chia-Hung Chen, Chih-Yen Tu, Hung-Jen Chen, Te-Chun Hsia, Wen-Chien Cheng
BMC Cancer.2022;[Epub] CrossRef
State-of-the-Art Molecular Oncology of Lung Cancer in Taiwan
Yung-Hung Luo, Kung-Hao Liang, Hsu-Ching Huang, Chia-I Shen, Chi-Lu Chiang, Mong-Lien Wang, Shih-Hwa Chiou, Yuh-Min Chen
International Journal of Molecular Sciences.2022; 23(13): 7037. CrossRef
Comparison of afatinib and erlotinib combined with bevacizumab in untreated stage IIIB/IV epidermal growth factor receptor-mutated lung adenocarcinoma patients: a multicenter clinical analysis study
Suey-Haur Lee, Yu-Ching Lin, Li-Chung Chiu, Jia-Shiuan Ju, Pi-Hung Tung, Allen Chung-Cheng Huang, Shih-Hong Li, Yueh-Fu Fang, Chih-Hung Chen, Scott Chih-Hsi Kuo, Chin-Chou Wang, Cheng-Ta Yang, Ping-Chih Hsu
Therapeutic Advances in Medical Oncology.2022;[Epub] CrossRef
The efficacy and tolerability of combining pemetrexed-based chemotherapy with gefitinib in the first-line treatment of non-small cell lung cancer with mutated EGFR: A pooled analysis of randomized clinical trials
Bi-Cheng Wang, Wen-Xuan Zhang, Bo-Hua Kuang, Guo-He Lin, Alessandro Rizzo
PLOS ONE.2022; 17(10): e0275919. CrossRef

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General

Targeted Liquid Biopsy Using Irradiation to Facilitate the Release of Cell-Free DNA from a Spatially Aimed Tumor Tissue: Jae Myoung Noh, Yeon Jeong Kim, Ho Yun Lee, Changhoon Choi, Won-Gyun Ahn, Taeseob Lee, Hongryull Pyo, Jee Hyun Park, Donghyun Park, Woong-Yang Park; Cancer Res Treat. 2022;54(1):40-53. Published online May 25, 2021; DOI: https://doi.org/10.4143/crt.2021.151

Abstract PDF Supplementary Material PubReader ePub

Purpose
We investigated the feasibility of using an anatomically localized, target-enriched liquid biopsy (TLB) in mouse models of lung cancer.
Materials and Methods
After irradiating xenograft mouse with human lung cancer cell lines, H1299 (NRAS proto-oncogene, GTPase [NRAS] Q61K) and HCC827 (epidermal growth factor receptor [EGFR] E746-750del), circulating (cell-free) tumor DNA (ctDNA) levels were monitored with quantitative polymerase chain reaction on human long interspersed nuclear element-1 and cell line-specific mutations. We checked dose-dependency at 6, 12, or 18 Gy to each tumor-bearing mouse leg using 6-MV photon beams. We also analyzed ctDNA of lung cancer patients by LiquidSCAN, a targeted deep sequencing to validated the clinical performances of TLB method.
Results
Irradiation could enhance the detection sensitivity of NRAS Q61K in the plasma sample of H1299-xenograft mouse to 4.5- fold. While cell-free DNA (cfDNA) level was not changed at 6 Gy, ctDNA level was increased upon irradiation. Using double-xenograft mouse with H1299 and HCC827, ctDNA polymerase chain reaction analysis with local irradiation in each region could specify mutation type matched to transplanted cell types, proposing an anatomically localized, TLB. Furthermore, when we performed targeted deep sequencing of cfDNA to monitor ctDNA level in 11 patients with lung cancer who underwent radiotherapy, the average ctDNA level was increased within a week after the start of radiotherapy.
Conclusion
TLB using irradiation could temporarily amplify ctDNA release in xenograft mouse and lung cancer patients, which enables us to develop theragnostic method for cancer patients with accurate ctDNA detection.

Citations

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Surpassing sensitivity limits in liquid biopsy
Tina Moser, Ellen Heitzer
Science.2024; 383(6680): 260. CrossRef
Priming agents transiently reduce the clearance of cell-free DNA to improve liquid biopsies
Carmen Martin-Alonso, Shervin Tabrizi, Kan Xiong, Timothy Blewett, Sainetra Sridhar, Andjela Crnjac, Sahil Patel, Zhenyi An, Ahmet Bekdemir, Douglas Shea, Shih-Ting Wang, Sergio Rodriguez-Aponte, Christopher A. Naranjo, Justin Rhoades, Jesse D. Kirkpatric
Science.2024;[Epub] CrossRef
Treatment Response Biomarkers: Working Toward Personalized Radiotherapy for Lung Cancer
Ashley Horne, Ken Harada, Katherine D. Brown, Kevin Lee Min Chua, Fiona McDonald, Gareth Price, Paul Martin Putora, Dominic G. Rothwell, Corinne Faivre-Finn
Journal of Thoracic Oncology.2024; 19(8): 1164. CrossRef
Modulating cell-free DNA biology as the next frontier in liquid biopsies
Shervin Tabrizi, Carmen Martin-Alonso, Kan Xiong, Sangeeta N. Bhatia, Viktor A. Adalsteinsson, J. Christopher Love
Trends in Cell Biology.2024;[Epub] CrossRef
Basic Science with Preclinical Models to Investigate and Develop Liquid Biopsy: What Are the Available Data and Is It a Fruitful Approach?
Benedetta Cena, Emmanuel Melloul, Nicolas Demartines, Olivier Dormond, Ismail Labgaa
International Journal of Molecular Sciences.2022; 23(10): 5343. CrossRef
Analytical and Clinical Validation of Cell-Free Circulating Tumor DNA Assay for the Estimation of Tumor Mutational Burden
Kwang Seob Lee, Jieun Seo, Choong-Kun Lee, Saeam Shin, Zisun Choi, Seungki Min, Jun Hyuek Yang, Woo Sun Kwon, Woobin Yun, Mi Ri Park, Jong Rak Choi, Hyun Cheol Chung, Seung-Tae Lee, Sun Young Rha
Clinical Chemistry.2022; 68(12): 1519. CrossRef

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Lung and Thoracic cancer

Occupational Exposure to Pesticides and Lung Cancer Risk: A Propensity Score Analyses: Byungmi Kim, Eun Young Park, Jinsun Kim, Eunjung Park, Jin-Kyoung Oh, Min Kyung Lim; Cancer Res Treat. 2022;54(1):130-139. Published online March 31, 2021; DOI: https://doi.org/10.4143/crt.2020.1106

Abstract PDF Supplementary Material PubReader ePub

Purpose
Occupational exposure to pesticides is thought to be associated with lung cancer, but studies have yielded conflicting results. We performed a propensity score (PS) based analyses to evaluate the relationship between occupational exposure to pesticides and lung cancer risk in the Korea National Cancer Center community-based cohort study (KNCCCS).
Materials and Methods
During the follow-up period, 123 incidental lung cancer cases were identified, of the 7,471 subjects in the final statistical analysis. Information about occupational exposure to pesticides and other factors was collected at enrollment (2003-2010). Cox proportional hazards regression analyses were conducted. Four PS-based approaches (i.e., matching, stratification, inverse probability-of-treatment weighting, and the use of the PS as a covariate) were adopted, and the results were compared. PS was obtained from the logistic regression model. Absolute standardized differences according to occupational exposure to pesticides were provided to evaluate the balance in baseline characteristics.
Results
In the Cox proportional hazards regression model, the hazard ratio (HR) for lung cancer according to occupational exposure to pesticides was 1.82 (95% confidence interval [CI], 1.11 to 2.98). With all the propensity score matching (PSM) methods, the HRs for lung cancer based on exposure to pesticides ranged from 1.65 (95% CI, 1.04 to 2.64) (continuous term with PSM) to 2.84 (95% CI, 1.81 to 4.46) (stratification by 5 strata of the PS). The results varied slightly based on the method used, but the direction and statistical significance remained the same.
Conclusion
Our results strengthen the evidence for an association between occupational exposure to pesticides and the risk of lung cancer.

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Flavonoids as Insecticides in Crop Protection—A Review of Current Research and Future Prospects
Verónica Pereira, Onofre Figueira, Paula C. Castilho
Plants.2024; 13(6): 776. CrossRef
Comprehensive assessment of pesticide use patterns and increased cancer risk
Jacob Gerken, Gear Thomas Vincent, Demi Zapata, Ileana G. Barron, Isain Zapata
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Dietary Exposure to Pesticide and Veterinary Drug Residues and Their Effects on Human Fertility and Embryo Development: A Global Overview
Ambra Colopi, Eugenia Guida, Silvia Cacciotti, Serena Fuda, Matteo Lampitto, Angelo Onorato, Alice Zucchi, Carmela Rita Balistreri, Paola Grimaldi, Marco Barchi
International Journal of Molecular Sciences.2024; 25(16): 9116. CrossRef
Longitudinal study and predictive modelling of urinary pesticide metabolite concentrations in residents of Guangzhou, China
Xiangyu Jia, Xiaotong Li, Fenfang Deng, Jia He, Qin Li, Chongshan Guo, Jun Yuan, Lei Tan
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Trend Analysis of Lung Cancer Incidence and Mortality in Xiamen (2011-2020)
Jianni Cong, Jiahuang Chi, Junli Zeng, Yilan Lin
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Geographical disparities in cancer and occupational exposure to pesticides in a French-West Indies territory (2006–2019)
Rémi Houpert, Jacqueline Véronique-Baudin, Thierry Almont, Murielle Beaubrun-Renard, Manon Boullard, Aimée Pierre-Louis, Mylène Vestris, Stephen Ulric-Gervaise, Christelle Montabord, Jonathan Macni, Emmanuelle Sylvestre, Clarisse Joachim
BMC Cancer.2024;[Epub] CrossRef
Different types of pesticide exposure and lung cancer incidence in the Agricultural Health Study cohort: A systematic review and meta-analysis
Yu Wang, Jingxuan Yang, Xialian Hu, Jingyi Shi, Jiaxin Deng
Archives of Environmental & Occupational Health.2024; 79(7-8): 263. CrossRef
How Does Environmental and Occupational Exposure Contribute to Carcinogenesis in Genitourinary and Lung Cancers?
Massimiliano Cani, Fabio Turco, Simona Butticè, Ursula Maria Vogl, Consuelo Buttigliero, Silvia Novello, Enrica Capelletto
Cancers.2023; 15(10): 2836. CrossRef
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Qizheng He, Yong Sun, Maoan Yi, Huimin Huang
Frontiers in Sustainable Food Systems.2023;[Epub] CrossRef
Vaping, Environmental Toxicants Exposure, and Lung Cancer Risk
Shaimaa A. Shehata, Eman A. Toraih, Ezzat A. Ismail, Abeer M. Hagras, Ekramy Elmorsy, Manal S. Fawzy
Cancers.2023; 15(18): 4525. CrossRef
Respiratory Tract Cancer Incidences across Industry Groups: A Nationwide Cohort Study with More Than 70 Million Person-Years of Follow-Up
Seong-Uk Baek, Woo-Ri Lee, Ki-Bong Yoo, Jun-Hyeok Choi, Kyung-Eun Lee, Wanhyung Lee, Jin-Ha Yoon
Cancers.2022; 14(21): 5219. CrossRef

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Lung Cancer

Conditional Survival of Surgically Treated Patients with Lung Cancer: A Comprehensive Analyses of Overall, Recurrence-free, and Relative Survival: Dong Wook Shin, Jong Ho Cho, Jung Eun Yoo, Juhee Cho, Dong Woog Yoon, Genehee Lee, Sumin Shin, Hong Kwan Kim, Yong Soo Choi, Jhingook Kim, Jae Ill Zo, Young Mog Shim; Cancer Res Treat. 2021;53(4):1057-1071. Published online March 9, 2021; DOI: https://doi.org/10.4143/crt.2020.1308

Abstract PDF PubReader ePub

Purpose
Survival probability changes over time in cancer survivors. This study examined conditional survival in patients undergoing curative resection for non-small cell lung cancer (NSCLC).
Materials and Methods
Five-year conditional recurrence-free survival (CRFS), conditional overall survival (COS), and conditional relative survival (CRS) up to 10 years after surgery were calculated in patients who underwent NSCLC resection from 1994 to 2016. These rates were stratified according to age, sex, year of diagnosis, pathological stage, tumor histology, smoking status, comorbidity, and lung function.
Results
Five-year CRFS increased from 65.6% at baseline to 90.9% at 10 years after surgery. Early differences in 5-year CRFS according to stratified patient characteristics disappeared, except for age: older patients exhibited persistently lower 5-year CRFS. Five-year COS increased from 72.7% to 78.3% at 8 years and then decreased to 75.4% at 10 years. Five-year CRS increased from 79.0% at baseline to 86.8% at 10 years. Older age and higher pathologic stage were associated with lower 5-year COS and CRS up to 10 years after surgery. Female patients, those with adenocarcinoma histology, non-smokers, patient without comorbidities and had good lung function showed higher COS and CRS.
Conclusion
CRFS improved over time, but significant risk remained after 5 years. CRS slightly improved over time but did not reach 90%, suggesting significant excess mortality compared to the general population. Age and stage remained significant predictors of conditional survival several years after surgery. Our conditional survival estimates should help clinicians and patients make informed treatment and personal life decisions based on survivorship status.

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Talib Chaudhry, Vaishnavi Krishnan, Andrew E. Donaldson, Zachary M. Palmisano, Sanjib Basu, Nicole M. Geissen, Justin M. Karush, Gillian C. Alex, Jeffrey A. Borgia, Michael J. Liptay, Christopher W. Seder
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