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Cancers
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2nd Edition: Imaging and Therapy in Lung Cancer and Mesothelioma
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2nd Edition: Imaging and Therapy in Lung Cancer and Mesothelioma

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

Deadline for manuscript submissions: 15 December 2024 | Viewed by 8214

Special Issue Editor

Dr. Egesta Lopci

E-Mail Website
Guest Editor
Nuclear Medicine Unit, Humanitas Clinical and Research Hospital-IRCCS, Via Manzoni 56, 20089 Rozzano, Italy
Interests: molecular imaging; positron emission tomography; cancer imaging; immunotherapy; treatment response assessment
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This collection is the second edition of the previous "Advances in Lung Cancer Imaging and Therapy"(https://www.mdpi.com/journal/cancers/special_issues/Advances_Lung_Cancer_Imaging_Therapy), now extended to other thoracic tumors, such as malignant mesothelioma.

The treatment algorithm for thoracic tumors, including lung cancer and malignant pleural mesothelioma, has recently experienced 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 clinical practice, immunotherapy with checkpoint inhibitors has gradually replaced the previously used chemotherapeutic agents. The remarkable results obtained to date 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 may rely 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, "2nd Edition: Imaging and Therapy in Lung Cancer and Mesothelioma", is to provide an overview of the state-of-the-art in therapeutic strategies for lung cancer and malignant mesothelioma, while reserving a space for validated imaging techniques and future biomarkers for predicting response to therapy.

Dr. Egesta Lopci
Guest Editor

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
  • malignant mesothelioma
  • immunotherapy
  • combination therapy
  • radiotherapy
  • molecular imaging
  • radiomics
  • response assessment

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Published Papers (6 papers)

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Research

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15 pages, 1835 KiB  
Article
Therapeutic Patterns and Clinical Outcomes in Limited Disease Small Cell Lung Cancer: A Decade of Analysis at a Tertiary Cancer Center
by David Alexander Ziegler, Cecilia Christiane Cleve, Sonia Ziegler, Markus Anton Schirmer, Laura Anna Fischer, Hanibal Bohnenberger, Tobias Raphael Overbeck, Friederike Braulke, Alexander von Hammerstein-Equord, Martin Leu, Manuel Guhlich, Leif Hendrik Dröge, Stefan Rieken, Achim Rittmeyer and Rami A. El Shafie
Cancers 2024, 16(11), 1953; https://doi.org/10.3390/cancers16111953 - 21 May 2024
Viewed by 1301
Abstract
In this study, we investigated the outcomes and factors influencing treatment efficacy in 93 patients with limited disease small cell lung cancer (LD-SCLC), with a median age of 64 years. We focused on the impact of chemotherapy regimens, prophylactic cranial irradiation (PCI), and [...] Read more.
In this study, we investigated the outcomes and factors influencing treatment efficacy in 93 patients with limited disease small cell lung cancer (LD-SCLC), with a median age of 64 years. We focused on the impact of chemotherapy regimens, prophylactic cranial irradiation (PCI), and patient-related variables. The median follow-up for OS was 17.3 months. We observed a statistically significant difference in PFS between LD-SCLC patients treated with cisplatin and etoposide (EP) and those treated with carboplatin and etoposide (CP) (PFS: EP 13.63 months vs. CP 6.54 months, p < 0.01). Patients treated with EP had better overall survival (OS) than CP-treated patients (OS: EP 26.9 months vs. CP 16.16 months, p < 0.01). Concomitant chemotherapy was associated with improved PFS (p = 0.003) and OS (p = 0.002). Patients receiving PCI showed superior OS (p = 0.05) and a trend towards improved PFS (p = 0.057). Female gender was associated with better OS (p = 0.025). Most patients had an ECOG performance status of 0 (71%). This real-world study underscores the importance of multidisciplinary LD-SCLC management, emphasizing the roles of chemotherapy, radiotherapy, and PCI. These findings inform personalized treatment strategies and emphasize the need for prospective trials to validate these results and optimize LD-SCLC treatment. Full article
(This article belongs to the Special Issue 2nd Edition: Imaging and Therapy in Lung Cancer and Mesothelioma)
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14 pages, 1221 KiB  
Article
Safety and Efficacy of Single-Fraction Carbon-Ion Radiotherapy for Early-Stage Lung Cancer with Interstitial Pneumonia
by Shuri Aoki, Hitoshi Ishikawa, Mio Nakajima, Naoyoshi Yamamoto, Shinichiro Mori, Tokuhiko Omatsu, Yuji Tada, Teruaki Mizobuchi, Satoshi Ikeda, Ichiro Yoshino and Shigeru Yamada
Cancers 2024, 16(3), 562; https://doi.org/10.3390/cancers16030562 - 29 Jan 2024
Cited by 1 | Viewed by 1288
Abstract
Patients with lung cancer complicated by interstitial pneumonia (IP) often lose treatment options early owing to acute exacerbation of IP concerns. Carbon-ion radiotherapy (CIRT) can provide superior tumor control and low toxicity at high dose concentrations. We conducted a retrospective analysis of the [...] Read more.
Patients with lung cancer complicated by interstitial pneumonia (IP) often lose treatment options early owing to acute exacerbation of IP concerns. Carbon-ion radiotherapy (CIRT) can provide superior tumor control and low toxicity at high dose concentrations. We conducted a retrospective analysis of the efficacy and tolerability of a single-fraction CIRT using 50 Gy for IP-complicated lung cancer. The study included 50 consecutive patients treated between April 2013 and September 2022, whose clinical stage of lung cancer (UICC 7th edition) was 1A:1B:2A:2B = 32:13:4:1. Of these, 32 (64%) showed usual interstitial pneumonia patterns. With a median follow-up of 23.5 months, the 3-year overall survival (OS), cause-specific survival, and local control rates were 45.0, 75.4, and 77.8%, respectively. The median lung V5 and V20 were 10.0 and 5.2%, respectively (mean lung dose, 2.6 Gy). The lung dose, especially lung V20, showed a strong association with OS (p = 0.0012). Grade ≥ 2 pneumonia was present in six patients (13%), including two (4%) with suspected grade 5. CIRT can provide a relatively safe and curative treatment for patients with IP-complicated lung cancer. However, IP increases the risk of severe radiation pneumonitis, and further studies are required to assess the appropriate indications. Full article
(This article belongs to the Special Issue 2nd Edition: Imaging and Therapy in Lung Cancer and Mesothelioma)
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13 pages, 6117 KiB  
Article
A Novel Method for Evaluating Early Tumor Response Based on Daily CBCT Images for Lung SBRT
by Wei Luo, Zijian Xiu, Xiaoqin Wang, Ronald McGarry and Joshua Allen
Cancers 2024, 16(1), 20; https://doi.org/10.3390/cancers16010020 - 19 Dec 2023
Viewed by 1097
Abstract
Background: We aimed to develop a new tumor response assessment method for lung SBRT. Methods: In total, 132 lung cancer patients with 134 tumors who received SBRT treatment with daily CBCT were included in this study. The information about tumor size (area), contrast [...] Read more.
Background: We aimed to develop a new tumor response assessment method for lung SBRT. Methods: In total, 132 lung cancer patients with 134 tumors who received SBRT treatment with daily CBCT were included in this study. The information about tumor size (area), contrast (contrast-to-noise ratio (CNR)), and density/attenuation (μ) was derived from the CBCT images for the first and the last fractions. The ratios of tumor area, CNR, and μ (RA, RCNR, Rμ) between the last and first fractions were calculated for comparison. The product of the three rations was defined as a new parameter (R) for assessment. Tumor response was independently assessed by a radiologist based on a comprehensive analysis of the CBCT images. Results: R ranged from 0.27 to 1.67 with a mean value of 0.95. Based on the radiologic assessment results, a receiver operation characteristic (ROC) curve with the area under the curve (AUC) of 95% was obtained and the optimal cutoff value (RC) was determined as 1.1. The results based on RC achieved a 94% accuracy, 94% specificity, and 90% sensitivity. Conclusion: The results show that R was correlated with early tumor response to lung SBRT and that using R for evaluating tumor response to SBRT would be viable and efficient. Full article
(This article belongs to the Special Issue 2nd Edition: Imaging and Therapy in Lung Cancer and Mesothelioma)
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Review

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24 pages, 1497 KiB  
Review
What Does N2 Lymph Node Involvement Mean for Patients with Non-Small Cell Lung Cancer (NSCLC)?—A Review of Implications for Diagnosis and Treatment
by Julio Linares Díaz, John Edwards, Anne-Leen Deleu, Niccolo Giaj-Levra, Elena Prisciandaro, Benoit Roch, Marianne Paesmans, Thierry Berghmans and Mariana Brandão
Cancers 2024, 16(15), 2673; https://doi.org/10.3390/cancers16152673 - 26 Jul 2024
Viewed by 1183
Abstract
Patients with stage III NSCLC with N2 lymph node involvement carry a complex and diverse disease entity. Challenges persist in the areas of diagnosis, staging, multimodal management, and the determination of surgical indications and resectability criteria. Therefore, this review focuses on the latest [...] Read more.
Patients with stage III NSCLC with N2 lymph node involvement carry a complex and diverse disease entity. Challenges persist in the areas of diagnosis, staging, multimodal management, and the determination of surgical indications and resectability criteria. Therefore, this review focuses on the latest updates in N2 disease staging and its prognostic and treatment implications. Emphasis is placed on the importance of accurate staging using imaging modalities such as [18F]FDG-PET/CT as well as minimally invasive mediastinal staging endoscopic techniques. The evolving role of surgery in the management of N2 disease is also explored. The benefits of neoadjuvant and adjuvant treatments have been demonstrated, along with the efficacy of a combined multimodal approach with chemo-immunotherapy in the perioperative setting, reigniting the debate of N2 disease subsets and optimal treatment options. Furthermore, this review addresses the controversies surrounding surgical approaches in upfront “borderline” resectable stage III NSCLC as well as the benefits of combined chemoradiotherapy with consolidation immunotherapy for patients with unresectable tumors. In conclusion, personalized diagnostic and treatment approaches tailored to individual patient characteristics, resource availability, and institutional expertise are essential for optimizing outcomes in patients with stage III-N2 NSCLC. Full article
(This article belongs to the Special Issue 2nd Edition: Imaging and Therapy in Lung Cancer and Mesothelioma)
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26 pages, 830 KiB  
Review
Targeted Therapy in Mesotheliomas: Uphill All the Way
by Elisa Bertoli, Elisa De Carlo, Martina Bortolot, Brigida Stanzione, Alessandro Del Conte, Michele Spina and Alessandra Bearz
Cancers 2024, 16(11), 1971; https://doi.org/10.3390/cancers16111971 - 22 May 2024
Viewed by 1031
Abstract
Mesothelioma (MM) is an aggressive and lethal disease with few therapeutic opportunities. Platinum-pemetrexed chemotherapy is the backbone of first-line treatment for MM. The introduction of immunotherapy (IO) has been the only novelty of the last decades, allowing an increase in survival compared to [...] Read more.
Mesothelioma (MM) is an aggressive and lethal disease with few therapeutic opportunities. Platinum-pemetrexed chemotherapy is the backbone of first-line treatment for MM. The introduction of immunotherapy (IO) has been the only novelty of the last decades, allowing an increase in survival compared to standard chemotherapy (CT). However, IO is not approved for epithelioid histology in many countries. Therefore, therapy for relapsed MM remains an unmet clinical need, and the prognosis of MM remains poor, with an average survival of only 18 months. Increasing evidence reveals MM complexity and heterogeneity, of which histological classification fails to explain. Thus, scientific focus on possibly new molecular markers or cellular targets is increasing, together with the search for target therapies directed towards them. The molecular landscape of MM is characterized by inactivating tumor suppressor alterations, the most common of which is found in CDKN2A, BAP1, MTAP, and NF2. In addition, cellular targets such as mesothelin or metabolic enzymes such as ASS1 could be potentially amenable to specific therapies. This review examines the major targets and relative attempts of therapeutic approaches to provide an overview of the potential prospects for treating this rare neoplasm. Full article
(This article belongs to the Special Issue 2nd Edition: Imaging and Therapy in Lung Cancer and Mesothelioma)
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18 pages, 301 KiB  
Review
Retreatment with Immune Checkpoint Inhibitors in the New Scenario of Immunotherapy in Non-Small Cell Lung Cancer
by Sabrina Rossi, Silvia Masini, Giovanna Finocchiaro, Elena Lorenzi, Luca Toschi and Armando Santoro
Cancers 2024, 16(9), 1683; https://doi.org/10.3390/cancers16091683 - 26 Apr 2024
Viewed by 1719
Abstract
The advent of immunotherapy has transformed the treatment paradigm for metastatic non-small cell lung cancer (NSCLC). In the past few years, several studies have investigated the potential role of immune checkpoint inhibitors (ICIs) in resectable and unresectable locally advanced disease, achieving remarkable results [...] Read more.
The advent of immunotherapy has transformed the treatment paradigm for metastatic non-small cell lung cancer (NSCLC). In the past few years, several studies have investigated the potential role of immune checkpoint inhibitors (ICIs) in resectable and unresectable locally advanced disease, achieving remarkable results that led to their approval in clinical practice. However, there is limited evidence on immunotherapy rechallenge after recurrence, with the majority of available knowledge coming from retrospective studies which involve heavily pretreated patients with advanced NSCLC. The recent introduction in the curative setting and the potential regulatory restrictions raise questions about the optimal choice of first-line and subsequent therapies for patients with systemic relapse. The role of immunotherapy readministration in this new scenario needs to be clarified, as well as the identification of patients for whom it is more appropriate, including clinical characteristics, duration of response, switching to other ICIs, reasons for discontinuation and immune-related toxicity. Here, we review literature on rechallenge with immunotherapy, including efficacy, safety profile and potential predictive factors of response. Full article
(This article belongs to the Special Issue 2nd Edition: Imaging and Therapy in Lung Cancer and Mesothelioma)
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