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Current Status and Future Directions in Non-Small Cell Lung Cancer...
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Current Status and Future Directions in Non-Small Cell Lung Cancer Therapy

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (20 October 2023) | Viewed by 4181

Special Issue Editors

Dr. Fei Zhou

E-Mail Website
Guest Editor
Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai 200433, China
Interests: lung cancer; targeted therapy; cancer immunology; cancer biomarkers; translational medicine
Dr. Xiaoxia Chen

E-Mail Website
Guest Editor
Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai 200433, China
Interests: lung cancer; targeted therapy; cancer immunology; cancer biomarkers; translational medicine

Special Issue Information

Dear Colleagues,

It is with great pleasure that I invite you to contribute to this interesting Special Issue on “Current Status and Future Directions in Non-Small Cell Lung Cancer Therapy”.

The therapeutic strategies for non-small cell lung cancer have evolved rapidly in recent years. For patient with targetable oncogenes, including EGFR mutations, ALK/ROS1/RET fusions, targeted therapy with small molecular tyrosine kinase inhibitors, have demonstrated superior efficacy over classical chemotherapy. Great progress has also been achieved in some rare oncogenes, including BRAFV600E mutations, HER2 mutations, EGFR 20ins, NTRK fusions et al. On the other hand, for patients without oncogenic drivers, immune checkpoint inhibitors, targeting the PD-1/PD-L1 axis, either as monotherapy or in combination with chemotherapy, have been the standard of care and have resulted in long-term survival in a subset of patients. Despite these advancements, acquired resistance inevitably occurs. A better understanding of the mechanisms of resistance to therapy is essential to further expand the survival benefits. In the future, we believe novel targets and novel agents (i.e. bispecific antibody, antibody–drug conjugate) will help translating this malignancy into a “chronic disease”.

The aim of this Special Issue is to highlight current status and future directions in non-small cell lung cancer therapy.

Dr. Fei Zhou
Dr. Xiaoxia Chen
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short 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. Journal of Clinical Medicine 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 2600 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

  • non-small cell lung cancer
  • targeted therapy
  • cancer immunology
  • cancer biomarkers
  • immune checkpoint inhibitors
  • PD-1/PD-L1
  • bispecific antibody
  • antibody-drug conjugate

Published Papers (3 papers)

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Research

10 pages, 900 KiB  
Article
Diagnostic Performance and Cell Count of EBUS–TBNA Needle Gauges: A Prospective Trial
by Juliana Guarize, Cristina Diotti, Monica Casiraghi, Stefano Donghi, Clementina Di Tonno, Patrizia Mancuso, Laura Zorzino, Giulia Sedda, Davide Radice, Luca Bertolaccini and Lorenzo Spaggiari
J. Clin. Med. 2023, 12(12), 4033; https://doi.org/10.3390/jcm12124033 - 13 Jun 2023
Cited by 1 | Viewed by 1075
Abstract
Background. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a well-established diagnostic procedure for evaluating hilar and mediastinal lymphadenopathies and is the gold standard for lung cancer diagnosis and staging. Recent studies assessed the effectiveness of the 19-G flex needle in obtaining larger EBUS-TBNA [...] Read more.
Background. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a well-established diagnostic procedure for evaluating hilar and mediastinal lymphadenopathies and is the gold standard for lung cancer diagnosis and staging. Recent studies assessed the effectiveness of the 19-G flex needle in obtaining larger EBUS-TBNA samples, and prospective small series gave similar results in terms of diagnostic yield when testing different gauge needles. The lack of homogeneity between series and the small sample size of some prospective cohorts poses a limit to the validity of those results. This prospective controlled study compared the 19-G flex and 22-G needles in terms of diagnostic yield. An objective laboratory method was used to count cells and compare the two needles’ cytologic yields. Material. A prospective controlled study was conducted on 90 patients undergoing EBUS-TBNA for the diagnosis of hilar and mediastinal lymphadenopathies. The institutional ethic committee (IEO573) approved the study, and informed consent was obtained from all patients. Results. A total of 90 patients were enrolled in this study, 84.4% of whom were diagnosed with malignancy and 15.6% with non-neoplastic disease. Sensitivity for malignancy was 93.4% (CI: 87.4–97.1%) for the 19-G needle and 92.6% (CI: 86.3–96.5%) for the 22-G needle (p = 0.80). The percentage of malignant cells in the cell block was 63.9% and 61.5% for the 22-G and 19-G needles, respectively. The cell count assessed by flow cytometry was 2071 cells/µL (IQR: 600,2265) with the 22-G needle and 2761 cells/µL (IQR: 505,3250) with the 19-G needle (p = 0.79). The malignant cell count was 0.05 × 103 cells/µL with the 22-G and 0.08 × 103 cells/µL with the 19-G needle (p = 0.70). There was no difference in the presence of tissue cores in the samples, and rapid on-site evaluation (ROSE) cellularity was comparable between the two needles. Conclusions. The 19-G flex EBUS-TBNA needle is comparable to the 22-G needle in terms of diagnostic yield for cyto-histological evaluation of hilar and mediastinal lymphadenopathies. There is no difference between the 19-G and 22-G needle cell counts evaluated by flow cytometry. Full article
(This article belongs to the Special Issue Current Status and Future Directions in Non-Small Cell Lung Cancer Therapy)
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13 pages, 504 KiB  
Article
Identification of Factors Related to the Quality of Lymphadenectomy for Lung Cancer: Secondary Analysis of Prospective Randomized Trial Data
by Piotr Gabryel, Magdalena Roszak, Piotr Skrzypczak, Anna Gabryel, Dominika Zielińska, Magdalena Sielewicz, Alessio Campisi, Mariusz Kasprzyk and Cezary Piwkowski
J. Clin. Med. 2023, 12(11), 3780; https://doi.org/10.3390/jcm12113780 - 31 May 2023
Cited by 2 | Viewed by 995
Abstract
The outcomes of non-small cell lung cancer surgery are influenced by the quality of lymphadenectomy. This study aimed to evaluate the impact of different energy devices on lymphadenectomy quality and identify additional influencing factors. This secondary analysis of the prospective randomized trial data [...] Read more.
The outcomes of non-small cell lung cancer surgery are influenced by the quality of lymphadenectomy. This study aimed to evaluate the impact of different energy devices on lymphadenectomy quality and identify additional influencing factors. This secondary analysis of the prospective randomized trial data (clinicaltrials.gov: NCT03125798) compared patients who underwent thoracoscopic lobectomy with the LigaSure device (study group, n = 96) and monopolar device (control group, n = 94). The primary endpoint was the lobe-specific mediastinal lymphadenectomy. Lobe-specific mediastinal lymphadenectomy criteria were met in 60.4% and 38.3% of patients in the study and control groups, respectively (p = 0.002). In addition, in the study group, the median number of mediastinal lymph node stations removed was higher (4 vs. 3, p = 0.017), and complete resection was more often achieved (91.7% vs. 80.9%, p = 0.030). Logistic regression analysis indicated that lymphadenectomy quality was positively associated with the use of the LigaSure device (OR, 2.729; 95% CI, 1.446 to 5.152; p = 0.002) and female sex (OR, 2.012; 95% CI, 1.058 to 3.829; p = 0.033), but negatively associated with a higher Charlson Comorbidity Index (OR, 0.781; 95% CI, 0.620 to 0.986; p = 0.037), left lower lobectomy (OR, 0.263; 95% CI, 0.096 to 0.726; p = 0.010) and middle lobectomy (OR, 0.136; 95% CI, 0.031 to 0.606, p = 0.009). This study found that using the LigaSure device can improve the quality of lymphadenectomy in lung cancer patients and also identified other factors that affect the quality of lymphadenectomy. These findings contribute to improving lung cancer surgical treatment outcomes and provide valuable insights for clinical practice. Full article
(This article belongs to the Special Issue Current Status and Future Directions in Non-Small Cell Lung Cancer Therapy)
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16 pages, 996 KiB  
Article
Nivolumab or Atezolizumab in the Second-Line Treatment of Advanced Non-Small Cell Lung Cancer? A Prognostic Index Based on Data from Daily Practice
by Magdalena Knetki-Wróblewska, Sylwia Tabor, Aleksandra Piórek, Adam Płużański, Kinga Winiarczyk, Magdalena Zaborowska-Szmit, Katarzyna Zajda, Dariusz M. Kowalski and Maciej Krzakowski
J. Clin. Med. 2023, 12(6), 2409; https://doi.org/10.3390/jcm12062409 - 21 Mar 2023
Cited by 2 | Viewed by 1768
Abstract
Background: The efficacy of nivolumab and atezolizumab in advanced pre-treated NSCLC was documented in prospective trials. We aim to confirm the benefits and indicate predictive factors for immunotherapy in daily practice. Methods: This study was a retrospective analysis. The median PFS and OS [...] Read more.
Background: The efficacy of nivolumab and atezolizumab in advanced pre-treated NSCLC was documented in prospective trials. We aim to confirm the benefits and indicate predictive factors for immunotherapy in daily practice. Methods: This study was a retrospective analysis. The median PFS and OS were estimated using the Kaplan-Meier method. The log-rank test was used for comparisons. Multivariate analyses were performed using the Cox regression method. Results: A total of 260 patients (ECOG 0-1) with advanced NSCLC (CS III-IV) were eligible to receive nivolumab or atezolizumab as second-line treatment. Median PFS and OS were three months (95% confidence interval [CI] 2.57–3.42) and 10 months (95% CI 8.03–11.96), respectively, for the overall population. The median OS for the atezolizumab arm was eight months (95% CI 5.89–10.1), while for the nivolumab group, it was 14 months (95% CI 10.02–17.97) (p = 0.018). The sum of all measurable changes >100.5 mm (p = 0.007; HR = 1.003, 95% CI 1.001–1.005), PLT > 281.5 G/l (p < 0.001; HR = 1.003, 95% CI 1.001–1.003) and bone metastases (p < 0.004; HR = 1.58, 95% CI 1.04–2.38) were independent negative prognostic factors for OS in multivariate analysis. Based on preliminary analyses, a prognostic index was constructed to obtain three prognostic groups. Median OS in the subgroups was 16 months (95% CI 13.3–18.7), seven months (95% CI 4.83–9.17) and four months (95% CI 2.88–5.13), respectively (p < 0.001). Conclusions: Nivolumab and atezolizumab provided clinical benefit in real life. Clinical and laboratory factors may help to identify subgroups likely to benefit. The use of prognostic indices may be valuable in clinical practice. Full article
(This article belongs to the Special Issue Current Status and Future Directions in Non-Small Cell Lung Cancer Therapy)
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