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Biomedicines
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Advancements in Lung Cancer Precision Oncology Research and Treatments
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Advancements in Lung Cancer Precision Oncology Research and Treatments

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Cancer Biology and Oncology".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 2981

Special Issue Editors

Dr. Panagiotis Paliogiannis

E-Mail Website
Guest Editor
Anatomic Pathology and Histology Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro 43, Sassari, Italy
Interests: molecular pathology of solid tumors; lung cancer; melanoma; circulating biomarkers
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Giuseppe Palmieri

E-Mail Website
Co-Guest Editor
Unit of Immuno-Oncology, Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro 43, Sassari, Italy
Interests: cancer genetics; molecular diagnosis; biomarkers; precision medicine; melanoma and non-melanoma pathogenesis
Special Issues, Collections and Topics in MDPI journals
Dr. Francesca Colonese

E-Mail Website
Co-Guest Editor
Medical Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori Hospital in Monza, Via Giambattista Pergolesi 33, 20900 Monza, Italy
Interests: immunotherapy; NSCLC
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Lung cancer is one of the most common malignancies and the first cause of cancer death worldwide. It is currently estimated that less than 21% of lung cancer patients are alive five years from diagnosis; this depends on several factors, including the silent clinical course of the disease leading to late diagnosis, advanced age, respiratory impairment, cardiovascular and metabolic comorbidities, histology, and others. Significant improvements in lung cancer survival have been obtained in the last decade by introducing two novel therapeutic approaches for patients affected by non-small cell lung cancer (NSCLC), a histological subtype that includes approximately 85% of lung cancers: immunotherapy and gene-targeted therapy. These treatments are based on identifying predictive biomarkers, revolutionizing daily practice in modern pathology and medical oncology, and bridging consistent survival advantages in NSCLC patients. Currently, EGFR, KRAS, BRAF, ERBB2, ALK, ROS1, MET, RET, and NTRK genetic alterations and PD-L1 immunohistochemical expression are used to make treatment decisions, and a great number of ongoing clinical trials investigate novel molecular targets, medications, treatment combinations and protocols against lung cancer. This Special Issue aims to shed light on the most recent advancements in precision oncology research and current innovations in targeted and immunological treatments against lung cancer.

Dr. Panagiotis Paliogiannis
Prof. Dr. Giuseppe Palmieri
Dr. Francesca Colonese
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. Biomedicines is an international peer-reviewed open access monthly 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

  • lung
  • cancer
  • NSCLC
  • targeted therapies
  • immunotherapy
  • precision oncology
  • EGFR
  • KRAS
  • ALK
  • ROS1

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Published Papers (4 papers)

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11 pages, 957 KiB  
Article
Efficacy of Durvalumab Consolidation Therapy After Sequential Chemoradiotherapy in Patients with Unresectable Stage III Non-Small Cell Lung Cancer—Experience from the Daily Hospital of Clinic for Pulmonology, University Clinical Center of Serbia
by Vesna Ćeriman Krstić, Natalija Samardžić, Spasoje Popević, Ruža Stević, Branislav Ilić, Milija Gajić, Nikola Čolić, Katarina Lukić, Brankica Milošević Maračić, Bojana Poparić Banđur, Biljana Šeha, Damir Radončić and Jelena Milin Lazović
Biomedicines 2025, 13(4), 892; https://doi.org/10.3390/biomedicines13040892 - 7 Apr 2025
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Abstract
Background/Objectives: Patients with stage III non-small cell lung cancer represent a very heterogeneous group of patients. In the past, the standard of care for patients with inoperable stage III non-small cell lung cancer was concurrent or sequential radical radiotherapy and chemotherapy. But the [...] Read more.
Background/Objectives: Patients with stage III non-small cell lung cancer represent a very heterogeneous group of patients. In the past, the standard of care for patients with inoperable stage III non-small cell lung cancer was concurrent or sequential radical radiotherapy and chemotherapy. But the progression-free survival was 8 months, and the 5-year overall survival rate was less than 20%. After the results of the PACIFIC study, the standard of care for this group of patients is chemoradiotherapy with durvalumab as consolidation therapy. The aim of our study was to evaluate the efficacy of consolidation durvalumab in a real-world setting after sequential CRT. Methods: We included 24 patients with unresectable stage III non-small cell lung cancer who did not progress after sequential chemoradiotherapy and who received durvalumab consolidation. Results: Median progression-free survival was 16 months, 95% CI (0.5–31.5), and median overall survival was 20 months, 95% CI (13.4–26.6 months). The twelve-month progression-free survival and overall survival rate were 55.1% and 68%, respectively, and the 18-month progression-free survival and overall survival rates were 44.1% and 56.5%, respectively. Conclusions: Durvalumab introduced a new era in the treatment of patients with unresectable stage III non-small cell lung cancer with a significantly prolonged 5-year overall survival rate. Our study is one of the few that investigated the efficacy of durvalumab in a real-world setting after sequential CRT. Our results showed that durvalumab is effective in patients who were treated with sequential CRT. However, the time between radiotherapy termination and the start of durvalumab should be shorter. Full article
(This article belongs to the Special Issue Advancements in Lung Cancer Precision Oncology Research and Treatments)
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13 pages, 775 KiB  
Article
Real-World Performance of the EasyPGX® Ready Epidermal Growth Factor Receptor Assay for Genomic Testing of Non-Small Cell Lung Cancer Samples
by Michael Bento Schmid, Izadora Demmer, Sandra Floriani, Diana Born and Wolfram Jochum
Biomedicines 2025, 13(4), 814; https://doi.org/10.3390/biomedicines13040814 - 28 Mar 2025
Viewed by 365
Abstract
Background/Objectives: Activating epidermal growth factor receptor (EGFR) variants is the most common targetable alteration in non-small cell lung cancer (NSCLC). Clinical decision-making requires fast and reliable detection of EGFR variants in early and advanced NSCLC, but limited available tissue necessitates [...] Read more.
Background/Objectives: Activating epidermal growth factor receptor (EGFR) variants is the most common targetable alteration in non-small cell lung cancer (NSCLC). Clinical decision-making requires fast and reliable detection of EGFR variants in early and advanced NSCLC, but limited available tissue necessitates tissue-sparing approaches and optimized sample management. The objective of this study was to assess the performance of the commercial EasyPGX® ready EGFR assay using real-world clinical NSCLC samples. Methods: A consecutive cohort of 804 non-squamous NSCLC samples was prospectively analyzed with the real-time quantitative polymerase chain reaction (RT-qPCR)-based EasyPGX® ready EGFR assay (Diatech Pharmacogenetics, Jesi, Ancona, Italy) and compared to next-generation sequencing (NGS) assays. Results: NGS revealed conclusive results in 99.7% samples, of which 11.1% had at least one EGFR variant. The most common variants were exon 19 deletions and p.L858R. The RT-qPCR-based assay identified EGFR variants with high accuracy (overall concordance rate 94.3%) over a broad range of clinical sample types, variant allele frequencies, tumor cell contents and deoxyribonucleic acid (DNA) input amounts. Conclusions: This study demonstrates that the EasyPGX® ready EGFR assay is a valid approach for the rapid detection of common EGFR variants in real-world clinical NSCLC samples with DNA inputs as low as 5 ng (less than the 15 ng recommended by the manufacturer), improving sample management in small specimens with limited quantity of nucleic acids. Full article
(This article belongs to the Special Issue Advancements in Lung Cancer Precision Oncology Research and Treatments)
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18 pages, 302 KiB  
Article
Immunotherapy in Non-Small-Cell Lung Cancer: A Modified Delphi Survey Consensus on First Line Treatment, Special Populations and Rechallenge
by Francesca Colonese, Alessandra Bulotta, Carlo Genova, Diego Signorelli, Laura Bonanno, Claudia Proto, Immunotherapy in NSCLC Delphi Panel and Diego Luigi Cortinovis
Biomedicines 2024, 12(12), 2742; https://doi.org/10.3390/biomedicines12122742 - 29 Nov 2024
Viewed by 1215
Abstract
Background: The treatment landscape for non-small cell lung cancer (NSCLC) has evolved significantly with the advent of immunotherapy. Nonetheless, uncertainty regarding optimal first-line treatments, special populations, and the feasibility of rechallenge remains. This study aims to investigate Italian oncologists’ opinions on these [...] Read more.
Background: The treatment landscape for non-small cell lung cancer (NSCLC) has evolved significantly with the advent of immunotherapy. Nonetheless, uncertainty regarding optimal first-line treatments, special populations, and the feasibility of rechallenge remains. This study aims to investigate Italian oncologists’ opinions on these aspects through a Delphi Survey. Methods: A steering committee (SC) of six oncologists identified three topics of interest, namely NSCLC (first line) therapeutic choice, NSCLC special populations, and NSCLC immunotherapy rechallenge), and drafted several topic-related statements to be voted in the Delphi Survey by the 61 oncologists forming the Delphi Panel. The survey included two rounds, wherein the experts rated their agreement/disagreement with the statements on a 5-point Likert scale. Consensus was defined as agreement/disagreement by at least 75% of the panel. Results: The SC drafted 69 statements for the first round, of which 16 (23.2%) met the agreement threshold, 5 (7.2%) met the disagreement threshold, and 48 (69.6%) did not reach consensus. The SC revised the latter statements and drafted 37 for the second round. Overall, 5 (13.5%) statements met the agreement threshold, 1 (2.7%) met the disagreement threshold, and 31 (83.8%) did not reach consensus in the second round. Conclusions: The survey showed agreement on the necessity of molecular characterization, mutations, smoke, the role of steroid therapy, and immunotherapy rechallenge, and revealed several areas of uncertainty among Italian oncologists on the use of immunotherapy in NSCLC. Statements—where consensus was not met—can be used to guide future clinical research in resolving the issues. Full article
(This article belongs to the Special Issue Advancements in Lung Cancer Precision Oncology Research and Treatments)

Other

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12 pages, 1296 KiB  
Project Report
Immune Clustering Reveals Molecularly Distinct Subtypes of Lung Adenocarcinoma
by Yan Lender, Ofer Givton, Ruth Bornshten, Meitar Azar, Roy Moscona, Yosef Yarden and Eitan Rubin
Biomedicines 2025, 13(4), 849; https://doi.org/10.3390/biomedicines13040849 - 2 Apr 2025
Viewed by 349
Abstract
Background/objectives: Lung adenocarcinoma, the most prevalent type of non-small cell lung cancer, consists of two driver mutations in KRAS or EGFR. These mutations are generally mutually exclusive and biologically and clinically different. In this study, we aimed to test if lung adenocarcinoma tumors [...] Read more.
Background/objectives: Lung adenocarcinoma, the most prevalent type of non-small cell lung cancer, consists of two driver mutations in KRAS or EGFR. These mutations are generally mutually exclusive and biologically and clinically different. In this study, we aimed to test if lung adenocarcinoma tumors could be separated by their immune profiles using an unsupervised machine learning method. The underlying assumption was that differences in the immune response to tumors are characteristic of tumor subtypes. Methods: RNA-seq data were projected into inferred immune profiles. Unsupervised learning was used to divide the lung adenocarcinoma population based on their projected immune profiles. Results: The patient population was divided into three subgroups, one of which appeared to contain mostly EGFR patients. The tumors in the different clusters significantly differed in their expression of some of their known immune checkpoints (TIGIT, PD-1/PD-L1, and CTLA4). Discussion: We argue that EGFR mutations in each subgroup are immunologically different, which implies a distinct tumor microenvironment and might relate to the relatively high resistance of EGFR-positive tumors to immune checkpoint inhibitors. However, we cannot make the same claim about KRAS mutations. Full article
(This article belongs to the Special Issue Advancements in Lung Cancer Precision Oncology Research and Treatments)
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