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Clinical Pathology of Lung Cancer (2nd Edition)
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Clinical Pathology of Lung Cancer (2nd Edition)

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

Deadline for manuscript submissions: 30 June 2026 | Viewed by 2114

Special Issue Editor

Dr. Letizia Gnetti

E-Mail Website
Guest Editor
Pathology Unit, University Hospital of Parma, Parma, Italy
Interests: lung cancer; pathology; diagnosis; treatment; targeted therapies; immunotherapy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue is the second edition of our previous one, entitled "Clinical Pathology of Lung Cancer" (https://www.mdpi.com/journal/cancers/special_issues/S07XDE88CP).

Lung cancer is one of the most common causes of death due to cancer in men and women. Tobacco is the principal cause of lung cancer, but other causes include environmental exposure, asbestos, radon, exposure to ionizing radiation, and polycyclic aromatic hydrocarbons. Radiotherapy has also been proposed as a possible contributory cause in patients treated for breast cancer and Hodgkin lymphoma.

On suspicion of lung cancer, CT imaging is necessary to guide diagnosis. Tissue biopsy is mandatory to determine the histological tumor type, and this guides both the molecular investigations and the biomarkers performed. Once the diagnosis has been made, it is desirable to perform a PET scan to understand the extent of the disease and brain magnetic resonance imaging (MRI) to assess if there are brain metastases and complete the disease staging.

Early diagnosis and the therapeutic innovations which have appeared in recent years (targeted therapies or different modalities of immunotherapy) have changed the therapeutic approach and also the course of the disease. At the same time, current therapies have highlighted new toxicities and resistances that increasingly lead to re-biopsy and liquid biopsy for the evaluation of minimal residual disease too.

For all these reasons, we believe that this Special Issue will be of interest to all medical specialties that contribute to the diagnosis and treatment of lung cancer.

Dr. Letizia Gnetti
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 250 words) can be sent to the Editorial Office for assessment.

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
  • pathology
  • diagnosis
  • treatment
  • targeted therapies
  • immunotherapy

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Published Papers (2 papers)

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Research

12 pages, 1455 KB  
Article
Comprehensive Molecular Diagnostic Tests in Non-Small Cell Lung Cancer: Frequency of ALK, ROS1, RET, and Other Gene Fusions/Rearrangements in a Romanian Cohort
by Ester-Andreea Cohn (Vizitiu), Ecaterina Tataru and Ortansa Csutak
Cancers 2025, 17(22), 3673; https://doi.org/10.3390/cancers17223673 - 17 Nov 2025
Viewed by 606
Abstract
Background/Objectives: Lung cancer remains among the most frequently diagnosed malignancies in Romania, with a high mortality rate. Beyond EGFR mutations, clinically relevant genetic alterations in non-small cell lung cancer (NSCLC) include fusions involving ALK, ROS1, RET, and NTRK1/2/3. [...] Read more.
Background/Objectives: Lung cancer remains among the most frequently diagnosed malignancies in Romania, with a high mortality rate. Beyond EGFR mutations, clinically relevant genetic alterations in non-small cell lung cancer (NSCLC) include fusions involving ALK, ROS1, RET, and NTRK1/2/3. This study aimed to determine the prevalence of these mutations in a Romanian cohort and evaluate their associations with clinicopathological features. Methods: DNA and RNA were simultaneously extracted from formalin-fixed, paraffin-embedded (FFPE) tissue sections using the Genexus Purification System (ThermoFisher Scientific). Concentrations were quantified fluorometrically, and gene fusions were analyzed with Ion Torrent NGS (Ion GeneStudio S5) with the Oncomine Focus Assay (ThermoFisher Scientific). Library preparation was automated with the Ion Chef System, and data interpretation was conducted using Ion Reporter. Results: Among 721 newly diagnosed NSCLC patients, 28 (3.88%) harbored gene fusions. Adenocarcinoma prevailed among fusion-positive cases (85.7%). The subgroup included 15 males and 13 females, with a mean age of 63.25 years (range 43–83). ALK fusions were most frequent (1.66% of the cohort; 42.86% of positives), predominantly EML4::ALK. ROS1 fusions were detected in five patients (0.7%), most frequently CD74::ROS1. RET fusions occurred in 1.11%. Rare fusions included one ETV6::NTRK3, one PTPRZ1::MET, and one FGFR3::TACC3 co-occurring with EGFR L858R. Conclusions: Gene fusions were present in a minority of NSCLC cases, with ALK, ROS1, and RET being the most clinically relevant. These alterations were mutually exclusive with common drivers such as EGFR or KRAS. Detection of rare fusions highlights the therapeutic potential of comprehensive NGS profiling in Romanian NSCLC patients. Full article
(This article belongs to the Special Issue Clinical Pathology of Lung Cancer (2nd Edition))
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19 pages, 1074 KB  
Article
Inflammation-Based Prognostication in Advanced-Stage NSCLC: A Retrospective Cohort Study
by Carina Golban, Cristina-Miriam Blaga, Norberth-Istvan Varga, Alina Gabriela Negru, Delia Hutanu, Sorin Saftescu and Serban Mircea Negru
Cancers 2025, 17(17), 2910; https://doi.org/10.3390/cancers17172910 - 5 Sep 2025
Viewed by 1141
Abstract
Background/Objectives: Neutrophil-to-lymphocyte ratio (NLR), a marker of systemic inflammation, has prognostic value in non-small cell lung cancer (NSCLC), but its longitudinal performance in routine care is unclear. We evaluated baseline and 12-month changes in NLR and hemoglobin in a single-center, Eastern European [...] Read more.
Background/Objectives: Neutrophil-to-lymphocyte ratio (NLR), a marker of systemic inflammation, has prognostic value in non-small cell lung cancer (NSCLC), but its longitudinal performance in routine care is unclear. We evaluated baseline and 12-month changes in NLR and hemoglobin in a single-center, Eastern European cohort. Methods: In this retrospective study, 180 adults with histologically confirmed NSCLC, diagnosed May 2022–April 2024 at a Romanian tertiary center, were followed until 30 April 2025. Baseline demographics, tumor characteristics, molecular profiles, laboratory parameters, and treatments were extracted from electronic health records. Progression-free survival (PFS) was the primary endpoint, overall survival (OS) the secondary, analyzed using Kaplan–Meier curves and Cox proportional hazards models. An additional treatment-start-anchored sensitivity analysis in treated patients was conducted. Results: The cohort (median age 67.8 years, 68.9% stage IV) received chemo-immunotherapy (58.9%), immunotherapy (26.7%), chemotherapy (9.4%), or supportive care (5.0%). Median for PFS was 8.2 months and for OS 14.5 months. A high baseline NLR (≥3, 58.9%) increased progression risk (HR 1.60, 95% CI 1.10–2.32, p = 0.014), with a trend for worse OS (HR 1.45, 95% CI 0.99–2.12). A 12-month NLR increase (62.2%) further elevated progression risk (HR 1.52, 95% CI 1.05–2.20, p = 0.026). Low hemoglobin (<12 g/dL) had a non-significant effect (HR 1.38, 95% CI 0.97–1.96, p = 0.074). PD-L1 ≥ 50% and chemo-immunotherapy correlated with longer PFS. Findings were consistent in the treatment-start anchored sensitivity analysis. Conclusions: These exploratory findings suggest that inexpensive hematologic markers can complement clinical assessment in advanced-stage NSCLC; prospective multi-center validation is warranted. Full article
(This article belongs to the Special Issue Clinical Pathology of Lung Cancer (2nd Edition))
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