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Cancers
Special Issues
Diagnosis and Innovative Treatment of Localized Lung Cancer
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Diagnosis and Innovative Treatment of Localized Lung Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Causes, Screening and Diagnosis".

Deadline for manuscript submissions: closed (10 March 2024) | Viewed by 3132

Special Issue Editors

Prof. Dr. Giulia Veronesi

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Guest Editor
1. Division of Thoracic Surgery, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Manzoni 56, 20089 Rozzano, MI, Italy
2. School of Medicine, Vita-Salute San Raffaele University, 20132 Milano, MI, Italy
Interests: robotic and minimally invasive surgery; lung cancer limited resection; lung cancer screening; mediastinal disease
Special Issues, Collections and Topics in MDPI journals
Dr. Piergiorgio Muriana

E-Mail Website
Guest Editor
Department of Thoracic Surgery, Scientific Institute and University Vita-Salute San Raffaele, Hospital San Raffaele Milano, 20132 Milan, Italy
Interests: thoracic surgery; lung cancer
Dr. Pierluigi Novellis

E-Mail Website
Guest Editor
Division of Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Via Olgettina 58, 20132 Milan, Italy
Interests: pleural mesothelioma; lung cancer; robotic thoracic surgery; lung cancer screening

Special Issue Information

Dear Colleagues, 

Lung cancer is still the leading cause of cancer-related death in Western countries. Screening programs using low-dose CT scanning in at-risk populations for smoking exposure have been demonstrated to be effective in reducing disease burden. Novel developments regarding molecular and circulating cellular markers for early diagnosis and prediction of treatment response are under development. New technologies, including neural network algorithms for imaging, high-throughput technologies for sequencing and multiple-fluorescence-activated cellular sorters, will change the diagnostic and prognostic paradigm for liquid biopsy and tumor tissue. Similarly, the treatment of early-stage disease is evolving, with emerging developments in integrated multidisciplinary management including immune system checkpoint inhibitors, lung-sparing surgery, molecularly target drugs and advanced radiotherapy. This Special Issue will present a series of papers focusing on novelties in the prevention, early diagnosis and treatment of localized lung cancer.

Prof. Dr. Giulia Veronesi
Dr. Piergiorgio Muriana
Dr. Pierluigi Novellis
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 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
  • LDCT screening
  • molecular markers
  • thoracic surgery
  • robotic surgery
  • immunotherapy
  • systemic treatment
  • lung-sparing surgery

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Published Papers (1 paper)

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Research

18 pages, 2410 KiB  
Article
The Smokers Health Multiple ACtions (SMAC-1) Trial: Study Design and Results of the Baseline Round
by Alberto Antonicelli, Piergiorgio Muriana, Giovanni Favaro, Giuseppe Mangiameli, Ezio Lanza, Manuel Profili, Fabrizio Bianchi, Emanuela Fina, Giuseppe Ferrante, Simone Ghislandi, Daniela Pistillo, Giovanna Finocchiaro, Gianluigi Condorelli, Rosalba Lembo, Pierluigi Novellis, Elisa Dieci, Simona De Santis and Giulia Veronesi
Cancers 2024, 16(2), 417; https://doi.org/10.3390/cancers16020417 - 18 Jan 2024
Viewed by 2664
Abstract
Background: Lung cancer screening with low-dose helical computed tomography (LDCT) reduces mortality in high-risk subjects. Cigarette smoking is linked to up to 90% of lung cancer deaths. Even more so, it is a key risk factor for many other cancers and cardiovascular and [...] Read more.
Background: Lung cancer screening with low-dose helical computed tomography (LDCT) reduces mortality in high-risk subjects. Cigarette smoking is linked to up to 90% of lung cancer deaths. Even more so, it is a key risk factor for many other cancers and cardiovascular and pulmonary diseases. The Smokers health Multiple ACtions (SMAC-1) trial aimed to demonstrate the feasibility and effectiveness of an integrated program based on the early detection of smoking-related thoraco-cardiovascular diseases in high-risk subjects, combined with primary prevention. A new multi-component screening design was utilized to strengthen the framework on conventional lung cancer screening programs. We report here the study design and the results from our baseline round, focusing on oncological findings. Methods: High-risk subjects were defined as being >55 years of age and active smokers or formers who had quit within 15 years (>30 pack/y). A PLCOm2012 threshold >2% was chosen. Subject outreach was streamlined through media campaign and general practitioners’ engagement. Eligible subjects, upon written informed consent, underwent a psychology consultation, blood sample collection, self-evaluation questionnaire, spirometry, and LDCT scan. Blood samples were analyzed for pentraxin-3 protein levels, interleukins, microRNA, and circulating tumor cells. Cardiovascular risk assessment and coronary artery calcium (CAC) scoring were performed. Direct and indirect costs were analyzed focusing on the incremental cost-effectiveness ratio per quality-adjusted life years gained in different scenarios. Personalized screening time-intervals were determined using the “Maisonneuve risk re-calculation model”, and a threshold <0.6% was chosen for the biennial round. Results: In total, 3228 subjects were willing to be enrolled. Out of 1654 eligible subjects, 1112 participated. The mean age was 64 years (M/F 62/38%), with a mean PLCOm2012 of 5.6%. Former and active smokers represented 23% and 77% of the subjects, respectively. At least one nodule was identified in 348 subjects. LDCTs showed no clinically significant findings in 762 subjects (69%); thus, they were referred for annual/biennial LDCTs based on the Maisonneuve risk (mean value = 0.44%). Lung nodule active surveillance was indicated for 122 subjects (11%). Forty-four subjects with baseline suspicious nodules underwent a PET-FDG and twenty-seven a CT-guided lung biopsy. Finally, a total of 32 cancers were diagnosed, of which 30 were lung cancers (2.7%) and 2 were extrapulmonary cancers (malignant pleural mesothelioma and thymoma). Finally, 25 subjects underwent lung surgery (2.25%). Importantly, there were zero false positives and two false negatives with CT-guided biopsy, of which the patients were operated on with no stage shift. The final pathology included lung adenocarcinomas (69%), squamous cell carcinomas (10%), and others (21%). Pathological staging showed 14 stage I (47%) and 16 stage II-IV (53%) cancers. Conclusions: LDCTs continue to confirm their efficacy in safely detecting early-stage lung cancer in high-risk subjects, with a negligible risk of false-positive results. Re-calculating the risk of developing lung cancer after baseline LDCTs with the Maisonneuve model allows us to optimize time intervals to subsequent screening. The Smokers health Multiple ACtions (SMAC-1) trial offers solid support for policy assessments by policymakers. We trust that this will help in developing guidelines for the large-scale implementation of lung cancer screening, paving the way for better outcomes for lung cancer patients. Full article
(This article belongs to the Special Issue Diagnosis and Innovative Treatment of Localized Lung Cancer)
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