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Cancers
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The Role of Radiotherapy, Immunotherapy and New Surgical Techniques in...
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The Role of Radiotherapy, Immunotherapy and New Surgical Techniques in the Treatment of Lung Neoplasms

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

Deadline for manuscript submissions: 1 July 2025 | Viewed by 5050

Special Issue Editor

Dr. Elisa Meacci

E-Mail Website
Guest Editor
Department of Thoracic Surgery, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
Interests: NSCLC; minimally invasive techniques; robotic surgery; VATS

Special Issue Information

Dear Colleagues,

Radiotherapy, immunotherapy, and new surgical techniques can be used to explore the evolving landscape of lung cancer treatment. This Special Issue delves into the pivotal roles of radiotherapy, immunotherapy, and cutting-edge surgical approaches in managing lung neoplasms. This publication highlights how these modalities, deployed individually and in combination, are revolutionizing patient care and improving outcomes in the battle against this formidable disease. This SI will emphasize the advancements in each field and their role in enhancing the overall therapeutic landscape for patients with lung neoplasms.

Dr. Elisa Meacci
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

  • radiotherapy
  • immunotherapy
  • new surgical techniques
  • lung cancer

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Published Papers (3 papers)

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Research

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12 pages, 1632 KiB  
Article
Molecular Diagnostic Yield and Safety Profile of Ultrasound-Guided Lung Biopsies: A Cross-Sectional Study
by Vito D’Agnano, Fabio Perrotta, Giulia Maria Stella, Raffaella Pagliaro, Filippo De Rosa, Francesco Saverio Cerqua, Angela Schiattarella, Edoardo Grella, Umberto Masi, Luigi Panico, Andrea Bianco and Carlo Iadevaia
Cancers 2024, 16(16), 2860; https://doi.org/10.3390/cancers16162860 - 16 Aug 2024
Viewed by 1800
Abstract
Background: The recent advances in precision oncology for lung cancer treatment has focused attention on the importance of obtaining appropriate specimens for tissue diagnosis as well as comprehensive molecular profiling. CT scan-guided biopsies and bronchoscopy are currently the main procedures employed for tissue [...] Read more.
Background: The recent advances in precision oncology for lung cancer treatment has focused attention on the importance of obtaining appropriate specimens for tissue diagnosis as well as comprehensive molecular profiling. CT scan-guided biopsies and bronchoscopy are currently the main procedures employed for tissue sampling. However, growing evidence suggests that ultrasound-guided biopsies may represent an effective as well as safe approach in this diagnostic area. This study explores the safety and the diagnostic yield for cancer molecular profiling in ultrasound-guided percutaneous lung lesion biopsies (US-PLLB). Methods: One hundred consecutive patients with suspected lung cancer, between January 2021 and May 2024, who had ultrasound-guided lung biopsies have been retrospectively analyzed. Molecular profiling was conducted with next-generation sequencing Genexus using Oncomine precision assay or polymerase chain reaction according to specimen quality. Qualitative immunohistochemical assay of programmed death ligand 1 (PD-L1) expression was evaluated by the Dako PD-L1 immunohistochemistry 22C3 pharmDx assay. The co-primary endpoints were the molecular diagnostic yield and the safety profile of US-guided lung biopsies. Results: From January 2021 to May 2024, 100 US-guided lung biopsies were carried out and 95 were considered for inclusion in the study. US-PLLB provided informative tissue for a histological evaluation in 93 of 95 patients with an overall diagnostic accuracy of 96.84% [Sensitivity: 92.63%; Specificity: 96.84%; PPV: 100%; NPV: 100%]. Sixty-Six patients were diagnosed with NSCLC (69.47%) and were considered for molecular diagnostic yield evaluation and PD-L1 testing. Four patients had malignant lymphoid lesions. US-PLLB was not adequate to achieve a final diagnosis in three patients (3.16%). Complete molecular profiling and PD-L1 evaluation were achieved in all patients with adenocarcinoma (molecular diagnostic yield: 100%). PD-L1 evaluation was achieved in 28 of 29 patients (96.55%) with either SCC or NOS lung cancer. The overall complication rate was 9.47% (n = 9). Six patients (6.31%) developed pneumothorax, while three patients (3.16%) suffered mild haemoptysis without desaturation. Conclusions: According to our findings, US-guided lung biopsy is a safe, minimally invasive procedure in patients with suspected lung malignancies, providing an excellent diagnostic yield for both comprehensive molecular profiling and PD-L1 testing. In addition, our results suggest that US-guided biopsy may also be an effective diagnostic approach in patients with suspected lung lymphoma. Full article
(This article belongs to the Special Issue The Role of Radiotherapy, Immunotherapy and New Surgical Techniques in the Treatment of Lung Neoplasms)
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10 pages, 247 KiB  
Article
Uniportal Video-Assisted Thoracoscopic Anatomic Lung Resection after Neoadjuvant Chemotherapy for Lung Cancer: A Case-Matched Analysis
by Marco Andolfi, Elisa Meacci, Michele Salati, Francesco Xiumè, Alberto Roncon, Gian Marco Guiducci, Michela Tiberi, Anna Chiara Nanto, Dania Nachira, Adriana Nocera, Giuseppe Calabrese, Maria Teresa Congedo, Riccardo Inchingolo, Stefano Margaritora and Majed Refai
Cancers 2024, 16(15), 2642; https://doi.org/10.3390/cancers16152642 - 25 Jul 2024
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Abstract
Background: The advantages of video-assisted thoracic surgery (VATS) are well-recognized in several studies. However, in the cases of advanced lung cancer after neoadjuvant chemotherapy (nCT), the role of VATS is still questionable, with concerns about safety, technical feasibility, and oncological completeness. The aim [...] Read more.
Background: The advantages of video-assisted thoracic surgery (VATS) are well-recognized in several studies. However, in the cases of advanced lung cancer after neoadjuvant chemotherapy (nCT), the role of VATS is still questionable, with concerns about safety, technical feasibility, and oncological completeness. The aim of this study was to assess the impact of nCT on patients who had undergone uniportal VATS (U-VATS) anatomic lung resections for lung cancer, by comparing the short-term outcomes of patients after nCT with case-matched counterparts (treated by surgery alone). Methods: We performed a retrospective, comparative study enrolling 927 patients (nCT: 60; non-nCT:867) who underwent U-VATS anatomic lung resections from 2014 to 2020 in two centers. Data were collected in a shared database with standardized variables’ definition. Propensity score matching using 15 baseline preoperative patients’ characteristics was performed in order to minimize selection-confounding factors between the two groups, which then were directly compared in terms of perioperative outcomes. Results: After propensity score matching, two groups of 60 patients had been defined. The nCT-group had a higher conversion rate compared to the control group (13.3% vs. 0%, p = 0.003) without an increase in operation time or cardiopulmonary complications. In addition, no differences between the two groups were recorded in terms of prolonged air leaks, length of stay, and readmission. Conclusions: U-VATS after nCT is a feasible approach, showing a similar rate of cardiopulmonary complications and length of stay when compared with the control group. However, it remains a challenging surgery due to its great technical complexity as well as the clinical status of the patients. Full article
(This article belongs to the Special Issue The Role of Radiotherapy, Immunotherapy and New Surgical Techniques in the Treatment of Lung Neoplasms)

Review

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12 pages, 1107 KiB  
Review
The Role of Hyperthermic Intrathoracic Chemotherapy (HITHOC) in Thoracic Tumors
by Federica Danuzzo, Maria Chiara Sibilia, Sara Vaquer, Andrea Cara, Enrico Mario Cassina, Lidia Libretti, Emanuele Pirondini, Federico Raveglia, Antonio Tuoro and Francesco Petrella
Cancers 2024, 16(14), 2513; https://doi.org/10.3390/cancers16142513 - 11 Jul 2024
Cited by 3 | Viewed by 1779
Abstract
Pleural mesothelioma (PM) is a rare but aggressive thoracic tumor with a poor prognosis. Multimodal treatment—including induction chemotherapy, aggressive surgical resection, radiotherapy and immunotherapy in selected cases—currently represents the best therapeutic option. Single-center studies advocate hyperthermic intrathoracic chemotherapy (HITHOC) during surgical resection as [...] Read more.
Pleural mesothelioma (PM) is a rare but aggressive thoracic tumor with a poor prognosis. Multimodal treatment—including induction chemotherapy, aggressive surgical resection, radiotherapy and immunotherapy in selected cases—currently represents the best therapeutic option. Single-center studies advocate hyperthermic intrathoracic chemotherapy (HITHOC) during surgical resection as an additional therapeutic option, although its impact on post-operative morbidity and survival has not yet been evaluated on a larger scale. HITHOC can be applied not only in the case of mesothelioma, but also in the case of thymoma with pleural involvement or—in very selected cases—in patients with secondary pleural metastases. Despite favorable outcomes and reduced clinical risks, there is no uniform approach to HITHOC, and a wide variety of indications and technical applications are still reported. Based on available data, HITHOC seems to offer a clear benefit in regard to overall survival of all mesothelioma patients; however, multicenter randomized controlled trials are required to validate and standardize this approach. The aim of this review is to focus on the present role of HITHOC in thoracic tumors with pleural involvement as well as on future challenges, particularly in the light of possible combined therapy of thoracic tumors still presenting poor prognoses. Full article
(This article belongs to the Special Issue The Role of Radiotherapy, Immunotherapy and New Surgical Techniques in the Treatment of Lung Neoplasms)
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