Acquired Resistance and Malignant Progression of Lung Adenocarcinoma

Dear colleagues,

Lung adenocarcinoma is the most common subtype of lung cancer. Thanks to the advances in molecular oncology, a number of driver genes have been identified in lung adenocarcinoma, and appropriate inhibitors have been developed against each molecular target. Now, lung adenocarcinoma is the best solid cancer to which targeted therapy is established and clinically available. However, tumors resistant against targeted drugs develop frequently, providing the biggest challenge in current treatment of lung cancer. Fortunately, this problem is also being overcome by elucidating the mechanisms of resistance and developing the next generation of targeted drugs, which are designed to overcome initial resistance. At present, two resistance mechanisms are demonstrated clearly in lung adenocarcinoma; on-target resistance, in which a targeting protein itself is mutated, and off-target resistance, in which downstream or parallel pathways are activated. Furthermore, changes in cellular context or lineage, such as epithelial–mesenchymal transition and SCLC transition, are reported to be possible additional mechanisms for resistance against EGFR-tyrosine kinase inhibitors, suggesting that acquired resistance could be associated with invasion and metastasis in advanced lung adenocarcinoma. In fact, it is convincing that invasion and metastasis, which cause over 90% of direct cancer death in solid tumors, are another big target for treatment of lung adenocarcinoma. However, no available drugs against cancer invasion and metastasis are currently developed partly due to the complexity of signaling, spreading to the whole body, and difficulty in assessment of the inhibitory effect in invasion and metastasis. Thus, elucidation of cell signaling involved in resistance, invasion, and metastasis by novel approaches and development of multidisciplinary treatment are prerequisites to overcome lung adenocarcinoma. The primary focus of this topic will be cell signaling and context in acquired resistance of lung adenocarcinoma against targeted therapy. In addition, the reviews and original articles will explore the mechanisms and signaling of cancer invasion and metastasis from the viewpoint of malignant progression and resistance to the treatment of lung adenocarcinoma.

Dr. Yoshinori Murakami
Guest Editor

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