Early Stage NSCLC: New Age Paradigms

A special issue of Current Oncology (ISSN 1718-7729). This special issue belongs to the section "Thoracic Oncology".

Deadline for manuscript submissions: closed (15 August 2024) | Viewed by 2320

Special Issue Editors


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Guest Editor
Department of Medical Oncology, Cliniche Humanitas Gavazzeni, 24125 Bergamo, Italy
Interests: thymoma; thymic epithelial tumor; thymus neoplasms; lung cancer
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Guest Editor
Department of Medical Oncology, Cliniche Humanitas Gavazzeni, 24125 Bergamo, Italy
Interests: immunotherapy; target therapy; chemotherapy; radiotherapy; early stage NSCLC; SCLC; study with innovative drugs; thoracic neoplasms

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Guest Editor
Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
Interests: immunotherapy; target therapy; chemotherapy; radiotherapy; early stage NSCLC; SCLC; study with innovative drugs; thoracic neoplasms

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Guest Editor
Department of Onco-Hematology, Università degli Studi di Messina, 98158 Messina, Italy
Interests: immunotherapy; target therapy; chemotherapy; radiotherapy; early stage NSCLC; liquid biopsy; thoracic neoplasms; SCLC
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

As randomized trials demonstrate the efficacy of new therapeutic approaches in early stage NSCLC, all current treatment paradigms will need to be critically reviewed and many therapeutic strategies that have been used for years will soon need to be modified.

Namely, peri-operative immuno-chemotherapy has shown significant improvement in patient outcomes and will become a routinary treatment strategy for many patients with localized disease, raising questions about the timing and duration of treatment based on multiple variables. Moreover, the efficacy of EGFR TKI in adjuvant settings has been well established, and many trials targeting other actionable targets are ongoing.

These new data also lead to the anticipation of molecular features (NGS) and PD(L)1 analyses compared to current practice, which imposes a different diagnostic logarithm before surgery.

Once all staging and molecular data will be available, a multidisciplinary team will have to decide whether a patient can be considered suitable for surgery or not, as the decision algorithms will be different and it will not be possible to defer this assessment to a later stage.

In this Special Issue, we will analyze the results of the most important studies and discuss their therapeutic implications as well as the changes required in diagnostic and therapeutic strategy.

Some of these consideration will concern the following:

  • The need to test molecular tumor features at the time of diagnosis for a multidisciplinary decision-making process;
  • Criteria to select individualized peri-operative treatment strategy both pre- and/or after surgery, if surgery is required;
  • The variables that the multidisciplinary team will have to take into account in order to set up a correct treatment strategy.

Prof. Dr. Tommaso Martino Martino De Pas
Dr. Chiara Catania
Dr. Claudia Proto
Dr. Alessandro Russo
Guest Editors

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Keywords

  • immunotherapy
  • target therapy
  • chemotherapy
  • radiotherapy
  • early stage NSCLC

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Published Papers (1 paper)

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Research

11 pages, 1785 KiB  
Article
Confirmation of Recurrent Lung Cancer Following Resection Using Liquid Biopsy, a Proof-of-Concept Real-World Study
by Julia R. Naso, Stephen Yip, Curtis Hughesman, Barb Melosky, Tanner Dowhy, Melissa K. McConechy, John C. English, Penelope M. A. Brasher, James Choi, Kyle Grant, John Yee, Stephen Lam and Anna McGuire
Curr. Oncol. 2024, 31(7), 4052-4062; https://doi.org/10.3390/curroncol31070302 - 17 Jul 2024
Viewed by 1765
Abstract
Appropriate management requires timely and accurate confirmation of non-small cell lung cancer (NSCLC) recurrence in patients who have had curative-intent surgical resection. We assessed the association between circulating tumor DNA (ctDNA) identified using amplicon sequencing and evidence of recurrence on CT surveillance. A [...] Read more.
Appropriate management requires timely and accurate confirmation of non-small cell lung cancer (NSCLC) recurrence in patients who have had curative-intent surgical resection. We assessed the association between circulating tumor DNA (ctDNA) identified using amplicon sequencing and evidence of recurrence on CT surveillance. A prospective cohort study of NSCLC patients with early-stage disease undergoing curative-intent resection was conducted. Surveillance was performed post-operatively at pre-defined intervals with both liquid biopsy and chest CT imaging. Amplicon panel next-generation sequencing was performed on DNA and RNA from tumor tissue and on plasma cell-free DNA for tumor-informed ctDNA detection. Resected tumors from 78 NSCLC patients were analyzed. Alterations were detected on the DNA assay for 65 tumors and only on the RNA assay for 4 tumors. Of the 65 patients with alterations detected on the tumor DNA assay, 29 completed post-operative liquid biopsy testing. Four of those 29 patients had evidence of recurrence on imaging, of whom two had biopsy confirmation of recurrence and detectable ctDNA at the 12-month follow-up. Molecular confirmation of NSCLC recurrence can be provided through amplicon sequencing of plasma cell-free DNA in cases with imaging evidence of recurrence. Invasive tissue diagnosis may be avoidable in patients with ctDNA confirmation of recurrence that is suspected based on imaging. Further study of ctDNA assessment technologies in the setting of suspected recurrence is necessary to inform post-operative lung cancer surveillance guidelines. Full article
(This article belongs to the Special Issue Early Stage NSCLC: New Age Paradigms)
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