Special Issue "New Advances in the Treatment of Resectable Non-small Cell Lung Cancer"

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

Deadline for manuscript submissions: 28 February 2023 | Viewed by 1418

Special Issue Editors

Dr. Francesco Facciolo
E-Mail Website
Guest Editor
Thoracic Surgery Department, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
Interests: lung cancer; surgery; robotic surgery; minimally invasive thoracic surgery; lymphadenectomy
Dr. Luca Bertolaccini
E-Mail Website
Guest Editor
Division of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
Interests: lung cancer; biostatistics; minimally invasive thoracic surgery; oligometastatic lung cancer
Special Issues, Collections and Topics in MDPI journals
Dr. Federico Cappuzzo
E-Mail Website
Guest Editor
Medical Oncology, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
Interests: lung cancer; target therapy; immunotherapy; clinical trials

Special Issue Information

Dear Colleagues,

Despite the evolution in non-small cell lung cancer treatment, the overall prognosis is still poor. In this context, lobectomy and radical lymphadenectomy remain the cornerstone of surgical treatment of resectable NSCLC. One of the most important prognostic factors remains the presence of lymph node involvement, particularly the presence of mediastinal nodal involvement, as demonstrated in the VIII TNM staging system edition with a clear prognosis stratification considering the presence of nodal metastases. Furthermore, correct intraoperative staging is mandatory to reach an actual pathological status of the disease. The recent approval of Osimertinib for resected EGFR-mutated NSCLC in an adjuvant setting has led to the hypothesis that other targeted therapies used in metastatic patients can also lead to improved early-stage outcomes of NSCLC. Indeed, in addition to surgical treatment, some target therapies are being tested in adjuvant settings with promising outcomes. Some trials are open which use these therapies in the neoadjuvant setting. For this Special Issue, we welcome manuscripts focusing on recent advancements in the preoperative staging, the surgical resection of NSCLC, and the role of the new medications approved as adjuvant and neoadjuvant therapies. We also welcome systematic reviews, original research, economic evaluation, and cost-effectiveness studies on this relevant topic.

Dr. Francesco Facciolo
Dr. Luca Bertolaccini
Dr. Federico Cappuzzo
Guest Editors

Manuscript Submission Information

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Keywords

  • early-stage NSCLC
  • lymphadenectomy
  • robotic surgery
  • adjuvant therapy
  • neoadjuvant therapy

Published Papers (2 papers)

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Case Report
Acquired G2032R Resistance Mutation in ROS1 to Lorlatinib Therapy Detected with Liquid Biopsy
Curr. Oncol. 2022, 29(9), 6628-6634; https://doi.org/10.3390/curroncol29090520 - 16 Sep 2022
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Abstract
Lorlatinib, a third-generation anaplastic lymphoma kinase (ALK)/receptor tyrosine kinase inhibitor (ROS1), demonstrated efficacy in ROS1 positive (ROS1+) non-small cell lung cancer (NSCLC), although approval is currently limited to the treatment of ALK+ patients. However, lorlatinib-induced resistance mechanisms, and its efficacy against the resistance [...] Read more.
Lorlatinib, a third-generation anaplastic lymphoma kinase (ALK)/receptor tyrosine kinase inhibitor (ROS1), demonstrated efficacy in ROS1 positive (ROS1+) non-small cell lung cancer (NSCLC), although approval is currently limited to the treatment of ALK+ patients. However, lorlatinib-induced resistance mechanisms, and its efficacy against the resistance mutation G2032R in ROS1, respectively, have not yet been fully understood. Furthermore, concomitant tumor suppressor gene p53 (TP53) mutations occur in driver alteration positive NSCLC, but their prognostic contribution in the context of ROS1 inhibition remains unclear. Here we report a ROS1+ NSCLC patient who developed an on target G2032R resistance mutation during second-line lorlatinib treatment, indicating the lack of activity of lorlatinib against ROS1 G2032R. The resistance mutation was detected in plasma-derived ctDNA, signifying the clinical utility of liquid biopsies. Full article
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Case Report
Neoadjuvant Immunotherapy Combined with Chemotherapy for Local Advanced Non-Small-Cell Lung Cancer in a Patient with a History of Breast Cancer: A Case Report
Curr. Oncol. 2022, 29(9), 6203-6210; https://doi.org/10.3390/curroncol29090487 - 29 Aug 2022
Viewed by 772
Abstract
Durvalumab consolidation therapy is the standard treatment after concurrent chemoradiotherapy for patients with surgically unresectable stage IIIA (N2) non-small-cell lung cancer (NSCLC). Neoadjuvant therapy followed by surgery could reduce locoregional and distant recurrence and improve the survival rate for surgically resectable NSCLC. However, [...] Read more.
Durvalumab consolidation therapy is the standard treatment after concurrent chemoradiotherapy for patients with surgically unresectable stage IIIA (N2) non-small-cell lung cancer (NSCLC). Neoadjuvant therapy followed by surgery could reduce locoregional and distant recurrence and improve the survival rate for surgically resectable NSCLC. However, the value of neoadjuvant therapy in locally advanced potentially resectable NSCLC remains controversial. Herein, we report a locally advanced potentially resectable NSCLC case with a history of breast cancer who achieved a pathologic complete response (pCR) after preoperative treatment with pembrolizumab and chemotherapy. A 50-year-old woman developed squamous cell carcinoma (SCC) (left lower lobe of the lung, stage IIIA-N2) after two years of chemotherapy and anti-HER2 therapy following a diagnosis of HER2-overexpressing breast cancer. Surgical resection was attempted despite an MDT classification as unamenable to curative surgical resection. After two cycles of neoadjuvant chemotherapy combined with anti-PD1 immunotherapy, the tumor significantly shrank, then the patient underwent a left lower lobectomy. Complete resection with negative margins (R0 resection) was achieved in the patient. The patient experienced grade 1–2 adverse effects and no grade 3 or worse adverse effects occurred. Cardiotoxicity did not occur in the patient despite prior anti-HER2 treatment for breast cancer. Our case study contributes to the existing evidence on the feasibility, efficacy, and safety of neoadjuvant immunotherapy combined with chemotherapy in locally advanced unresectable NSCLC. Furthermore, future studies are needed to determine which patients can benefit from immunoadjuvant therapy and the duration and course of preoperative and postoperative immunotherapy. Full article
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