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Molecular Biology of Lung Cancer: From Intrinsic to Acquired Resistance Mechanisms

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Oncology".

Deadline for manuscript submissions: closed (20 February 2026) | Viewed by 3003

Special Issue Editor

Special Issue Information

Dear Colleagues,

Overall, lung cancer remains one of the major causes of cancer-related deaths worldwide. Despite the big efforts in ameliorating therapeutic strategies, both intrinsic and acquired resistance represent a concrete obstacle to the effectiveness of long-term treatment, resulting in ineffective therapeutic action and poor prognosis of lung cancer patients. Resistance mechanisms currently include genetic mutations and/or epigenetic changes, unregulated overexpression of drug efflux pumps, reduced oxygen availability, genomic instability and other pathological molecular events. In this context, the deregulation of epigenetic mechanisms, as well as DNA methylation, histone modification, and non-coding RNA regulation, could contribute to tumor resistance. To this purpose, a comprehensive overview of the current knowledge about several mechanisms responsible for targeting genetic and/or epigenetic factors linked to therapeutic resistance could be an effective strategy to reverse or overcome acquired drug resistance in patients with solid cancer, particularly in lung cancer patients.

This special issue aims to focus on the understanding of current landscape of intrisinic and acquired resistance in lung cancer cells and patients after therapy and the potential interventions to overcome these resistance mechanisms.

We encourage contributions of original research articles and reviews in the field of both genetic and epigenetic mechanisms related to lung cancer research.

Dr. Federico Pio Fabrizio
Guest Editor

Manuscript Submission Information

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Keywords

  • lung cancer
  • NSCLC
  • cancer therapy
  • resistance
  • DNA methylation

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Published Papers (2 papers)

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Editorial

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4 pages, 195 KB  
Editorial
Tumor Methylation Burden (TMeB) in Non-Small Cell Lung Cancer: A New Way of Thinking About Epigenetics
by Federico Pio Fabrizio and Lucia Anna Muscarella
Int. J. Mol. Sci. 2024, 25(23), 12966; https://doi.org/10.3390/ijms252312966 - 2 Dec 2024
Cited by 2 | Viewed by 1849
Abstract
Lung cancer represents a substantial proportion of cancer-associated mortality worldwide, with non-small cell lung cancer (NSCLC) accounting for most of these cases [...] Full article

Research

Jump to: Editorial

21 pages, 3532 KB  
Article
Longitudinal Analysis of Peripheral Blood CD4+ T-Cell Profiles and Clinical Outcomes in Metastatic Non-Small-Cell Lung Cancer Patients Following Bronchoscopic Cryotherapy and Pembrolizumab-Based Therapy
by Gediminas Vasiliauskas, Evelina Žemaitė, Erika Skrodenienė, Lina Poškienė, Skaidrius Miliauskas and Marius Žemaitis
Int. J. Mol. Sci. 2026, 27(7), 2927; https://doi.org/10.3390/ijms27072927 - 24 Mar 2026
Viewed by 290
Abstract
Bronchoscopic cryotherapy is routinely used for endobronchial tumor debulking, but may also exert systemic immunologic effects that could interact with immune checkpoint blockade. We investigated peripheral blood T-cell dynamics following bronchoscopic cryotherapy and subsequent pembrolizumab-based first-line therapy in metastatic non-small-cell lung cancer (NSCLC). [...] Read more.
Bronchoscopic cryotherapy is routinely used for endobronchial tumor debulking, but may also exert systemic immunologic effects that could interact with immune checkpoint blockade. We investigated peripheral blood T-cell dynamics following bronchoscopic cryotherapy and subsequent pembrolizumab-based first-line therapy in metastatic non-small-cell lung cancer (NSCLC). In this prospective, randomized, controlled single-center study, patients with metastatic NSCLC were randomized into treatment groups of bronchoscopic cryotherapy performed 7 (±1) days before standard-of-care pembrolizumab (with or without platinum-based chemotherapy) or to standard-of-care therapy alone. Peripheral blood mononuclear cells were analyzed by flow cytometry at baseline, week 3, and week 6. Radiologic response was assessed using RECIST 1.1. Progression-free survival (PFS) and overall survival (OS) were evaluated using the Kaplan–Meier test and Cox regression. Flow cytometry was performed on 34 cryotherapy and 42 control patients. The cryotherapy group demonstrated a decrease in circulating CD4+ T cells (p = 0.002) and an increase in circulating CD8+ T cells (p = 0.013) by week 6. CD25+FOXP3+CD4+ Tregs decreased from baseline to week 3 (p = 0.024) and remained reduced through week 6. Overall response rate was higher in the cryotherapy group (41.2% vs. 16.7%; p = 0.022), while PFS and OS were numerically longer, although not statistically different (median PFS 9.5 vs. 5.3 months; median OS 17.6 vs. 14.8 months). The decrease in Tregs at week 3 was observed to predict better PFS. In patients with metastatic NSCLC receiving first-line pembrolizumab with or without chemotherapy, the addition of bronchoscopic cryotherapy was associated with a detectable peripheral immune remodeling and a higher objective response rate, whereas PFS and OS were numerically longer but not statistically different. Full article
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