scholarly journals Comprehensive Perspective for Lung Cancer Characterisation Based on AI Solutions Using CT Images

2020 ◽  
Vol 10 (1) ◽  
pp. 118
Author(s):  
Tania Pereira ◽  
Cláudia Freitas ◽  
José Luis Costa ◽  
Joana Morgado ◽  
Francisco Silva ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Targeted Therapies ◽  
Treatment Plan ◽  
Personalised Medicine ◽  
Growth Factor Receptor ◽  
Accurate Diagnosis ◽  
Cancer Development ◽  
Thoracic Computed Tomography ◽  
Plan Selection ◽  
Ct Image Analysis

Lung cancer is still the leading cause of cancer death in the world. For this reason, novel approaches for early and more accurate diagnosis are needed. Computer-aided decision (CAD) can be an interesting option for a noninvasive tumour characterisation based on thoracic computed tomography (CT) image analysis. Until now, radiomics have been focused on tumour features analysis, and have not considered the information on other lung structures that can have relevant features for tumour genotype classification, especially for epidermal growth factor receptor (EGFR), which is the mutation with the most successful targeted therapies. With this perspective paper, we aim to explore a comprehensive analysis of the need to combine the information from tumours with other lung structures for the next generation of CADs, which could create a high impact on targeted therapies and personalised medicine. The forthcoming artificial intelligence (AI)-based approaches for lung cancer assessment should be able to make a holistic analysis, capturing information from pathological processes involved in cancer development. The powerful and interpretable AI models allow us to identify novel biomarkers of cancer development, contributing to new insights about the pathological processes, and making a more accurate diagnosis to help in the treatment plan selection.

scholarly journals PHARMACOTHERAPY OF NON-SMALL CELL LUNG CANCER: A SHORT REVIEW

2018 ◽  
Vol 11 (3) ◽  
pp. 7
Author(s):  
Balaji O
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Targeted Therapies ◽  
Advanced Disease ◽  
Growth Factor Receptor ◽  
The United States ◽  
Small Cell ◽  
Small Cell Lung ◽  
Anaplastic Lymphoma

 Lung cancer is a global health problem with non-small cell lung cancer (NSCLC) being the most common histopathological variant causing almost 28% deaths in the United States of America. Platinum compounds were the mainstay of treatment, and since past 10 years, various newer targeted therapies have come into play. Epidermal growth factor receptor and anaplastic lymphoma kinase mutations play a major role in the development of advanced disease. Hence, targeted therapies and immunotherapies will remain an integral part in the management of advanced disease. Hence, this review focuses on the newer drugs approved by Food and Drug Administration to treat NSCLC

scholarly journals Lymph/angiogenesis contributes to sex differences in lung cancer through oestrogen receptor alpha signalling

2019 ◽  
Vol 26 (2) ◽  
pp. 201-216 ◽  
Author(s):  
Charline Dubois ◽  
Natacha Rocks ◽  
Silvia Blacher ◽  
Irina Primac ◽  
Anne Gallez ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Oestrogen Receptor ◽  
Personalised Medicine ◽  
Tumour Microenvironment ◽  
Cancer Development ◽  
Lung Tumour ◽  
Lung Tumours ◽  
Oestrogen Receptor Alpha ◽  
Altered Blood ◽  
Immunocompetent Mice

Oestrogen signalling pathways are emerging targets for lung cancer therapy. Unravelling the contribution of oestrogens in lung cancer development is a pre-requisite to support the development of sex-based treatments and identify patients who could potentially benefit from anti-oestrogen treatments. In this study, we highlight the contribution of lymphatic and blood endothelia in the sex-dependent modulation of lung cancer. The orthotopic graft of syngeneic lung cancer cells into immunocompetent mice showed that lung tumours grow faster in female mice than in males. Moreover, oestradiol (E2) promoted tumour development, increased lymph/angiogenesis and VEGFA and bFGF levels in lung tumours of females through an oestrogen receptor (ER) alpha-dependent pathway. Furthermore, while treatment with ERb antagonist was inefficient, ERa antagonist (MPP) and tamoxifen decreased lung tumour volumes, altered blood and lymphatic vasculature and reduced VEGFA and bFGF levels in females, but not in males. Finally, the quantification of lymphatic and blood vasculature of lung adenocarcinoma biopsies from patients aged between 35 and 55 years revealed more extensive lymphangiogenesis and angiogenesis in tumour samples issued from women than from men. In conclusion, our findings highlight an E2/ERa-dependent modulation of lymphatic and blood vascular components of lung tumour microenvironment. Our study has potential clinical implication in a personalised medicine perspective by pointing to the importance of oestrogen status or supplementation on lung cancer development that should be considered to adapt therapeutic strategies.

scholarly journals Genetic Alteration Profiling of Chinese Lung Adenocarcinoma and Its Effect on Targeted Therapy Efficacy

2021 ◽  
Vol 11 ◽  
Author(s):  
Jie Liu ◽  
Wang-yang Xu ◽  
Maosong Ye ◽  
Zilong Liu ◽  
Chun Li
Keyword(s):  
Lung Cancer ◽  
Tyrosine Kinase ◽  
Lung Adenocarcinoma ◽  
Receptor Tyrosine Kinase ◽  
Targeted Therapies ◽  
Kinase Inhibitors ◽  
Eastern China ◽  
Growth Factor Receptor ◽  
Treatment Decision ◽  
Tyrosine Kinase 2

BackgroundNon-small cell lung cancer (NSCLC) is the most common type of lung cancer and a highly heterogeneous disease with a diversity of phenotypes and genotypes in different populations. The purpose of this study is to investigate oncogenic alterations of lung adenocarcinoma (LUAD) in eastern China and their significance in targeted therapies.MethodsThis study enrolled 101 LUAD patients and used a customized DNA panel to detect molecular alterations. Comprehensive analysis of mutations and clinical application of genomic profiling was carried out.ResultsThe most commonly mutated genes were epidermal growth factor receptor (EGFR) (53%) and tumor protein p53 (TP53) (32%). The less frequently mutated genes were erb-b2 receptor tyrosine kinase 2 (ERBB2) (25%), ATR serine/threonine kinase (ATR) (20%), CCAAT enhancer binding protein alpha (CEBPA) (16%), RB transcriptional corepressor 1 (RB1) (16%), transcription factor 7 like 2 (TCF7L2) (14%), ROS proto-oncogene 1, receptor tyrosine kinase (ROS1) (12%) and spectrin alpha, erythrocytic 1 (SPTA1) (12%). Among them, the frequency of ERBB2, ATR, CEBPA, RB1 and TCF7L2 mutations was much higher than that in the databases. Seventy percent of the patients harbored at least one actionable alteration according to the OncoKB evidence. CEBPA mutations affected the efficacy of EGFR-tyrosine kinase inhibitors. ERBB2, CEBPA and TCF7L2 mutated tumors tend to have higher tumor mutation burden (TMB).ConclusionsLUAD patients from eastern China have a unique profile of mutations. The targeted DNA panel is helpful for personalized treatment decision of LUAD patients, and specific mutations may affect the efficacy of targeted therapies.

scholarly journals Real-world implementation of sequential targeted therapies for EGFR-mutated lung cancer

2021 ◽  
Vol 13 ◽  
pp. 175883592199650
Author(s):  
Nikolaus Magios ◽  
Farastuk Bozorgmehr ◽  
Anna-Lena Volckmar ◽  
Daniel Kazdal ◽  
Martina Kirchner ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Targeted Therapies ◽  
Kinase Inhibitors ◽  
Growth Factor Receptor ◽  
Resistance Mechanisms ◽  
Subsequent Treatment ◽  
Clinical Deterioration ◽  
Published Data ◽  
Tki Treatment ◽  
Nsclc Patients

Background: Epidermal growth factor receptor-mutated (EGFR+) non-small-cell lung cancer (NSCLC) patients failing tyrosine kinase inhibitors (TKI) can benefit from next-line targeted therapies, but implementation is challenging. Methods: EGFR+ NSCLC patients treated with first/second-generation (1G/2G) TKI at our institution with a last follow-up after osimertinib approval (February 2016), were analyzed retrospectively, and the results compared with published data under osimertinib. Results: A total of 207 patients received erlotinib (37%), gefitinib (16%) or afatinib (47%). The median age was 66 years, with a predominance of female (70%), never/light-smokers (69%). T790M testing was performed in 174/202 progressive cases (86%), positive in 93/174 (53%), and followed by osimertinib in 87/93 (94%). Among the 135 deceased patients, 94 (70%) received subsequent systemic treatment (43% chemotherapy, 39% osimertinib), while 30% died without, either before (4%) or after progression, due to rapid clinical deterioration (22%), patient refusal of further therapy (2%), or severe competing illness (2%). Lack of subsequent treatment was significantly (4.5x, p < 0.001) associated with lack of T790M testing, whose most frequent cause (in approximately 50% of cases) was also rapid clinical decline. Among the 127 consecutive patients with failure of 1G/2G TKI started after November 2015, 47 (37%) received osimertinib, with a median overall survival of 36 months versus 24 and 21 months for patients with alternative and no subsequent therapies ( p = 0.003). Conclusion: Osimertinib after 1G/2G TKI failure prolongs survival, but approximately 15% and 30% of patients forego molecular retesting and subsequent treatment, respectively, mainly due to rapid clinical deterioration. This is an important remediable obstacle to sequential TKI treatment for EGFR+ NSCLC. It pertains also to other actionable resistance mechanisms emerging under 1G/2G inhibitors or osimertinib, whose rate for lack of next-line therapy is similar (approximately 35% in the FLAURA/AURA3 trials), and highlights the need for closer monitoring alongside broader profiling of TKI-treated EGFR+ NSCLC in the future.

Epidermal Growth Factor Receptor (EGFR) Targeted Therapies in Non- Small Cell Lung Cancer (NSCLC)

2006 ◽  
Vol 1 (1) ◽  
pp. 1-13 ◽  
Author(s):  
Giulio Metro ◽  
Giovanna Finocchiaro ◽  
Luca Toschi ◽  
Stefania Bartolini ◽  
Elisabetta Magrini ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Epidermal Growth Factor Receptor ◽  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Small Cell Lung Cancer ◽  
Targeted Therapies ◽  
Growth Factor Receptor ◽  
Small Cell ◽  
Small Cell Lung ◽  
Epidermal Growth

OC-0319: Multi-criteria optimization individualizes treatment plan selection in stage III lung cancer patients

2014 ◽  
Vol 111 ◽  
pp. S124-S125
Author(s):  
E. Loeters ◽  
J. Politiek ◽  
T. Eiland ◽  
H. Westendorp ◽  
R. Kattevilder ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Treatment Plan ◽  
Stage Iii ◽  
Lung Cancer Patients ◽  
Plan Selection

Strategies for Overcoming Acquired Resistance to Epidermal Growth Factor Receptor–Targeted Therapies in Lung Cancer

2012 ◽  
Vol 136 (10) ◽  
pp. 1205-1209 ◽  
Author(s):  
Geoffrey R. Oxnard
Keyword(s):  
Lung Cancer ◽  
Epidermal Growth Factor Receptor ◽  
Growth Factor ◽  
Epidermal Growth Factor ◽  
Targeted Therapies ◽  
Acquired Resistance ◽  
Growth Factor Receptor ◽  
Egfr Inhibition ◽  
Epidermal Growth ◽  
Egfr Mutant

Acquired resistance to targeted therapy in epidermal growth factor receptor (EGFR)–mutant lung cancer represents a valuable model for considering strategies of overcoming different types of cellular resistance mechanisms. Using existing data on resistance in EGFR-mutant lung cancer, this review will discuss 3 basic approaches for overcoming resistance to EGFR-targeted therapies: intensification of EGFR inhibition, combination of EGFR inhibitors with other targeted therapies, and changing to anticancer therapies acting via alternate pathways.

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