Diagnostic and therapeutic ERβ, HER2, BRCA biomakers in the histological subtypes of lung adenocarcinoma according to the IASLC/ATS/ERS classification

Impact of histopathological subtypes on invasive lung adenocarcinoma: from epidemiology to tumour microenvironment to therapeutic strategies

Lung adenocarcinoma is the most prevalent type of lung cancer, with invasive lung adenocarcinoma being the most common subtype. Screening and early treatment of high-risk individuals have improved survival; however, significant differences in prognosis still exist among patients at the same stage, especially in the early stages. Invasive lung adenocarcinoma has different histological morphologies and biological characteristics that can distinguish its prognosis. Notably, several studies have found that the pathological subtypes of invasive lung adenocarcinoma are closely associated with clinical treatment. This review summarised the distribution of various pathological subtypes of invasive lung adenocarcinoma in the population and their relationship with sex, smoking, imaging features, and other histological characteristics. We comprehensively analysed the genetic characteristics and biomarkers of the different pathological subtypes of invasive lung adenocarcinoma. Understanding the interaction between the pathological subtypes of invasive lung adenocarcinoma and the tumour microenvironment helps to reveal new therapeutic targets for lung adenocarcinoma. We also extensively reviewed the prognosis of various pathological subtypes and their effects on selecting surgical methods and adjuvant therapy and explored future treatment strategies.

Treatment Response Biomarkers: Working Toward Personalized Radiotherapy for Lung Cancer

Owing to major advances in the field of radiation oncology, patients with lung cancer can now receive technically individualized radiotherapy treatments. Nevertheless, in the era of precision oncology, radiotherapy-based treatment selection needs to be improved as many patients do not benefit or are not offered optimum therapies. Cost-effective robust biomarkers can address this knowledge gap and lead to individuals being offered more bespoke treatments leading to improved outcome. This narrative review discusses some of the current achievements and challenges in the realization of personalized radiotherapy delivery in patients with lung cancer.

Selection of potential targets for stratifying congenital pulmonary airway malformation patients with molecular imaging: is MUC1 the one?

Currently there is a global lack of consensus about the best treatment for asymptomatic congenital pulmonary airway malformation (CPAM) patients. The somatic KRAS mutations commonly found in adult lung cancer combined with mucinous proliferations are sometimes found in CPAM. For this risk of developing malignancy, 70% of paediatric surgeons perform a resection for asymptomatic CPAM. In order to stratify these patients into high- and low-risk groups for developing malignancy, a minimally invasive diagnostic method is needed, for example targeted molecular imaging. A prerequisite for this technique is a cell membrane bound target. The aim of this study was to review the literature to identify potential targets for molecular imaging in CPAM patients and perform a first step to validate these findings.A systematic search was conducted to identify possible targets in CPAM and adenocarcinoma in situ (AIS) patients. The most interesting targets were evaluated with immunofluorescent staining in adjacent lung tissue, KRAS+ CPAM tissue and KRAS- CPAM tissue.In 185 included studies, 143 possible targets were described, of which 20 targets were upregulated and membrane-bound. Six of them were also upregulated in lung AIS tissue (CEACAM5, E-cadherin, EGFR, ERBB2, ITGA2 and MUC1) and as such of possible interest. Validating studies showed that MUC1 is a potential interesting target.This study provides an extensive overview of all known potential targets in CPAM that might identify those patients at risk for malignancy and conducted the first step towards validation, identifying MUC1 as the most promising target.

Evaluation of fluorine-18-fluorodeoxyglucose PET/computed tomography and human epithelial growth factor receptor 2 expression in treatment-naive patients with lung adenocarcinoma

OBJECTIVE

Human epithelial growth factor receptor 2 (HER2) is overexpressed in several types of cancers. The correlation between tumor glucose activity and HER2 expression can vary. This study is a retrospective investigation of fluorine-18-fluorodeoxyglucose PET/computed tomography (18F-FDG PET/CT) and HER2 expression status in patients with lung adenocarcinoma.

METHODS

The maximum standard uptake value (SUVmax) of 18F-FDG PET/CT was compared with the HER2 expression status in pretreated patients with lung adenocarcinoma. Moreover, clinicopathological characteristics, including age, gender, smoking, serum tumor markers, tumor location, size, stage and genetic mutation, were also evaluated in groups with different HER2 expressions. Patients' progression-free survival (PFS) and overall survival (OS) were also analyzed.

RESULTS

Ninety-six patients with HER2 expression, including 54 patients with HER2 overexpression and 30 patients without HER2 expression were enrolled in this study. The primary pulmonary lesion was single in all patients, and all lesions were FDG-avid on PET/CT. SUVmax had no significant association with HER2 expression or overexpression in lung adenocarcinoma. Moreover, elevated serum CYFRA211 levels were obviously associated with HER2 expression but not associated with HER2 overexpression. There were no significant differences in other clinicopathological characteristics in groups with different HER2 expressions. Furthermore, multivariate Cox regression analysis revealed that SUVmax, HER2 expression and tumor node metastasis stage were independent predictors of PFS, and SUVmax, CYFRA211 and epidermal growth factor receptor mutation were independent predictors of OS.

CONCLUSION

SUVmax had no significant association with the HER2 expression status in lung adenocarcinoma. 18F-FDG PET/CT and HER2 expression could provide valuable prognostic information for treatment-naive patients with lung adenocarcinoma.