New Targets in Non-Small Cell Lung Cancer

Identifying druggable targets from active constituents of Azadirachta indica A. Juss. for non-small cell lung cancer using network pharmacology and validation through molecular docking

INTRODUCTION

Azadirachta indica A. Juss. is a well-known medicinal plant that has been used traditionally to cure various ailments in every corner of the globe. There are many in vitro and in vivo experimental evidences in connection with the bioactivity of the extracts of this plant. Lung cancer is the deadliest form of cancer and contributes to the most cancer related deaths. The mode of action of anticancer components of this plant is still to be established explicitly.

OBJECTIVE

The objective of this study is to identify druggable targets of active constituents of A. indica A. Juss. for non-small cell lung cancer (NSCLC) using network pharmacology and validation of activity through molecular docking analysis.

METHODOLOGY

Targets of all the active phytochemicals from A. indica were predicted and genes related to NSCLC were retrieved. A protein-protein interaction (PPI) network of the overlapping genes were prepared. Various databases and servers were employed to analyse the disease pathway enrichment analysis of the clustered genes. Validation of the gene/protein activity was achieved by performing molecular docking, and ADMET profiling of selected phytocompounds was performed.

RESULT

Gene networking revealed three key target genes as EGFR, BRAF and PIK3CA against NSCLC by the active components of A. indica. Molecular docking and ADMET analysis further validated that desacetylnimbin, nimbandiol, nimbin, nimbinene, nimbolide, salannin and vepinin are the best suited anti- NSCLC among all the phytocompounds present in this plant.

CONCLUSION

The present study has provided a better understanding of the pharmacological effects of active components from A. indica and its potential therapeutic effect on NSCLC.

A comprehensive and current review on the role of flavonoids in lung cancer-Experimental and theoretical approaches

BACKGROUND

It is well-known that flavonoids, which can be easily obtained from many fruits and vegetables are widely preferred in the treatment of some important diseases. Some researchers noted that these chemical compounds exhibit high inhibition effect against various cancer types. Many experimental studies proving this ability of the flavonoids with high antioxidant activity are available in the literature.

PUROPOSE

The main aim of this review is to summarize comprehensively anticancer properties of flavonoids against the lung cancer in the light of experimental studies and well-known theory and electronic structure principles. In this review article, more detailed and current information about the using of flavonoids in the treatment of lung cancer is presented considering theoretical and experimental approaches.

STUDY DESIGN

In addition to experimental studies including the anticancer effects of flavonoids, we emphasized the requirement of the well-known electronic structure principle in the development of anticancer drugs. For this aim, Conceptual Density Functional Theory should be considered as a powerful tool. Searching the databases including ScienceDirect, PubMed and Web of Science, the suitable reference papers for this project were selected.

METHODS

Theoretical tools like DFT and Molecular Docking provides important clues about anticancer behavior and drug properties of molecular systems. Conceptual Density Functional Theory and CDFT based electronic structure principles and rules like Hard and Soft Acid-Base Principle (HSAB), Maximum Hardness Principle, Minimum Polarizability, Minimum Electrophilicity Principles and Maximum Composite Hardness Rule introduced by one of the authors of this review are so useful to predict the mechanisms and powers of chemical systems. Especially, it cannot be ignored the success of HSAB Principle in the explanations and highlighting of biochemical interactions.

RESULTS

Both theoretical analysis and experimental studies confirmed that flavonoids have higher inhibition effect against lung cancer. In addition to many superior properties like anticancer activity, antimicrobial activity, antioxidant activity, antidiabetic effect of flavonoids, their toxicities are also explained with the help of published popular papers. Action modes of the mentioned compounds are given in detail.

CONCLUSION

The review includes detailed information about the mentioned electronic structure principles and rules and their applications in the cancer research. In addition, the epidemiology and types of lung cancer anticancer activity of flavonoids in lung cancer are explained in details.

Circular RNA circLDB2 functions as a competing endogenous RNA to suppress development and promote cisplatin sensitivity in non-squamous non-small cell lung cancer

Background

Circular RNAs (circRNAs) are covalently closed RNAs and are implicated in the development of non‐small cell lung cancer (NSCLC). Here, we identified the precise actions of circRNA LIM domain binding 2 (circLDB2, hsa_circ_0069244) in non‐squamous NSCLC development and drug sensitivity.

Methods

CircLDB2, microRNA (miR)‐346, and LIM and calponin‐homology domains 1 (LIMCH1) were quantified by quantitative real‐time polymerase chain reaction (qRT‐PCR) or western blot. Ribonuclease R (RNase R), actinomycin D, and subcellular localization assays were used to characterize circLDB2. Cell proliferation and viability, colony formation, apoptosis, migration, and invasion were gauged by Cell Counting Kit‐8 (CCK‐8), colony formation, flow cytometry, wound‐healing, and transwell assays, respectively. RNA immunoprecipitation (RIP), RNA pull‐down, and dual‐luciferase reporter assays were used to verify the direct relationship between miR‐346 and circLDB2 or LIMCH1. Animal studies were performed to evaluate the impact of circLDB2 in vivo.

Results

CircLDB2 was underexpressed in non‐squamous NSCLC and was identified as a bona fide circular transcript. Overexpression of circLDB2 impeded cell proliferation, migration, invasion, and enhanced apoptosis and cisplatin sensitivity in vitro, as well as promoted the antitumor effect of cisplatin in vivo. CircLDB2 regulated cell functional behaviors and cisplatin sensitivity by sponging miR‐346. LIMCH1 was a direct and functional target of miR‐346. Furthermore, circLDB2 acted as a competing endogenous RNA (ceRNA) for miR‐346 to induce LIMCH1 expression.

Conclusion

Our findings demonstrated that circLDB2 impeded non‐squamous NSCLC development and enhanced cisplatin sensitivity partially by acting as a ceRNA, highlighting circLDB2 as a promising candidate for the development of novel antitumor therapies.

A comparison of mRNA and circRNA expression between squamous cell carcinoma and adenocarcinoma of the lungs

Lung squamous cell carcinoma (LUSC) and lung adenocarcinoma (LUAD) are the two major subtypes of non-small-cell lung cancer (NSCLC). This study aimed to compare mRNA and circRNA expression patterns between LUSC and LUAD. Cancer tissues from 8 LUSC patients and 12 LUAD patients were collected to obtain mRNA and circRNA expression profiles. The differentially expressed mRNAs (DEmRNAs) and circRNAs (DE-circRNAs) between LUSC and LUAD were screened. Afterwards, miRNA-DEcircRNA pairs and miRNA-DEmRNA pairs were predicted to construct a competing endogenous RNAs (ceRNAs) network, followed by functional enrichment analysis and survival analysis. In total, 635 DEmRNAs and 245 DEcircRNAs were obtained. The ceRNA analysis revealed that genes, such as EPHA2, EPHA7, NTRK2, CDK6, hsa_circ_027570, hsa_circ_006089, and hsa-circ_035997, had distinct expression patterns between LUSC and LUAD. Also, functional enrichment analysis indicated that DEmRNAs were mainly enriched in ERK1 and ERK2 cascade. Survival analyses suggested that STXBP1 and PMEPA1 were associated the prognosis of with both LUAD and LUSC, whereas EPHA2 and CDK6 might serve as prognostic factors for LUSC and LUAD, respectively. In conclusion, genes such as EPHA2, EPHA7, NTRK2, and CDK6 had different patterns in the two major histological subtypes of NSCLC. Notably, EPHA2 and CDK6 might be considered as potential therapeutic targets for LUSC and LUAD, respectively.

Pulmonary Lymphoepithelioma-Like Carcinoma: A Mini-Review

Pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare and distinct subtype of non-small-cell lung carcinoma associated with Epstein–Barr virus (EBV) infection. We systematically reviewed the recent research that expands our knowledge about PLELC, with main focus on its genetic profile, tumor-infiltrating environment, PD-L1 expression, circulating EBV-DNA, clinical utility of 18F-FDG PET/CT, and treatment strategy. A low frequency of typical driver mutations and widespread existence of copy number variations was detected in PLELC. Persistent EBV infection may trigger intense infiltration of lymphocytes, representing enhanced tumor immunity and possibly resulting in a better prognosis. Circulating EBV-DNA in the plasma of patients with PLELC may predict disease progression and response to therapy. PLELC is 18F-FDG avid, and 18F-FDG PET may help refine palliation strategies and subsequently improve the prognosis. Most of the reported patients present at early and resectable stage, and surgical resection with curative intent is the preferred approach. There is currently no consensus on the regimen of chemotherapy for patients with advanced stages. EGFR-targeted therapies seem to have no therapeutic effect, and the clinical impact of PD-1/PD-L1 therapy is uncertain but worthy of further research.

Progress in Research on the Role of Flavonoids in Lung Cancer

Lung cancer is the leading cause of cancer deaths worldwide. Therefore, for the prevention, diagnosis, prognosis and treatment of lung cancer, efficient preventive strategies and new therapeutic strategies are needed to face these challenges. Natural bioactive compounds and particular flavonoids compounds have been proven to have an important role in lung cancer prevention and of particular interest is the dose used for these studies, to underline the molecular effects and mechanisms at a physiological concentration. The purpose of this review was to summarize the current state of knowledge regarding relevant molecular mechanisms involved in the pharmacological effects, with a special focus on the anti-cancer role, by regulating the coding and non-coding genes. Furthermore, this review focused on the most commonly altered and most clinically relevant oncogenes and tumor suppressor genes and microRNAs in lung cancer. Particular attention was given to the biological effect in tandem with conventional therapy, emphasizing the role in the regulation of drug resistance related mechanisms.

[MET Exon 14 Skipping Mutations in Non-small Cell Lung Cancer]

近年来，靶向治疗在非小细胞肺癌（non-small cell lung cancer, NSCLC）患者的治疗中取得了巨大成功。间质-上皮细胞转化因子（mesenchymal-epithelial transition factor, MET）被认为是继表皮生长因子受体（epidermal growth factor receptor, EGFR）、间变性淋巴瘤激酶（anaplastic lymphoma kinase, ALK）之后又一重要的NSCLC分子治疗靶点。MET 14外显子跳跃突变患者在一些临床试验及个案报道中显示出对MET抑制剂良好的疗效，提示MET 14外显子跳跃突变或可成为靶向治疗的良好指标，但这仍需大样本量的临床研究来证实。本文就MET 14外显子跳跃突变的分子机制、人群特征、治疗策略及耐药机制作一综述。

Associations of sirtuins with clinicopathological parameters and prognosis in non-small cell lung cancer

BACKGROUND

Lung cancer is the leading cause of cancer-related death worldwide and it is critical to discover specific biomarkers to provide better individualized treatment and subsequently better prognosis. The sirtuins (SIRT1-7) have been reported to be involved in cancers including non-small cell lung cancer (NCSLC), however, the results are not consistent and not all the seven sirtuins are explored and compared.

METHODS

TCGA data was downloaded and used to investigate and compare the associations of sirtuins mRNA levels with clinicopathological parameters and prognosis in NSCLC.

RESULTS

Our results suggested SIRT1, SIRT3, SIRT4, and SIRT7 were highly expressed in adeno-carcinoma (ADC) patients and female patients while SIRT5 were highly expressed in squamous cell carcinoma (SCC) patients and male patients. Associations of high SIRT7 with younger onset age, high SIRT1 with distant metastasis and low T stage, and high SIRT4 with high T stage and TNM stage were also found. Kaplan-Meier plot curves and univariate Cox proportional regression analyses indicated that high SIRT2, SIRT4, and SIRT6 expressions were associated with longer overall survival (OS) time. Multivariate analyses indicated that SIRT2 and SIRT6 were still associated with OS. For recurrence-free survival (RFS), high SIRT1 expression was significantly associated with shorter RFS time while high SIRT2-3 and SIRT5-7 expressions were associated with longer RFS time in univariate analyses. After adjusting the confounding factors, significant associations were still found in SIRT1-2 and SIRT5-7 but not in SIRT3. We also stratified the patients by combining SIRT1 and SIRT2 and revealed that the combination of SIRT1 and SIRT2 was a better prediction model for RFS in NSCLC. To preliminarily understand the potential mechanisms of sirtuins in NSCLC carcinogenesis, the genes co-expressed with sirtuins were analyzed and annotated.

CONCLUSION

sirtuins might be the potential therapy targets and prognostic biomarkers in NSCLC.

Long non-coding RNAs function as novel predictors and targets of non-small cell lung cancer: a systematic review and meta-analysis

OBJECTIVES

Non-small cell lung cancer (NSCLC) is associated with high morbidity and mortality, leading the understanding the pathogenesis paramount. Recent studies suggest that long non-coding RNAs (lncRNAs) play an important role in NSCLC. We conducted a systematic review to examine the relationship between lncRNAs and NSCLC.

MATERIALS AND METHODS

We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) to estimate overall survival (OS), and odds ratios (ORs) and 95% CIs to assess clinicopathological parameters. Also, pooled sensitivity and specificity values were used to measure the diagnostic value of lncRNAs for NSCLC. Finally, we summarized the molecular mechanisms underlying the activity of lncRNAs in NSCLC.

RESULTS

We found that high expression of oncogenic lncRNAs was associated with a poor prognosis (OS: HR, 1.18; 95% CI, 1.14-1.22) and poor clinicopathological characteristics (tumor size: OR, 2.74 or 2.04; 95% CI, 1.66-4.52 or 1.09-3.79 based on the two classification criterias; lymph node metastasis: OR, 3.30; 95% Cl, 2.42-4.49), Also, high expression of tumor-suppressor lncRNAs was correlated with longer survival times (OS: HR, 0.54; 95% CI, 0.44-0.66) and improved clinical characteristics (tumor size: OR, 0.33 or 0.28; 95% CI, 0.14-0.75 or 0.18-0.45; lymph node metastasis: OR, 0.37; 95% Cl, 0.26-0.52). Furthermore, we found that lncRNAs could be used as serum biomarkers of NSCLC (sensitivity: 0.81; 95% CI, 0.72-0.87; specificity: 0.83; 95% CI, 0.73-0.90). Finally, lncRNAs regulated expression of key proteins, thereby mediating development of a malignant phenotype.

CONCLUSIONS

lncRNAs have significant clinical value in NSCLC and could function as novel predictors of disease and/or as therapeutic targets.

Concomitant Non-Small Cell Lung Cancer and Hairy Cell Leukemia in a Patient Harboring BRAF-V600E Mutation in Both Tissues: A Case Report

The BRAF-V600E mutation has been established as a signature alteration occurring almost universally in hairy cell leukemia. Moreover, it can be detected in a small percentage of patients with non-small cell lung cancer. We report the case of a patient with a metastatic BRAF-V600E-mutated lung adenocarcinoma suffering from concomitant hairy cell leukemia. The identification of an identical BRAF mutation in both malignancies raises physiopathological considerations and might offer unique therapeutic strategies for this group of patients.

SIRT3 deacetylates and promotes degradation of P53 in PTEN-defective non-small cell lung cancer

PURPOSE

In non-small cell lung cancer (NSCLC), success of targeted therapy has promoted researches explicitly orientated based on genetic background. Although PTEN deficiency is common in NSCLC, carcinogenesis about such genetic type has not been fully explored. Here, we have found that classical tumor suppressor P53 could be modulated by deacetylase sirtuin-3 (SIRT3) depending on the PTEN condition in NSCLC, which may be a novel breakpoint for handling PTEN deficiency NSCLC.

METHODS

First, we examined SIRT3 and P53 expression files in PTEN-deficient NSCLC clinical samples and investigated their correlation. Second, we built SIRT3 high or low expression models in different PTEN conditions by plasmid overexpression or si-RNA interference in NSCLC cell lines and explored the effect of SIRT3 upon P53. Furthermore, we investigated the influence of SIRT3 upon the ubiquitin-proteasome dependent degradation pathway of P53 in PTEN-deficient NSCLC cell lines. Finally, we probed into the deacetylation modification of P53 via SIRT3.

RESULTS

We found that SIRT3 expression was strongly positive and P53 expression was almost negative in PTEN-deficient NSCLC clinical samples. Further, we demonstrated that SIRT3 promoted degradation of P53 in PTEN-deficient NSCLC cell lines via the ubiquitin-proteasome pathway. Finally, we demonstrated that SIRT3 could deacetylate P53 at lysines 320 and 382, which may account for the observed degradation of P53 in PTEN-deficient tumor cells.

CONCLUSIONS

We have identified a novel mechanism by which P53 was inactivated via SIRT3 in PTEN-deficient cells. This may shed light on the mechanisms underlying the malignancy of PTEN-deficient NSCLC.

Clinicopathological characteristics and survival outcomes in adenosquamous carcinoma of the lung: a population-based study from the SEER database

Adenosquamous carcinoma (ASC) of the lung is an unusual histology type in non-small-cell lung cancers. Due to its rarity, the clinicopathological characteristics and survival outcomes of the lung ASC are incompletely understood. We used the Surveillance, Epidemiology, and End Results (SEER) database to enroll 203,208 eligible patients, including 4,245 ASC, 124,253 adenocarcinoma (ADC) and 74,710 squamous cell carcinoma (SCC) patients. To date, this is the largest cohort in a study for ASC of the lung. With regard to age, sex, race, year of diagnosis, tumor size and SEER stage, ASC was intermediate between ADC and SCC. However, compared with ADC and SCC patients, ASC patients presented with a higher tumor grade and lower prevalence of nodal metastasis. More ASC patients underwent surgery and a lower proportion underwent radiation treatment and chemotherapy. Kaplan-Meier analysis showed that ASC patients had a better prognosis than ADC and SCC patients, but stratified analysis showed that the prognosis of ASC patients was worse than that of ADC and SCC patients in surgery and non-surgery subgroup. Multivariate analysis further confirmed that the ASC histology type was a risk factor for poor prognosis with respect to ADC and SCC. Using the propensity score matching to 1:1 match ASC with ADC or SCC, we found that ASC patients had worse survival than ADC and SCC patients. Subgroup analysis further demonstrated that ASC was a more aggressive histology type with a worse prognosis. These results provided a deep understanding of ASC, which contributed to better clinical diagnosis and treatment.

Circulating microRNA-34 family low expression correlates with poor prognosis in patients with non-small cell lung cancer

Background

To evaluate the association of plasma miR-34a/b/c expressions with the clinicopathological properties and the prognosis in non-small cell lung cancer (NSCLC) patients.

Methods

A total of 196 NSCLC patients were recruited in the study. Plasma sample and tumor tissue sample were collected. Total RNA was extracted from plasma and tissue samples, and microR-34a/b/c expression was evaluated by real-time polymerase chain reaction (PCR).

Results

MiR-34a and miR-34c in plasma were positively associated with that in tumor tissue (P<0.001 and P=0.001, respectively). Plasma miR-34a expression was negatively correlated with lymph node metastasis (P=0.002), also tissue miR-34a expression was negatively associated with lymph node metastasis (P=0.018). Furthermore, plasma miR-34a high expression was correlated with prolonged disease-free survival (DFS) (P=0.011) and overall survival (OS) (P=0.011) compared to low expression, and plasma miR-34c high expression could predict longer DFS (P=0.038) than low expression, while no correlation of plasma miR-34b with DFS and OS was discovered. In terms of tissue sample, worse DFS was associated with miR-34a (P=0.002) and miR-34c (P=0.032) low expressions compared with high expressions, and miR-34a (P<0.001), as well as miR-34c (P=0.003) high expressions were associated with longer OS than low expressions. Plasma miR-34a was correlated with prolonged DFS and OS in univariate Cox model, while it could not independently predict DFS and OS of NSCLC patients in multivariate Cox model.

Conclusions

In conclusion, circulating miR-34a and miR-34c might be served as novel prognostic biomarkers in NSCLC patients.

Association of GOLPH2 expression with survival in non-small-cell lung cancer: clinical implications and biological validation

AIM

We investigated the role of GOLPH2 in non-small-cell lung cancer (NSCLC).

METHODS

We analyzed the relationship between the expression of GOLPH2 and the clinical pathological characteristics of patients with NSCLC. The function of GOLPH2 in NSCLC cell lines was also explored through overexpression and knockdown studies.

RESULTS

The positive expression rate of GOLPH2 protein in NSCLC tissue was higher than that of normal lung tissue. We found that positive GOLPH2 expression was closely associated with unfavorable features of patients with NSCLC. The GOLPH2 expression was an independent predictor of the prognosis of patients with NSCLC. That GOLPH2 can promote the proliferation and invasion of NSCLC cells.

CONCLUSION

The GOLPH2 is a novel marker for NSCLC.

Endogenous microRNA-424 predicts clinical outcome and its inhibition acts as cancer suppressor in human non-small cell lung cancer

PURPOSE

We examined the expression, clinical correlation and functional mechanisms of endogenous microRNA-424 (miR-424) in human non-small cell lung cancer (NSCLC).

METHODS

Expression pattern of endogenous miR-424 was examined by qRT-PCR in clinical samples obtained from 233 NSCLC patients. Correlations between differential miR-424 expression level (low vs. high) and NSCLC patients' clinicopathological parameters or survival were statistically examined. In in vitro NSCLC H596 and SW900 cells, miR-424 was either upregulated or downregulation by lentiviral transduction. Their effects on cancer cell viability, proliferation, and cell-cycle transition were also examined.

RESULTS

MiR-424 expression was not different between NSCLC tumors and healthy lung tissues. However, it is much upregulated in NSCLC tumors associated with patients at advanced clinical stages. Statistical analyses demonstrated that high endogenous miR-424 expression in NSCLC tumors was significantly correlated with patients' advanced clinical stages, aggressive tumor metastasis, and short survival. In addition, Cox regression model predicted that endogenous miR-424 might be an independent prognostic marker in NSCLC. In in vitro NSCLC cell lines, miR-424 downregulation had a significant suppressing effect on cancer proliferation and G1 to S phase cell-cycle transition. On the other hand, miR-424 upregulation had no effect on NSCLC in vitro.

CONCLUSION

High endogenous miR-424 expression in tumors may predict poor prognosis of patients with NSCLC. Inhibiting endogenous miR-424 may also serve an effective cancer suppressor in NSCLC.