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Bianchi F, Le Noci V, Bernardo G, Gagliano N, Colombo G, Sommariva M, Palazzo M, Dalle-Donne I, Milzani A, Pupa S, Tagliabue E, Sfondrini L. Cigarette smoke sustains immunosuppressive microenvironment inducing M2 macrophage polarization and viability in lung cancer settings. PLoS One 2024; 19:e0303875. [PMID: 38776331 PMCID: PMC11111031 DOI: 10.1371/journal.pone.0303875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 05/01/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND It is amply demonstrated that cigarette smoke (CS) has a high impact on lung tumor progression worsening lung cancer patient prognosis and response to therapies. Alteration of immune cell types and functions in smokers' lungs have been strictly related with smoke detrimental effects. However, the role of CS in dictating an inflammatory or immunosuppressive lung microenvironment still needs to be elucidated. Here, we investigated the effect of in vitro exposure to cigarette smoke extract (CSE) focusing on macrophages. METHODS Immortalized murine macrophages RAW 264.7 cells were cultured in the presence of CS extract and their polarization has been assessed by Real-time PCR and cytofluorimetric analysis, viability has been assessed by SRB assay and 3D-cultures and activation by exposure to Poly(I:C). Moreover, interaction with Lewis lung carcinoma (LLC1) murine cell models in the presence of CS extract were analyzed by confocal microscopy. RESULTS Obtained results indicate that CS induces macrophages polarization towards the M2 phenotype and M2-phenotype macrophages are resistant to the CS toxic activity. Moreover, CS impairs TLR3-mediated M2-M1 phenotype shift thus contributing to the M2 enrichment in lung smokers. CONCLUSIONS These findings indicate that, in lung cancer microenvironment of smokers, CS can contribute to the M2-phenotype macrophages prevalence by different mechanisms, ultimately, driving an anti-inflammatory, likely immunosuppressive, microenvironment in lung cancer smokers.
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Affiliation(s)
- Francesca Bianchi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- U.O. Laboratorio di Morfologia Umana Applicata, IRCCS San Donato, Milan, Italy
| | - Valentino Le Noci
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Giancarla Bernardo
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Nicoletta Gagliano
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Michele Sommariva
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Unit of Microenvironment and Biomarkers of Solid Tumors, Department of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Michele Palazzo
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Aldo Milzani
- Department of Biosciences, University of Milan, Milan, Italy
| | - Serenella Pupa
- Unit of Microenvironment and Biomarkers of Solid Tumors, Department of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Elda Tagliabue
- Unit of Microenvironment and Biomarkers of Solid Tumors, Department of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lucia Sfondrini
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Unit of Microenvironment and Biomarkers of Solid Tumors, Department of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Loh CH, Koh PW, Ang DJM, Lee WC, Chew WM, Koh JMK. Characteristics of Singapore lung cancer patients who miss out on lung cancer screening recommendations. Singapore Med J 2024; 65:279-287. [PMID: 35366661 DOI: 10.11622/smedj.2022039] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 11/22/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The National Lung Screening Trial (NLST) identified individuals at high risk for lung cancer and showed that serial low-dose helical computed tomography could identify lung cancer at an earlier stage, leading to mortality reduction. However, there is little evidence regarding the effectiveness of the NLST criteria for the Asian population. METHODS We performed a retrospective audit in our hospital from January 2018 to December 2018, with the aim to describe the characteristics of patients diagnosed with lung cancer and to identify patients who would miss out on lung cancer screening when the NLST criteria was applied. RESULTS We found that only 38.1% of our cohort who were diagnosed with lung cancer met the NLST criteria strictly by age and smoking status. Patients who met the screening criteria would have derived significant benefits from it, as 85.4% of our patients had presented at an advanced stage and 54.6% died within 1 year. When the United States Preventive Services Task Force criteria was applied, it increased the sensitivity of lung cancer diagnosis to 58.7%. Only 15.5% of the female patients with lung cancer met the NLST criteria; their low smoking quantity was a significant contributing factor for exclusion. CONCLUSION The majority of Singapore patients diagnosed with lung cancer, especially females, would not have been identified with the NLST criteria. However, those who met the inclusion criteria would have benefited greatly from screening. Extending the screening age upper limit may yield benefits and improved sensitivity in the Singapore context.
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Affiliation(s)
- Chee Hong Loh
- Department of Respiratory and Critical Care Medicine, Changi General Hospital, Singapore
| | - Pearly Wenjia Koh
- Department of Respiratory and Critical Care Medicine, Changi General Hospital, Singapore
| | | | - Wei Chee Lee
- Department of Respiratory and Critical Care Medicine, Changi General Hospital, Singapore
| | - Wui Mei Chew
- Department of Respiratory and Critical Care Medicine, Changi General Hospital, Singapore
| | - Jansen Meng Kwang Koh
- Department of Respiratory and Critical Care Medicine, Changi General Hospital, Singapore
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Trojnar A, Knetki-Wróblewska M, Sobieraj P, Domagała-Kulawik J. Lung Cancer in Women-Sociodemographic, Clinical and Psychological Characteristics with Comparison to Men. J Clin Med 2024; 13:1450. [PMID: 38592288 PMCID: PMC10934020 DOI: 10.3390/jcm13051450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/25/2024] [Accepted: 02/29/2024] [Indexed: 04/10/2024] Open
Abstract
(1) Background: There is a difference in the course of lung cancer between women and men. Therefore, there is a need to evaluate various factors in the patient population treated in daily practice. The purpose of this study was to analyze the clinical, sociodemographic and psychological aspects of female lung cancer. To better express the results, we compared women and men. (2) Methods: Consecutive patients with a history of lung cancer treatment admitted to the outpatient oncology clinic (Department of Lung Cancer and Chest Tumours, Maria Skłodowska-Curie National Research Institute of Oncology in Warsaw) and the Department of Internal Medicine, Pulmonary Diseases and Allergy, were enrolled. We conducted analyses of the clinical, psychological and socioeconomic factors of women with lung cancer treated in everyday practice, including a comparison with a group of men. Demographic data were collected from a self-administered questionnaire. We used the Perceived Stress Scale (PSS-10) and Acceptance of Illness Scale (AIS) questionnaires for psychological evaluation. (3) Results: A total of 100 patients with confirmed primary lung cancer with a history of treatment were enrolled in the study (50 women and 50 men). We found a significantly shorter history of smoking in the group of women; at the same time, there were no differences in the reported incidence of COPD. Despite comparable results to men on the psychological questionnaire (PSS-10, AIS), women more often reported a willingness to be supported by a psychologist or psychiatrist due to lung cancer. However, they did not decide to consult them more often than men. Immunotherapy was a significantly less frequently used method in women. (4) Conclusions: We should be more active in finding out the willingness to consult a psychologist or psychiatrist among women with lung cancer. The diagnosis of COPD should be considered more often among women due to the lack of differences in the reported incidence of COPD between men and women, despite a clear contrast in the number of pack-years.
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Affiliation(s)
- Anna Trojnar
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Magdalena Knetki-Wróblewska
- Department of Internal Medicine, Pulmonary Diseases and Allergy, Medical University of Warsaw, 02-091 Warsaw, Poland;
- Department of Lung Cancer and Chest Tumors, Maria Skłodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Piotr Sobieraj
- Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Joanna Domagała-Kulawik
- Maria Skłodowska-Curie Medical Academy, Institute of Clinical Sciences, 00-136 Warsaw, Poland;
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4
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Wei X, Sun D, Gao J, Zhang J, Zhu M, Yu C, Ma Z, Fu Y, Ji C, Pei P, Yang L, Millwood IY, Walters RG, Chen Y, Du H, Jin G, Chen Z, Hu Z, Li L, Shen H, Lv J, Ma H. Development and evaluation of a polygenic risk score for lung cancer in never-smoking women: A large-scale prospective Chinese cohort study. Int J Cancer 2024; 154:807-815. [PMID: 37846649 DOI: 10.1002/ijc.34765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/30/2023] [Accepted: 09/13/2023] [Indexed: 10/18/2023]
Abstract
The proportion of lung cancer in never smokers is rising, especially among Asian women, but there is no effective early detection tool. Here, we developed a polygenic risk score (PRS), which may help to identify the population with higher risk of lung cancer in never-smoking women. We first performed a large GWAS meta-analysis (8595 cases and 8275 controls) to systematically identify the susceptibility loci for lung cancer in never-smoking Asian women and then generated a PRS using GWAS datasets. Furthermore, we evaluated the utility and effectiveness of PRS in an independent Chinese prospective cohort comprising 55 266 individuals. The GWAS meta-analysis identified eight known loci and a novel locus (5q11.2) at the genome-wide statistical significance level of P < 5 × 10-8 . Based on the summary statistics of GWAS, we derived a polygenic risk score including 21 variants (PRS-21) for lung cancer in never-smoking women. Furthermore, PRS-21 had a hazard ratio (HR) per SD of 1.29 (95% CI = 1.18-1.41) in the prospective cohort. Compared with participants who had a low genetic risk, those with an intermediate (HR = 1.32, 95% CI: 1.00-1.72) and high (HR = 2.09, 95% CI: 1.56-2.80) genetic risk had a significantly higher risk of incident lung cancer. The addition of PRS-21 to the conventional risk model yielded a modest significant improvement in AUC (0.697 to 0.711) and net reclassification improvement (24.2%). The GWAS-derived PRS-21 significantly improves the risk stratification and prediction accuracy for incident lung cancer in never-smoking Asian women, demonstrating the potential for identification of high-risk individuals and early screening.
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Affiliation(s)
- Xiaoxia Wei
- Department of Epidemiology and Biostatistics, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Dianjianyi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Jiaxin Gao
- Department of Epidemiology and Biostatistics, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jing Zhang
- Department of Epidemiology and Biostatistics, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Meng Zhu
- Department of Epidemiology and Biostatistics, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Zhimin Ma
- Department of Epidemiology and Biostatistics, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yating Fu
- Department of Epidemiology and Biostatistics, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Chen Ji
- Department of Epidemiology and Biostatistics, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Pei Pei
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Ling Yang
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
| | - Iona Y Millwood
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
| | - Robin G Walters
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
| | - Yiping Chen
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
| | - Huaidong Du
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
| | - Guangfu Jin
- Department of Epidemiology and Biostatistics, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
| | - Zhibin Hu
- Department of Epidemiology and Biostatistics, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- State Key Laboratory of Reproductive Medicine, Center for Global Health, Nanjing Medical University, Nanjing, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Hongbing Shen
- Department of Epidemiology and Biostatistics, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
- Research Units of Cohort Study on Cardiovascular Diseases and Cancers, Chinese Academy of Medical Sciences, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China
| | - Hongxia Ma
- Department of Epidemiology and Biostatistics, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
- Research Units of Cohort Study on Cardiovascular Diseases and Cancers, Chinese Academy of Medical Sciences, Beijing, China
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5
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Nguyen H, Lao C, Keenan R, Laking G, Elwood M, McKeage M, Wong J, Aitken D, Chepulis L, Lawrenson R. Ethnic differences in the characteristics of patients with newly diagnosed lung cancer in the Te Manawa Taki region of New Zealand. Intern Med J 2024; 54:421-429. [PMID: 37584463 DOI: 10.1111/imj.16202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 07/19/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Māori have three times the mortality from lung cancer compared with non-Māori. The Te Manawa Taki region has a population of 900 000, of whom 30% are Māori. We have little understanding of the factors associated with developing and diagnosing lung cancer and ethnic differences in these characteristics. AIMS To explore the differences in the incidence and characteristics of patients with newly diagnosed lung cancer between Māori and non-Māori. METHODS Patients were identified from the regional register. Incidence rates were calculated based on population data from the 2013 and 2018 censuses. The patient and tumour characteristics of Māori and non-Māori were compared. The analysis used Χ2 tests and logistic models for categorical variables and Student t tests for continuous variables. RESULTS A total of 4933 patients were included, with 1575 Māori and 3358 non-Māori. The age-standardised incidence of Māori (236 per 100 000) was 3.3 times higher than that of non-Māori. Māori were 1.3 times more likely to have an advanced stage of disease and 1.97 times more likely to have small cell lung cancer. Māori were more likely to have comorbidities, chronic obstructive pulmonary disease, cardiovascular disease and diabetes. They also had higher levels of social deprivation and tended to be younger, female and current smokers. CONCLUSIONS The findings point to the need to address barriers to early diagnosis and the need for system change including the need to introduce a lung cancer screening focussing on Māori. There is also the need for preventive programmes to address comorbidities that impact lung cancer outcomes as well as a continued emphasis on creating a smoke-free New Zealand.
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Affiliation(s)
- Ha Nguyen
- Medical Research Centre, University of Waikato, Hamilton, New Zealand
| | - Chunhuan Lao
- Medical Research Centre, University of Waikato, Hamilton, New Zealand
| | - Rawiri Keenan
- Medical Research Centre, University of Waikato, Hamilton, New Zealand
| | - George Laking
- Faculty of Medical and Health Sciences, University of Auckland and Te Whatu Ora Health New Zealand Te Toka Tumai, Auckland, New Zealand
| | - Mark Elwood
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Mark McKeage
- Faculty of Medical and Health Sciences, University of Auckland and Te Whatu Ora Health New Zealand Te Toka Tumai, Auckland, New Zealand
| | - Janice Wong
- Te Whatu Ora Health New Zealand, Hamilton, New Zealand
| | - Denise Aitken
- Te Whatu Ora Health New Zealand, Rotorua, New Zealand
| | - Lynne Chepulis
- Medical Research Centre, University of Waikato, Hamilton, New Zealand
| | - Ross Lawrenson
- Medical Research Centre, University of Waikato, Hamilton, New Zealand
- Te Whatu Ora Health New Zealand, Hamilton, New Zealand
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Fiste O, Gkiozos I, Charpidou A, Syrigos NK. Artificial Intelligence-Based Treatment Decisions: A New Era for NSCLC. Cancers (Basel) 2024; 16:831. [PMID: 38398222 PMCID: PMC10887017 DOI: 10.3390/cancers16040831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/12/2024] [Accepted: 02/17/2024] [Indexed: 02/25/2024] Open
Abstract
Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related mortality among women and men, in developed countries, despite the public health interventions including tobacco-free campaigns, screening and early detection methods, recent therapeutic advances, and ongoing intense research on novel antineoplastic modalities. Targeting oncogenic driver mutations and immune checkpoint inhibition has indeed revolutionized NSCLC treatment, yet there still remains the unmet need for robust and standardized predictive biomarkers to accurately inform clinical decisions. Artificial intelligence (AI) represents the computer-based science concerned with large datasets for complex problem-solving. Its concept has brought a paradigm shift in oncology considering its immense potential for improved diagnosis, treatment guidance, and prognosis. In this review, we present the current state of AI-driven applications on NSCLC management, with a particular focus on radiomics and pathomics, and critically discuss both the existing limitations and future directions in this field. The thoracic oncology community should not be discouraged by the likely long road of AI implementation into daily clinical practice, as its transformative impact on personalized treatment approaches is undeniable.
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Affiliation(s)
- Oraianthi Fiste
- Oncology Unit, Third Department of Internal Medicine and Laboratory, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (I.G.); (A.C.); (N.K.S.)
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7
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Yu Z, Ni P, Yu H, Zuo T, Liu Y, Wang D. Effectiveness of a single low-dose computed tomography screening for lung cancer: A population-based perspective cohort study in China. Int J Cancer 2024; 154:659-669. [PMID: 37819155 DOI: 10.1002/ijc.34741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 09/01/2023] [Accepted: 09/06/2023] [Indexed: 10/13/2023]
Abstract
The purpose of this perspective cohort study was to evaluate the effectiveness of low-dose computed tomography (LDCT) screening for lung cancer in China. This study was conducted under the China Urban Cancer Screening Program (CanSPUC). The analysis was based on participants aged 40 to 74 years from 2012 to 2019. A total of 255 569 eligible participants were recruited in the study. Among the 58 136 participants at high risk of lung cancer, 20 346 (35.00%) had a single LDCT scan (defined as the screened group) and 37 790 (65.00%) not (defined as the non-screened group). Overall, 1162 participants were diagnosed with lung cancer at median follow-up time of 5.25 years. The screened group had the highest cumulative incidence of lung cancer and the non-screened group had the highest cumulative lung cancer mortality and all-cause cumulative mortality. We performed inverse probability weighting (IPW) to account for potential imbalances, and Cox proportional hazards model to estimate the weighted association between mortality and LDCT scans. After IPW adjusted with baseline characteristics, the lung cancer incidence density was significantly increased (37.0% increase) (HR1.37 [95%CI 1.12-1.69]), lung cancer mortality was decreased (31.0% decrease) (HR0.69 [95%CI 0.49-0.97]), and the all-cause mortality was significantly decreased (23.0% lower) (HR0.77 [95% CI 0.68-0.87]) in the screened group. In summary, a single LDCT for lung cancer screening will reduce the mortality of lung cancer and all-cause mortality in China.
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Affiliation(s)
- Zhifu Yu
- Liaoning Office for Cancer Control and Research, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, China
| | - Ping Ni
- Liaoning Office for Cancer Control and Research, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, China
| | - Huihui Yu
- Liaoning Office for Cancer Control and Research, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, China
| | - Tingting Zuo
- Liaoning Office for Cancer Control and Research, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, China
| | - Yunyong Liu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Danbo Wang
- Department of Gynecology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, China
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Chiu HY, Wang TW, Hsu MS, Chao HS, Liao CY, Lu CF, Wu YT, Chen YM. Progress in Serial Imaging for Prognostic Stratification of Lung Cancer Patients Receiving Immunotherapy: A Systematic Review and Meta-Analysis. Cancers (Basel) 2024; 16:615. [PMID: 38339369 PMCID: PMC10854498 DOI: 10.3390/cancers16030615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/23/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
Immunotherapy, particularly with checkpoint inhibitors, has revolutionized non-small cell lung cancer treatment. Enhancing the selection of potential responders is crucial, and researchers are exploring predictive biomarkers. Delta radiomics, a derivative of radiomics, holds promise in this regard. For this study, a meta-analysis was conducted that adhered to PRISMA guidelines, searching PubMed, Embase, Web of Science, and the Cochrane Library for studies on the use of delta radiomics in stratifying lung cancer patients receiving immunotherapy. Out of 223 initially collected studies, 10 were included for qualitative synthesis. Stratifying patients using radiomic models, the pooled analysis reveals a predictive power with an area under the curve of 0.81 (95% CI 0.76-0.86, p < 0.001) for 6-month response, a pooled hazard ratio of 4.77 (95% CI 2.70-8.43, p < 0.001) for progression-free survival, and 2.15 (95% CI 1.73-2.66, p < 0.001) for overall survival at 6 months. Radiomics emerges as a potential prognostic predictor for lung cancer, but further research is needed to compare traditional radiomics and deep-learning radiomics.
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Affiliation(s)
- Hwa-Yen Chiu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (H.-Y.C.); (T.-W.W.); (M.-S.H.); (H.-S.C.)
- Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Chutong 310, Taiwan
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan
| | - Ting-Wei Wang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (H.-Y.C.); (T.-W.W.); (M.-S.H.); (H.-S.C.)
- Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Ming-Sheng Hsu
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (H.-Y.C.); (T.-W.W.); (M.-S.H.); (H.-S.C.)
| | - Heng-Shen Chao
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (H.-Y.C.); (T.-W.W.); (M.-S.H.); (H.-S.C.)
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Chien-Yi Liao
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (C.-Y.L.); (C.-F.L.)
| | - Chia-Feng Lu
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei 112, Taiwan; (C.-Y.L.); (C.-F.L.)
| | - Yu-Te Wu
- Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
| | - Yuh-Ming Chen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan
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9
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Rallis KS, Makker S, Ghose A, Sideris M. Assessing Radiological Response to Immunotherapy in Lung Cancer: An Evolving Arena. CANCER DIAGNOSIS & PROGNOSIS 2024; 4:1-8. [PMID: 38173660 PMCID: PMC10758839 DOI: 10.21873/cdp.10278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/01/2023] [Indexed: 01/05/2024]
Abstract
In the past decade, immune checkpoint inhibitors (ICIs) have entered the treatment landscape of non-small-cell lung cancer, signalling a paradigm shift within the field characterized by significant survival benefits for patients with advanced and metastatic disease, and especially those with non-targetable genetic oncogenic driver mutations. However, the shift towards immune-based treatments has created new challenges in oncology. Atypical immunotherapy response patterns, including pseudo-progression and hyperprogressive disease, as well as immune-related adverse events have generated the need for new methods to predict patient response to treatment. Hence, new versions of the traditional Response Evaluation Criteria for Solid Tumors (RECIST) have emerged to help characterise with better accuracy radiological findings concerning patient response classification to immunotherapy. This review discusses response evaluation criteria relevant to unique radiological findings observed in patients treated with immunotherapy for non-small-cell lung cancer.
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Affiliation(s)
- Kathrine S Rallis
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, U.K
- Barts Cancer Institute, Queen Mary University of London, London, U.K
| | - Shania Makker
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, U.K
- University College London Cancer Institute, London, U.K
| | - Aruni Ghose
- Department of Medical Oncology, Barts Cancer Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, U.K
- Department of Medical Oncology, Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, Northwood, U.K
- Department of Medical Oncology, Medway NHS Foundation Trust, Immuno-Oncology Clinical Network, Kent, U.K
| | - Michail Sideris
- Wolfson Institute of Population Health, Cancer Research UK Barts Centre, Queen Mary University of London, London, U.K
- Department of Gynaecological Oncology, Barts Health NHS Trust, Royal London Hospital, London, U.K
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10
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Daylan AEC, Miao E, Tang K, Chiu G, Cheng H. Lung Cancer in Never Smokers: Delving into Epidemiology, Genomic and Immune Landscape, Prognosis, Treatment, and Screening. Lung 2023; 201:521-529. [PMID: 37973682 DOI: 10.1007/s00408-023-00661-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 11/11/2023] [Indexed: 11/19/2023]
Abstract
Lung cancer in never smokers (LCINS) represents a growing and distinct entity within the broader landscape of lung malignancies. This review provides a comprehensive overview of LCINS, encompassing its epidemiologic trends, risk factors, distinct genomic alterations, clinical outcomes and the ongoing initiative aimed at formulating screening guidelines tailored to this unique population. As LCINS continues to gain prominence, understanding its intricate genomic landscape has become pivotal for tailoring effective therapeutic strategies. Moreover, LCINS does not meet the criteria for lung cancer screening as per the current guidelines. Hence, there is an urgent need to explore its heterogeneity in order to devise optimal screening guidelines conducive to early-stage detection. This review underscores the vital importance of detailed research to elucidate the multifaceted nature of LCINS, with the potential to shape future clinical management and screening recommendations for this unique and growing patient cohort.
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Affiliation(s)
- Ayse Ece Cali Daylan
- Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Emily Miao
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Kevin Tang
- Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
| | - Grace Chiu
- Scarsdale High School, Scarsdale, NY, USA
| | - Haiying Cheng
- Department of Oncology, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY, 10461, USA.
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11
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Meaza I, Williams AR, Lu H, Kouokam JC, Toyoda JH, Croom-Perez TJ, Wise SS, Aboueissa AEM, Wise JP. Prolonged particulate hexavalent chromium exposure induces RAD51 foci inhibition and cytoplasmic accumulation in immortalized and primary human lung bronchial epithelial cells. Toxicol Appl Pharmacol 2023; 479:116711. [PMID: 37805091 PMCID: PMC10841504 DOI: 10.1016/j.taap.2023.116711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 10/09/2023]
Abstract
Hexavalent chromium [Cr(VI)] is a human lung carcinogen with widespread exposure risks. Cr(VI) causes DNA double strand breaks that if unrepaired, progress into chromosomal instability (CIN), a key driving outcome in Cr(VI)-induced tumors. The ability of Cr(VI) to cause DNA breaks and inhibit repair is poorly understood in human lung epithelial cells, which are extremely relevant since pathology data show Cr(VI)-induced tumors originate from bronchial epithelial cells. In the present study, we considered immortalized and primary human bronchial epithelial cells. Cells were treated with zinc chromate at concentrations ranging 0.05 to 0.4μg/cm2 for acute (24 h) and prolonged (120 h) exposures. DNA double strand breaks (DSBs) were measured by neutral comet assay and the status of homologous recombination repair, the main pathway to fix Cr(VI)-induced DSBs, was measured by RAD51 foci formation with immunofluorescence, RAD51 localization with confocal microscopy and sister chromatid exchanges. We found acute and prolonged Cr(VI) exposure induced DSBs. Acute exposure induced homologous recombination repair, but prolonged exposure inhibited it resulting in chromosome instability in immortalized and primary human bronchial epithelial cells.
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Affiliation(s)
- Idoia Meaza
- Wise Laboratory of Environmental and Genetic Toxicology, Department of Pharmacology and Toxicology, University of Louisville, 500 S Preston Street, Building 55A, Room 1422, Louisville, KY 40292, United States of America
| | - Aggie R Williams
- Wise Laboratory of Environmental and Genetic Toxicology, Department of Pharmacology and Toxicology, University of Louisville, 500 S Preston Street, Building 55A, Room 1422, Louisville, KY 40292, United States of America
| | - Haiyan Lu
- Wise Laboratory of Environmental and Genetic Toxicology, Department of Pharmacology and Toxicology, University of Louisville, 500 S Preston Street, Building 55A, Room 1422, Louisville, KY 40292, United States of America
| | - J Calvin Kouokam
- Wise Laboratory of Environmental and Genetic Toxicology, Department of Pharmacology and Toxicology, University of Louisville, 500 S Preston Street, Building 55A, Room 1422, Louisville, KY 40292, United States of America
| | - Jennifer H Toyoda
- Wise Laboratory of Environmental and Genetic Toxicology, Department of Pharmacology and Toxicology, University of Louisville, 500 S Preston Street, Building 55A, Room 1422, Louisville, KY 40292, United States of America
| | - Tayler J Croom-Perez
- Burnett School of Biomedical Sciences, University of Central Florida College of Medicine, 6900 Lake Nona Blvd., Orlando, FL 32827, United States of America
| | - Sandra S Wise
- Wise Laboratory of Environmental and Genetic Toxicology, Department of Pharmacology and Toxicology, University of Louisville, 500 S Preston Street, Building 55A, Room 1422, Louisville, KY 40292, United States of America
| | | | - John Pierce Wise
- Wise Laboratory of Environmental and Genetic Toxicology, Department of Pharmacology and Toxicology, University of Louisville, 500 S Preston Street, Building 55A, Room 1422, Louisville, KY 40292, United States of America.
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12
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Vassilenko V, Moura PC, Raposo M. Diagnosis of Carcinogenic Pathologies through Breath Biomarkers: Present and Future Trends. Biomedicines 2023; 11:3029. [PMID: 38002028 PMCID: PMC10669878 DOI: 10.3390/biomedicines11113029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/08/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
The assessment of volatile breath biomarkers has been targeted with a lot of interest by the scientific and medical communities during the past decades due to their suitability for an accurate, painless, non-invasive, and rapid diagnosis of health states and pathological conditions. This paper reviews the most relevant bibliographic sources aiming to gather the most pertinent volatile organic compounds (VOCs) already identified as putative cancer biomarkers. Here, a total of 265 VOCs and the respective bibliographic sources are addressed regarding their scientifically proven suitability to diagnose a total of six carcinogenic diseases, namely lung, breast, gastric, colorectal, prostate, and squamous cell (oesophageal and laryngeal) cancers. In addition, future trends in the identification of five other forms of cancer, such as bladder, liver, ovarian, pancreatic, and thyroid cancer, through perspective volatile breath biomarkers are equally presented and discussed. All the results already achieved in the detection, identification, and quantification of endogenous metabolites produced by all kinds of normal and abnormal processes in the human body denote a promising and auspicious future for this alternative diagnostic tool, whose future passes by the development and employment of newer and more accurate collection and analysis techniques, and the certification for utilisation in real clinical scenarios.
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Affiliation(s)
- Valentina Vassilenko
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Department of Physics, NOVA School of Science and Technology, NOVA University of Lisbon, Campus FCT-UNL, 2829-516 Caparica, Portugal;
| | - Pedro Catalão Moura
- Laboratory for Instrumentation, Biomedical Engineering and Radiation Physics (LIBPhys-UNL), Department of Physics, NOVA School of Science and Technology, NOVA University of Lisbon, Campus FCT-UNL, 2829-516 Caparica, Portugal;
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13
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Chien LH, Jiang HF, Tsai FY, Chang HY, Freedman ND, Rothman N, Lan Q, Hsiung CA, Chang IS. Incidence of Lung Adenocarcinoma by Age, Sex, and Smoking Status in Taiwan. JAMA Netw Open 2023; 6:e2340704. [PMID: 37910104 PMCID: PMC10620613 DOI: 10.1001/jamanetworkopen.2023.40704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/19/2023] [Indexed: 11/03/2023] Open
Abstract
Importance Knowing whether the effects of smoking and other risk factors with lung adenocarcinoma (ADC) incidence varies by sex would provide information on lung cancer prevention strategies. Objective To evaluate whether women in Taiwan have higher age- and tumor stage-specific lung ADC incidence rates than men irrespective of smoking status (ie, ever smoker or never smoker). Design, Setting, and Participants This population-based cohort study used data sets synthesized from the Taiwan Cancer Registry (TCR) from 1979 to 2019; the TCR Long Form (TCRLF) from 2011 to 2019, which provides individual-level smoking and tumor stage information; the Taiwan Cause of Death Database (TCOD) from 1985 to 2019; the National Health Insurance Research Database (NHIRD) from 2000 to 2020; the Monthly Bulletin of Interior Statistics (MBIS) from 2011 to 2019; the National Health Interview Survey from 2001, 2005, 2009, 2013, and 2017; and Taiwan Biobank data from 2008 to 2021. Included patients were aged 40 to 84 years and had any invasive lung cancer from January 1, 2011, to December 31, 2019. Exposure Smoking status. Main Outcomes and Measures The main outcomes were age-specific female-to-male incidence rate ratios (IRRs) of lung ADC by smoking status and tumor stage. Linked data from the TCR, TCOD, NHIRD, Taiwan National Health Interview Survey, and MBIS were used to estimate the age- and sex-specific numbers of cancer-free individuals at midyears from 2011 to 2019 by smoking status. Using the TCR and TCRLF, age-, sex-, tumor stage-, and diagnosis year-specific numbers of patients with lung ADC from 2011 to 2019 by smoking status were estimated. Results A total of 61 285 patients (32 599 women [53.2%]) aged 40 to 84 years (mean [SD] age, 64.66 [10.79] years) in the Taiwanese population of approximately 23 million were diagnosed with invasive lung ADC as their first lifetime cancer between 2011 and 2019. Among smokers, men had higher tobacco use by almost all examined metrics, including nearly twice the mean (SD) number of pack-years smoked (eg, 7.87 [8.30] for men aged 30-34 years vs 4.38 [5.27] for women aged 30-34 years). For 5-year age bands between 40 and 84 years, incidence of lung ADC was significantly higher among females than males for nearly all age groups irrespective of tumor stage and smoking status (eg, for the age group 70-74 years, the female-to-male IRR for late-stage lung ADC among never smokers was 1.38 [95% CI, 1.30-1.50]). Conclusions and Relevance In this cohort study, women had higher age- and stage-specific lung ADC incidence rates than men in Taiwan for both never and ever smokers, suggesting the possibility of differential exposures between sexes to risk factors other than smoking and the potential modification of ADC risk factors by sex. Further work is needed to determine whether this pattern replicates in other populations, discover the causes of lung ADC, and put preventive measures in place.
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Affiliation(s)
- Li-Hsin Chien
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
- Department of Applied Mathematics, Chung-Yuan Christian University, Chung-Li, Taiwan
| | - Hsin-Fang Jiang
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Fang-Yu Tsai
- National Institute of Cancer Research, National Health Research Institutes, Zhunan, Taiwan
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Neal D. Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Qing Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Chao A. Hsiung
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - I-Shou Chang
- National Institute of Cancer Research, National Health Research Institutes, Zhunan, Taiwan
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14
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Choi E, Su CC, Wu JT, Aredo JV, Neal JW, Leung AN, Backhus LM, Lui NS, Le Marchand L, Stram DO, Liang SY, Cheng I, Wakelee HA, Han SS. Second Primary Lung Cancer Among Lung Cancer Survivors Who Never Smoked. JAMA Netw Open 2023; 6:e2343278. [PMID: 37966839 PMCID: PMC10652150 DOI: 10.1001/jamanetworkopen.2023.43278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 10/05/2023] [Indexed: 11/16/2023] Open
Abstract
Importance Lung cancer among never-smokers accounts for 25% of all lung cancers in the US; recent therapeutic advances have improved survival among patients with initial primary lung cancer (IPLC), who are now at high risk of developing second primary lung cancer (SPLC). As smoking rates continue to decline in the US, it is critical to examine more closely the epidemiology of lung cancer among patients who never smoked, including their risk for SPLC. Objective To estimate and compare the cumulative SPLC incidence among lung cancer survivors who have never smoked vs those who have ever smoked. Design, Setting, and Participants This population-based prospective cohort study used data from the Multiethnic Cohort Study (MEC), which enrolled participants between April 18, 1993, and December 31, 1996, with follow-up through July 1, 2017. Eligible individuals for this study were aged 45 to 75 years and had complete smoking data at baseline. These participants were followed up for IPLC and further SPLC development through the Surveillance, Epidemiology, and End Results registry. The data were analyzed from July 1, 2022, to January 31, 2023. Exposures Never-smoking vs ever-smoking exposure at MEC enrollment. Main Outcomes and Measures The study had 2 primary outcomes: (1) 10-year cumulative incidence of IPLC in the entire study cohort and 10-year cumulative incidence of SPLC among patients with IPLC and (2) standardized incidence ratio (SIR) (calculated as the SPLC incidence divided by the IPLC incidence) by smoking history. Results Among 211 414 MEC participants, 7161 (3.96%) developed IPLC over 4 038 007 person-years, and 163 (2.28%) developed SPLC over 16 470 person-years. Of the participants with IPLC, the mean (SD) age at cohort enrollment was 63.6 (7.7) years, 4031 (56.3%) were male, and 3131 (43.7%) were female. The 10-year cumulative IPLC incidence was 2.40% (95% CI, 2.31%-2.49%) among ever-smokers, which was 7 times higher than never-smokers (0.34%; 95% CI, 0.30%-0.37%). However, the 10-year cumulative SPLC incidence following IPLC was as high among never-smokers (2.84%; 95% CI, 1.50%-4.18%) as ever-smokers (2.72%; 95% CI, 2.24%-3.20%), which led to a substantially higher SIR for never-smokers (14.50; 95% CI, 8.73-22.65) vs ever-smokers (3.50; 95% CI, 2.95-4.12). Conclusions and Relevance The findings indicate that SPLC risk among lung cancer survivors who never smoked is as high as among those with IPLC who ever-smoked, highlighting the need to identify risk factors for SPLC among patients who never smoked and to develop a targeted surveillance strategy.
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Affiliation(s)
- Eunji Choi
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California
| | - Chloe C. Su
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California
| | - Julie T. Wu
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | | | - Joel W. Neal
- Department of Medicine, Stanford University School of Medicine, Stanford, California
- Stanford Cancer Institute, Stanford, California
| | - Ann N. Leung
- Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Leah M. Backhus
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California
| | - Natalie S. Lui
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, California
| | - Loïc Le Marchand
- Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu
| | - Daniel O. Stram
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
| | - Su-Ying Liang
- Sutter Health, Palo Alto Medical Foundation Research Institute, Palo Alto, California
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Heather A. Wakelee
- Department of Medicine, Stanford University School of Medicine, Stanford, California
- Stanford Cancer Institute, Stanford, California
| | - Summer S. Han
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California
- Stanford Cancer Institute, Stanford, California
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California
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15
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Kobayashi K, Takemura RD, Miyamae J, Mitsui I, Murakami K, Kutara K, Saeki K, Kanda T, Okamura Y, Sugiyama A. Phenotypic and molecular characterization of novel pulmonary adenocarcinoma cell lines established from a dog. Sci Rep 2023; 13:16823. [PMID: 37798461 PMCID: PMC10556002 DOI: 10.1038/s41598-023-44062-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/03/2023] [Indexed: 10/07/2023] Open
Abstract
Canine pulmonary adenocarcinoma (PAC) resembles human lung tumors in never-smokers, but it is rarer than human pulmonary adenocarcinoma. Therefore, research on canine PAC is challenging. In the present study, we successfully established various novel canine PAC cell lines from a single lesion in a dog, including two parent cell lines and fourteen cloned cell lines, and characterized their cellular properties in vitro. Several of these cell lines showed epithelial-mesenchymal transition (EMT)-like and/or cancer stem cell (CSCs)-like phenotypes. We additionally assessed the sensitivity of the cells to vinorelbine in vitro. Three clonal lines, two of which showed EMT- and CSC-like phenotypes, were resistant to vinorelbine. Furthermore, we evaluated the expression and activation status of EGFR, HER2, and Ras signaling factors. The findings indicated that the cell lines we established preserved the expression and activation of these factors to varying extents. These novel canine PAC cell lines can be utilized in future research for understanding the pathogenesis and development of treatments for canine PAC.
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Affiliation(s)
- Kosuke Kobayashi
- Faculty of Veterinary Medicine, Okayama University of Science, Ikoino-oka 1-3, Imabari Ehime, Japan.
| | - Reika Deja Takemura
- Faculty of Veterinary Medicine, Okayama University of Science, Ikoino-oka 1-3, Imabari Ehime, Japan
| | - Jiro Miyamae
- Faculty of Veterinary Medicine, Okayama University of Science, Ikoino-oka 1-3, Imabari Ehime, Japan
| | - Ikki Mitsui
- Faculty of Veterinary Medicine, Okayama University of Science, Ikoino-oka 1-3, Imabari Ehime, Japan
| | - Kohei Murakami
- Faculty of Veterinary Medicine, Okayama University of Science, Ikoino-oka 1-3, Imabari Ehime, Japan
| | - Kenji Kutara
- Faculty of Veterinary Medicine, Okayama University of Science, Ikoino-oka 1-3, Imabari Ehime, Japan
| | - Kohei Saeki
- Faculty of Veterinary Medicine, Okayama University of Science, Ikoino-oka 1-3, Imabari Ehime, Japan
| | - Teppei Kanda
- Faculty of Veterinary Medicine, Okayama University of Science, Ikoino-oka 1-3, Imabari Ehime, Japan
| | - Yasuhiko Okamura
- Faculty of Veterinary Medicine, Okayama University of Science, Ikoino-oka 1-3, Imabari Ehime, Japan
| | - Akihiko Sugiyama
- Faculty of Veterinary Medicine, Okayama University of Science, Ikoino-oka 1-3, Imabari Ehime, Japan
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16
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McCarty RD, Barnard ME, Lawson-Michod KA, Owens M, Green SE, Derzon S, Karabegovic L, Akerley WL, Watt MH, Doherty JA, Grieshober L. Pathways to lung cancer diagnosis among individuals who did not receive lung cancer screening: a qualitative study. BMC PRIMARY CARE 2023; 24:203. [PMID: 37789288 PMCID: PMC10548694 DOI: 10.1186/s12875-023-02158-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 09/14/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Although early detection of lung cancer through screening is associated with better prognosis, most lung cancers are diagnosed among unscreened individuals. We therefore sought to characterize pathways to lung cancer diagnosis among unscreened individuals. METHODS Participants were individuals with lung cancer who did not undergo asymptomatic lung cancer screening (n = 13) and healthcare providers who may be involved in the pathway to lung cancer diagnosis (n = 13). We conducted semi-structured interviews to identify themes in lung cancer patients' narratives of their cancer diagnoses and providers' personal and/or professional experiences of various pathways to lung cancer diagnoses, to identify delays in diagnosis. We audio-recorded, transcribed, and coded interviews in two stages. First, we conducted deductive coding using three time-period intervals from the Models of Pathways to Treatment framework: appraisal, help-seeking, and diagnostic (i.e., excluding pre-treatment). Second, we conducted inductive coding to identify themes within each time-period interval, and classified these themes as either barriers or facilitators to diagnosis. Coding and thematic summarization were completed independently by two separate analysts who discussed for consensus. RESULTS Eight of the patient participants had formerly smoked, and five had never smoked. We identified eight barrier/facilitator themes within the three time-period intervals. Within the appraisal interval, the barrier theme was (1) minimization or misattribution of symptoms, and the facilitator theme was (2) acknowledgment of symptoms. Within the help-seeking interval, the barrier theme was (3) hesitancy to seek care, and the facilitator theme was (4) routine care. Within the diagnosis interval, barrier themes were (5) health system challenges, and (6) social determinants of health; and facilitator themes were (7) severe symptoms and known risk factors, and (8) self-advocacy. Many themes were interrelated, including minimization or misattribution of symptoms and hesitancy to seek care, which may collectively contribute to care and imaging delays. CONCLUSIONS Interventions to reduce hesitancy to seek care may facilitate timely lung cancer diagnoses. More prompt referral to imaging-especially computed tomography (CT)-among symptomatic patients, along with patient self-advocacy for imaging, may reduce delays in diagnosis.
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Affiliation(s)
- Rachel D McCarty
- Huntsman Cancer Institute, University of Utah, 2000 Cir of Hope Dr, Salt Lake City, UT, 84112, USA.
- Department of Population Health Sciences Spencer Fox Eccles School of Medicine, University of Utah Intermountain Healthcare, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA.
| | - Mollie E Barnard
- Huntsman Cancer Institute, University of Utah, 2000 Cir of Hope Dr, Salt Lake City, UT, 84112, USA
- Department of Population Health Sciences Spencer Fox Eccles School of Medicine, University of Utah Intermountain Healthcare, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA
- Slone Epidemiology Center, Boston University Chobanian & Avedisian School of Medicine, 72 East Concord St, Boston, MA, 02118, USA
| | - Katherine A Lawson-Michod
- Huntsman Cancer Institute, University of Utah, 2000 Cir of Hope Dr, Salt Lake City, UT, 84112, USA
- Department of Population Health Sciences Spencer Fox Eccles School of Medicine, University of Utah Intermountain Healthcare, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Makelle Owens
- Department of Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah, 30 N 1900 E, Salt Lake City, UT, 84132, USA
- San Antonio Military Medical Center Internal Medicine Residency, Brooke Army Medical Center, 3551 Roger Brooke Dr, San Antonio, TX, 78234, USA
| | - Sarah E Green
- Department of Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah, 30 N 1900 E, Salt Lake City, UT, 84132, USA
- Danbury Hospital Department of Surgery, Danbury Hospital, 24 Hospital Ave, Danbury, CT, 06810, USA
| | - Samantha Derzon
- Department of Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah, 30 N 1900 E, Salt Lake City, UT, 84132, USA
- Intermountain Healthcare, Utah Valley Hospital, Utah Valley Family Medicine Residency, 475 W 940 N, Provo, Provo, UT, 84604, USA
| | - Lea Karabegovic
- Department of Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah, 30 N 1900 E, Salt Lake City, UT, 84132, USA
| | - Wallace L Akerley
- Huntsman Cancer Institute, University of Utah, 2000 Cir of Hope Dr, Salt Lake City, UT, 84112, USA
- Division of Oncology, Spencer Fox Eccles School of Medicine, University of Utah, 30 N 1900 E, Salt Lake City, UT, 84132, USA
| | - Melissa H Watt
- Department of Population Health Sciences Spencer Fox Eccles School of Medicine, University of Utah Intermountain Healthcare, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Jennifer A Doherty
- Huntsman Cancer Institute, University of Utah, 2000 Cir of Hope Dr, Salt Lake City, UT, 84112, USA
- Department of Population Health Sciences Spencer Fox Eccles School of Medicine, University of Utah Intermountain Healthcare, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Laurie Grieshober
- Huntsman Cancer Institute, University of Utah, 2000 Cir of Hope Dr, Salt Lake City, UT, 84112, USA
- Department of Population Health Sciences Spencer Fox Eccles School of Medicine, University of Utah Intermountain Healthcare, University of Utah, 295 Chipeta Way, Salt Lake City, UT, 84108, USA
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17
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Leiter A, Veluswamy RR, Wisnivesky JP. The global burden of lung cancer: current status and future trends. Nat Rev Clin Oncol 2023; 20:624-639. [PMID: 37479810 DOI: 10.1038/s41571-023-00798-3] [Citation(s) in RCA: 57] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2023] [Indexed: 07/23/2023]
Abstract
Lung cancer is the leading cause of cancer-related death worldwide. However, lung cancer incidence and mortality rates differ substantially across the world, reflecting varying patterns of tobacco smoking, exposure to environmental risk factors and genetics. Tobacco smoking is the leading risk factor for lung cancer. Lung cancer incidence largely reflects trends in smoking patterns, which generally vary by sex and economic development. For this reason, tobacco control campaigns are a central part of global strategies designed to reduce lung cancer mortality. Environmental and occupational lung cancer risk factors, such as unprocessed biomass fuels, asbestos, arsenic and radon, can also contribute to lung cancer incidence in certain parts of the world. Over the past decade, large-cohort clinical studies have established that low-dose CT screening reduces lung cancer mortality, largely owing to increased diagnosis and treatment at earlier disease stages. These data have led to recommendations that individuals with a high risk of lung cancer undergo screening in several economically developed countries and increased implementation of screening worldwide. In this Review, we provide an overview of the global epidemiology of lung cancer. Lung cancer risk factors and global risk reduction efforts are also discussed. Finally, we summarize lung cancer screening policies and their implementation worldwide.
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Affiliation(s)
- Amanda Leiter
- Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Rajwanth R Veluswamy
- Division of Hematology and Oncology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Juan P Wisnivesky
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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18
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Sakoda LC, Alabaster A, Sumner ET, Gordon NP, Quesenberry CP, Velotta JB. Trends in Smoking-Specific Lung Cancer Incidence Rates Within a US Integrated Health System, 2007-2018. Chest 2023; 164:785-795. [PMID: 36934804 DOI: 10.1016/j.chest.2023.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 03/19/2023] Open
Abstract
BACKGROUND At least 10% of lung cancers arise in adults who have never used tobacco. Data remain inconclusive on whether lung cancer incidence has been increasing among adults who have never used tobacco. RESEARCH QUESTION How have age-adjusted incidence rates of lung cancer changed temporally, especially among adults who have never used tobacco? STUDY DESIGN AND METHODS Trends in lung cancer incidence were examined using linked electronic health record and cancer registry data on a dynamic cohort of adults ≥ 30 years of age at risk of incident lung cancer between January 1, 2007, and December 31, 2018, from an integrated health-care system in northern California. Truncated age-adjusted lung cancer incidence rates and average annual percentage change (AAPC) in rates were estimated, overall and separately for adults who have ever and never used tobacco by age, sex, and race or ethnicity. RESULTS The cohort included 3,751,348 adults (52.5% female, 48.0% non-Hispanic White, 63.1% have never used tobacco), among whom 18,627 (52.7% female, 68.6% non-Hispanic White, 15.4% have never used tobacco) received a diagnosis of lung cancer. The overall lung cancer incidence rate declined from 91.1 to 63.7 per 100,000 person-years between 2007 and 2009 and between 2016 and 2018 (AAPC, -3.9%; 95% CI, -4.2% to -3.6%). Among adults who have ever used tobacco, incidence rates declined overall from 167.0 to 113.4 per 100,000 person-years (AAPC, -4.2%; 95% CI, -4.4% to -3.9%) and, to varying degrees, within all age, sex, and racial or ethnic groups. Among adults who have never used tobacco, incidence rates were relatively constant, with 3-year-period estimates ranging from 19.9 to 22.6 per 100,000 person-years (AAPC, 0.9%; 95% CI, -0.3% to 2.1%). Incidence rates for adults who have never used tobacco seemed stable over time, within age, sex, and racial or ethnic groups, except for those of Asian and Pacific Islander (API) origin (AAPC, 2.0%; 95% CI, 0.1%-3.9%), whose rates were about twice as high compared with their counterparts. INTERPRETATION These observed trends underscore the need to elucidate further the cause of lung cancer in adults who have never used tobacco, including why incidence is higher and rising in API adults who have never used tobacco.
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Affiliation(s)
- Lori C Sakoda
- Division of Research, Kaiser Permanente Northern California, Oakland, CA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA.
| | - Amy Alabaster
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Eric T Sumner
- Department of Pulmonary and Critical Care Medicine, Kaiser Permanente Northern California, Oakland, CA
| | - Nancy P Gordon
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | | | - Jeffrey B Velotta
- Department of Thoracic Surgery, Kaiser Permanente Northern California, Oakland, CA
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19
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Wojcik R, Morris A. Aiming to Improve Equity in Lung Health: Sex and Gender. Clin Chest Med 2023; 44:613-622. [PMID: 37517839 DOI: 10.1016/j.ccm.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Sex and gender impact risk factors, presentations of, and response to therapy in lung diseases such as chronic obstructive pulmonary disease, asthma, lung cancer, interstitial lung disease, and obstructive sleep apnea. Many physicians lack training in the impact of sex and gender on lung disease, resulting in diagnostic delays. Scales and indices taught in the health care system are largely validated in male populations, thereby limiting their application to females. For transgender and lesbian, gay, bisexual, transgender, and questioning + patients, high rates of bias in health care may limit patients' willingness to seek health care.
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Affiliation(s)
- Rachel Wojcik
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Alison Morris
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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20
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Carroll NM, Burnett-Hartman AN, Rendle KA, Neslund-Dudas CM, Greenlee RT, Honda SA, Vachani A, Ritzwoller DP. Smoking status and the association between patient-level factors and survival among lung cancer patients. J Natl Cancer Inst 2023; 115:937-948. [PMID: 37228018 PMCID: PMC10407692 DOI: 10.1093/jnci/djad098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 05/16/2023] [Accepted: 05/19/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Declines in the prevalence of cigarette smoking, advances in targeted therapies, and implementation of lung cancer screening have changed the clinical landscape for lung cancer. The proportion of lung cancer deaths is increasing in those who have never smoked cigarettes. To better understand contemporary patterns in survival among patients with lung cancer, a comprehensive evaluation of factors associated with survival, including differential associations by smoking status, is needed. METHODS Patients diagnosed with lung cancer between January 1, 2010, and September 30, 2019, were identified. We estimated all-cause and lung cancer-specific median, 5-year, and multivariable restricted mean survival time (RMST) to identify demographic, socioeconomic, and clinical factors associated with survival, overall and stratified by smoking status (never, former, and current). RESULTS Analyses included 6813 patients with lung cancer: 13.9% never smoked, 54.2% formerly smoked, and 31.9% currently smoked. All-cause RMST through 5 years for those who never, formerly, and currently smoked was 32.1, 25.9, and 23.3 months, respectively. Lung cancer-specific RMST was 36.3 months, 30.3 months, and 26.0 months, respectively. Across most models, female sex, younger age, higher socioeconomic measures, first-course surgery, histology, and body mass index were positively associated, and higher stage was inversely associated with survival. Relative to White patients, Black patients had increased survival among those who formerly smoked. CONCLUSIONS We identify actionable factors associated with survival between those who never, formerly, and currently smoked cigarettes. These findings illuminate opportunities to address underlying mechanisms driving lung cancer progression, including use of first-course treatment, and enhanced implementation of tailored smoking cessation interventions for individuals diagnosed with cancer.
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Affiliation(s)
- Nikki M Carroll
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA
| | - Andrea N Burnett-Hartman
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Katharine A Rendle
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Stacey A Honda
- Hawaii Permanente Medical Group, Center for Integrated Healthcare Research, Kaiser Permanente Hawaii, Honolulu, HI, USA
| | - Anil Vachani
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Debra P Ritzwoller
- Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA
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21
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Fu Y, Liu J, Chen Y, Liu Z, Xia H, Xu H. Gender disparities in lung cancer incidence in the United States during 2001-2019. Sci Rep 2023; 13:12581. [PMID: 37537259 PMCID: PMC10400573 DOI: 10.1038/s41598-023-39440-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 07/25/2023] [Indexed: 08/05/2023] Open
Abstract
Lung cancer ranks as one of the top malignancies and the leading cause of cancer death in both males and females in the US. Using a cancer database covering the entire population, this study was to determine the gender disparities in lung cancer incidence during 2001-2019. Cancer patients were obtained from the National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology and End Results (SEER) database. The SEER*Stat software was applied to calculate the age-adjusted incidence rates (AAIR). Temporal changes in lung cancer incidence were analyzed by the Joinpoint software. A total of 4,086,432 patients (53.3% of males) were diagnosed with lung cancer. Among them, 52.1% were 70 years or older, 82.7% non-Hispanic white, 39.7% from the South, and 72.6% non-small cell lung cancer (NSCLC). The AAIR of lung cancer continuously reduced from 91.0 per 100000 to 59.2 in males during the study period, while it increased from 55.0 in 2001 to 56.8 in 2006 in females, then decreased to 48.1 in 2019. The female to male incidence rate ratio of lung cancer continuously increased from 2001 to 2019. Gender disparities were observed among age groups, races, and histological types. In those aged 0-54 years, females had higher overall incidence rates of lung cancer than males in recent years, which was observed in all races (except non-Hispanic black), all regions, and adenocarcinoma and small cell (but not squamous cell). Non-Hispanic black females aged 0-54 years had a faster decline rate than males since 2013. API females demonstrated an increased trend during the study period. Lung cancer incidence continues to decrease with gender disparities among age groups, races, regions, and histological types. Continuous anti-smoking programs plus reduction of related risk factors are necessary to lower lung cancer incidence further.
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Affiliation(s)
- Yu Fu
- Department of Physical Examination Center, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hanghzou, China
| | - Jun Liu
- Department of Clinical Laboratory, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hanghzou, 311202, China.
| | - Yan Chen
- Department of Gastroenterology, PLA Strategic Support Force Characteristic Medical Center, Beijing, China
| | - Zhuo Liu
- Department of Respiratory Therapy, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hanghzou, China
| | - Hongbo Xia
- Department of Respiratory Therapy, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hanghzou, China
| | - Haixia Xu
- Department of Respiratory Therapy, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hanghzou, China
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22
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Behinaein P, Treffalls J, Hutchings H, Okereke IC. The Role of Sublobar Resection for the Surgical Treatment of Non-Small Cell Lung Cancer. Curr Oncol 2023; 30:7019-7030. [PMID: 37504369 PMCID: PMC10378348 DOI: 10.3390/curroncol30070509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023] Open
Abstract
Lung cancer is the most common cancer killer in the world. The standard of care for surgical treatment of non-small cell lung cancer has been lobectomy. Recent studies have identified that sublobar resection has non-inferior survival rates compared to lobectomy, however. Sublobar resection may increase the number of patients who can tolerate surgery and reduce postoperative pulmonary decline. Sublobar resection appears to have equivalent results to surgery in patients with small, peripheral tumors and no lymph node disease. As the utilization of segmentectomy increases, there may be some centers that perform this operation more than other centers. Care must be taken to ensure that all patients have access to this modality. Future investigations should focus on examining the outcomes from segmentectomy as it is applied more widely. When employed on a broad scale, morbidity and survival rates should be monitored. As segmentectomy is performed more frequently, patients may experience improved postoperative quality of life while maintaining the same oncologic benefit.
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Affiliation(s)
- Parnia Behinaein
- School of Medicine, Wayne State University, Detroit, MI 48202, USA
| | - John Treffalls
- Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX 78229, USA
| | - Hollis Hutchings
- Department of Surgery, Henry Ford Health, Detroit, MI 48202, USA
| | - Ikenna C Okereke
- Department of Surgery, Henry Ford Health, Detroit, MI 48202, USA
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23
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Liu S, Hu C, Li M, Zhou W, Wang R, Xiao Y. Androgen receptor suppresses lung cancer invasion and increases cisplatin response via decreasing TPD52 expression. Int J Biol Sci 2023; 19:3709-3725. [PMID: 37564195 PMCID: PMC10411467 DOI: 10.7150/ijbs.84577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/07/2023] [Indexed: 08/12/2023] Open
Abstract
Lung cancer, as the most commonly diagnosed malignancy, still accounts for the leading cause of cancer-related deaths worldwide. The high rate of mortality and tumor recurrence has prompted clinicians and scientists to urgently explore new targets for improved treatment. Previous studies have indicated a potential role of the androgen receptor (AR) in the progression of non-small cell lung cancer (NSCLC). However, the precise mechanisms underlying this association, particularly its relation to TPD52-mediated cell invasion and cisplatin (DDP) response, have not been fully elucidated. Therefore, further investigation is necessary to gain a better understanding of these mechanisms and their potential implications for lung cancer treatment. In this study, we discovered that AR can suppress NSCLC cell invasion and increase cisplatin response by downregulating the expression of circular RNA (circRNA), specifically circ-SLCO1B7. This suppression is achieved through the direct binding of AR to the 5' promoter region of the host gene SLCO1B7. The decreased expression of circ-SLCO1B7, mediated by AR, released miR-139-5p back to the RISC (RNA induced silencing complex), where it bonds to the 3' untranslated region (3'UTR) of Tumor Protein D52 (TPD52) messenger RNA, resulting in TPD52 reduction. The in vivo data also validated the functional contribution of AR/circ-SLCO1B7/miR-139-5p/TPD52 axis to lung cancer progression. Furthermore, analysis of human NSCLC databases and clinical specimens confirmed the association of the AR/circ-SLCO1B7/miR-139-5p/TPD52 signaling pathway with NSCLC progression. Collectively, the results from our study suggest that AR can suppress lung cancer cell invasion and increase DDP response by modulating the circ-SLCO1B7/miR-139-5p/TPD52 signaling pathway. Targeting this novel signaling pathway may be a new therapeutic strategy to effectively constrain NSCLC development.
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Affiliation(s)
- Shiqing Liu
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
- Xiangya Lung Cancer Center, Xiangya Hospital, Central South University, Changsha, 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Chengping Hu
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
- Xiangya Lung Cancer Center, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Min Li
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, 410008, China
- Xiangya Lung Cancer Center, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Wolong Zhou
- Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, 410008, China
| | - Ronghao Wang
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Southwest Medical University, Luzhou 646000, China
| | - Yao Xiao
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, 410008, China
- International Joint Research Center of Minimally Invasive Endoscopic Technology Equipment & Standards, Changsha 410008, China
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24
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Inoue C, Miki Y, Suzuki T. New Perspectives on Sex Steroid Hormones Signaling in Cancer-Associated Fibroblasts of Non-Small Cell Lung Cancer. Cancers (Basel) 2023; 15:3620. [PMID: 37509283 PMCID: PMC10377312 DOI: 10.3390/cancers15143620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023] Open
Abstract
The importance of sex hormones, especially estrogen, in the pathogenesis of non-small-cell lung cancer (NSCLC) has attracted attention due to its high incidence among young adults and nonsmokers, especially those who are female. Cancer-associated fibroblasts (CAFs) reside in the cancer stroma and influence cancer growth, invasion, metastasis, and acquisition of drug resistance through interactions with cancer cells and other microenvironmental components. Hormone-mediated cell-cell interactions are classic cell-cell interactions and well-known phenomena in breast cancer and prostate cancer CAFs. In cancers of other organs, including NSCLC, the effects of CAFs on hormone-receptor expression and hormone production in cancer tissues have been reported; however, there are few such studies. Many more studies have been performed on breast and prostate cancers. Recent advances in technology, particularly single-cell analysis techniques, have led to significant advances in the classification and function of CAFs. However, the importance of sex hormones in cell-cell interactions of CAFs in NSCLC remains unclear. This review summarizes reports on CAFs in NSCLC and sex hormones in cancer and immune cells surrounding CAFs. Furthermore, we discuss the prospects of sex-hormone research involving CAFs in NSCLC.
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Affiliation(s)
- Chihiro Inoue
- Department of Anatomic Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Yasuhiro Miki
- Department of Anatomic Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Takashi Suzuki
- Department of Anatomic Pathology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
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25
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Karaağaç M, Geredeli Ç, Yıldırım MS, Altınok T, Dede İ, İnal A, Zamani AG, Kaya B, Demirkazık A, Artaç M. The XRCC1 and TP53 gene polymorphisms are associated with advanced-stage disease and early distant metastasis at diagnosis in non-small cell lung cancer. J Cancer Res Ther 2023; 19:1248-1254. [PMID: 37787291 DOI: 10.4103/jcrt.jcrt_1657_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Background Studies on single nucleotide polymorphisms (SNPs) in non-small cell lung cancer (NSCLC) suggest that DNA repair capacity may have prognostic implications for disease recurrence and survival. However, there is no study investigating the relationship between SNPs and the risk of metastasis at the time of initial diagnosis in patients with NSCLC. Objective This study aimed to investigate the potential predictive value of SNPs in detecting the risk of metastasis at the time of initial diagnosis and poor prognosis in patients with NSCLC. Material and Methods In this prospective cohort study, we evaluated 275 patients with NSCLC. Analysis of SNPs from peripheral blood cells was performed by a polymerase chain reaction. Excision repair cross-complementing group 1 (ERCC1)- Asn118Asn, excision repair cross-complementing group 2 (ERCC2)-Lys751Gln, X-ray repair cross-complementing group 1 (XRCC1)-Arg399Gln, and tumor protein 53 (TP53)-Arg72Pro polymorphisms were evaluated in conjunction with the development of metastasis. Results The ERCC1 normal genotype, ERCC2 heterozygote genotype, XRCC1 normal genotype, and TP53 normal genotype were associated with a higher stage and more advanced-stage disease at the time of initial diagnosis (P = 0.027, 0.005, <0.001, and 0.006, respectively). Also, XRCC1 normal genotype and TP53 normal genotype were associated with the risk of metastasis at the time of initial diagnosis (P = <0.001 and 0.002, respectively). Moreover, the XRCC1 normal genotype was associated with the risk of brain metastasis at the time of initial diagnosis (P = 0.031). Conclusions We showed that SNPs are related to a higher stage and more advanced-stage disease at the time of initial diagnosis in patients with NSCLC, and XRCC1 and TP53 gene polymorphisms are associated with the risk of metastasis. These results may contribute to the identification of high-risk groups and may help to earlier diagnosis and treatment in patients with NSCLC.
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Affiliation(s)
- Mustafa Karaağaç
- Department of Medical Oncology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Çağlayan Geredeli
- Department of Medical Oncology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Mahmut Selman Yıldırım
- Department of Medical Oncology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Tamer Altınok
- Department of Thoracic Surgery, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - İsa Dede
- Department of Medical Oncology, Medical Faculty, Ankara University, Ankara, Turkey
| | - Ali İnal
- Department of Medical Oncology, Medical Faculty, Dicle University, Diyarbakir, Turkey
| | - Ayşe Gül Zamani
- Department of Medical Oncology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Buğra Kaya
- Department of Nuclear Medicine, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
| | - Ahmet Demirkazık
- Department of Medical Oncology, Medical Faculty, Ankara University, Ankara, Turkey
| | - Mehmet Artaç
- Department of Medical Oncology, Meram Medical Faculty, Necmettin Erbakan University, Konya, Turkey
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26
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Finkelstein SR, Patel R, Deland K, Mercer J, Starr B, Zhu D, Min H, Reinsvold M, Campos LDS, Williams N, Luo L, Ma Y, Neff J, Hoenerhoff M, Moding EJ, Kirsch DG. 56 Fe ion exposure increases the incidence of lung and brain tumors at a similar rate in male and female mice. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.06.06.543754. [PMID: 37333373 PMCID: PMC10274718 DOI: 10.1101/2023.06.06.543754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
The main deterrent to long-term space travel is the risk of Radiation Exposure Induced Death (REID). The National Aeronautics and Space Administration (NASA) has adopted Permissible Exposure Levels (PELs) to limit the probability of REID to 3% for the risk of death due to radiation-induced carcinogenesis. The most significant contributor to current REID estimates for astronauts is the risk of lung cancer. Recently updated lung cancer estimates from Japan's atomic bomb survivors showed that the excess relative risk of lung cancer by age 70 is roughly four-fold higher in females compared to males. However, whether sex differences may impact the risk of lung cancer due to exposure to high charge and energy (HZE) radiation is not well studied. Thus, to evaluate the impact of sex differences on the risk of solid cancer development post-HZE radiation exposure, we irradiated Rb fl/fl ; Trp53 fl/+ male and female mice infected with Adeno-Cre with various doses of 320 kVp X-rays or 600 MeV/n 56 Fe ions and monitored them for any radiation-induced malignancies. We observed that lung adenomas/carcinomas and esthesioneuroblastomas (ENBs) were the most common primary malignancies in X-ray and 56 Fe ion-exposed mice, respectively. In addition, 1 Gy 56 Fe ion exposure compared to X-rays led to a significantly higher incidence of lung adenomas/carcinomas (p=0.02) and ENBs (p<0.0001). However, we did not find a significantly higher incidence of any solid malignancies in female mice as compared to male mice, regardless of radiation quality. Furthermore, gene expression analysis of ENBs suggested a distinct gene expression pattern with similar hallmark pathways altered, such as MYC targets and MTORC1 signaling, in X-ray and 56 Fe ion-induced ENBs. Thus, our data revealed that 56 Fe ion exposure significantly accelerated the development of lung adenomas/carcinomas and ENBs compared to X-rays, but the rate of solid malignancies was similar between male and female mice, regardless of radiation quality.
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27
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Zhang Z, Gao Y, Liu S, Ding B, Zhang X, Wu IXY. Initial low-dose computed tomography screening results and summary of participant characteristics: based on the latest Chinese guideline. Front Oncol 2023; 13:1085434. [PMID: 37293585 PMCID: PMC10247136 DOI: 10.3389/fonc.2023.1085434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 05/05/2023] [Indexed: 06/10/2023] Open
Abstract
Background Low-dose computed tomography (LDCT) has been promoted as a promising screening strategy for early detection of lung cancer. China released the latest lung cancer screening guideline in 2021. The compliance of the individuals who received LDCT for lung cancer screening with the guideline is unknown yet. It is necessary to summarize the distribution of guideline-defined lung cancer-related risk factors in the Chinese population so as to inform the selection of target population for the future lung cancer screening. Methods A single-center, cross-sectional study design was adopted. All participants were individuals who underwent LDCT at a tertiary teaching hospital in Hunan, China, between 1 January and 31 December 2021. LDCT results were derived along with guideline-based characteristics for descriptive analysis. Results A total of 5,486 participants were included. Over one-quarter (1,426, 26.0%) of the participants who received screening did not meet the guideline-defined high-risk population, even among non-smokers (36.4%). Most of the participants (4,622, 84.3%) were found to have lung nodules, while no clinical intervention was required basically. The detection rate of positive nodules varied from 46.8% to 71.2% when using different cut-off values for positive nodules. Among non-smoking women, ground glass opacity appeared to be more significantly common compared with non-smoking men (26.7% vs. 21.8%). Conclusion Over one-quarter of individuals who received LDCT screening did not meet the guideline-defined high-risk populations. Appropriate cut-off values for positive nodules need to be continuously explored. More precise and localized criteria for high-risk individuals are needed, especially for non-smoking women.
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Affiliation(s)
- Zixuan Zhang
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Yinyan Gao
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Shaohui Liu
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China
| | - Binrong Ding
- Department of Geriatrics, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Xuewei Zhang
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China
- Centre for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Irene X. Y. Wu
- Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China
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28
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Sandler KL, Henry TS, Amini A, Elojeimy S, Kelly AM, Kuzniewski CT, Lee E, Martin MD, Morris MF, Peterson NB, Raptis CA, Silvestri GA, Sirajuddin A, Tong BC, Wiener RS, Witt LJ, Donnelly EF. ACR Appropriateness Criteria® Lung Cancer Screening: 2022 Update. J Am Coll Radiol 2023; 20:S94-S101. [PMID: 37236754 DOI: 10.1016/j.jacr.2023.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 02/27/2023] [Indexed: 05/28/2023]
Abstract
Lung cancer remains the leading cause of cancer-related mortality for men and women in the United States. Screening for lung cancer with annual low-dose CT is saving lives, and the continued implementation of lung screening can save many more. In 2015, the CMS began covering annual lung screening for those who qualified based on the original United States Preventive Services Task Force (USPSTF) lung screening criteria, which included patients 55 to 77 year of age with a 30 pack-year history of smoking, who were either currently using tobacco or who had smoked within the previous 15 years. In 2021, the USPSTF issued new screening guidelines, decreasing the age of eligibility to 80 years of age and pack-years to 20. Lung screening remains controversial for those who do not meet the updated USPSTF criteria, but who have additional risk factors for the development of lung cancer. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
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Affiliation(s)
- Kim L Sandler
- Vanderbilt University Medical Center, Nashville, Tennessee.
| | | | - Arya Amini
- City of Hope National Medical Center, Duarte, California; Commission on Radiation Oncology
| | - Saeed Elojeimy
- Medical University of South Carolina, Charleston, South Carolina; Commission on Nuclear Medicine and Molecular Imaging
| | | | | | - Elizabeth Lee
- University of Michigan Health System, Ann Arbor, Michigan
| | - Maria D Martin
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | | | - Neeraja B Peterson
- Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee, Primary care physician
| | | | - Gerard A Silvestri
- Medical University of South Carolina, Charleston, South Carolina; American College of Chest Physicians
| | | | - Betty C Tong
- Duke University School of Medicine, Durham, North Carolina; The Society of Thoracic Surgeons
| | - Renda Soylemez Wiener
- Boston University School of Medicine and Center for Healthcare Organization & Implementation Research, VA Boston Healthcare System, Boston, Massachusetts; American College of Chest Physicians
| | - Leah J Witt
- University of California San Francisco, San Francisco, California; American Geriatrics Society
| | - Edwin F Donnelly
- Specialty Chair, Ohio State University Wexner Medical Center, Columbus, Ohio
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Kumar J, Patel S, Chang A, Mukherjee S, Small C, Gollapudi S, Butzmann A, Jangam D, Weinberg OK, George TI, Zehnder JL, Ohgami RS. Smoking status in acute myeloid leukemia is associated with worse overall survival and independent of prior nonhematopoietic malignancies, cytogenetic abnormalities, and WHO category. Hum Pathol 2023; 135:45-53. [PMID: 36921727 DOI: 10.1016/j.humpath.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023]
Abstract
Acute myeloid leukemia (AML) is an aggressive hematopoietic malignancy with several patient- and disease-associated variables known to impact prognosis. Tobacco smoking is an environmental factor associated with a greater incidence of AML, but there have been limited studies that evaluated smoking toward overall survival. We retrospectively searched for AML cases and collected clinical and diagnostic data for each case. We also used an independent next-generation sequencing (NGS) data set to assess for a distinct mutational signature associated with smoking. When stratified by smoking status, there was a greater number of males, patients aged ≥60 years, and patients with ≥2 comorbidities within the smoking category (P < .05). Survival analysis demonstrated decreased survival probability in the smokers, male smokers, smokers with 1 other comorbidity, and smokers without a prior history of nonhematopoietic malignancy (P < .05) as compared to nonsmokers. Smoking was associated with a decrease in survival within the World Health Organization categories of AML, not otherwise specified (AML NOS; P = .035) and AML with recurrent genetic abnormalities (AML RGA; P = .002). Multivariate analysis showed that patients who were smokers had a greater hazard ratio than nonsmokers after adjusting for the other covariates. Our findings demonstrated that smoking was independently associated with decreased overall survival after adjusting for other potentially confounding factors. In addition, our results suggest that a mutational signature can be recognized using NGS data in a subset of AML patients who smoke.
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Affiliation(s)
- Jyoti Kumar
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065 United States.
| | - Samit Patel
- Department of Pharmacy, Stanford University School of Medicine, Stanford, CA, 94305 United States
| | - Abraham Chang
- Department of Pharmacy, Stanford University School of Medicine, Stanford, CA, 94305 United States
| | - Soham Mukherjee
- Department of Pathology, University of California San Francisco, San Francisco, CA, 94143 United States
| | - Corinn Small
- Department of Pathology, University of California San Francisco, San Francisco, CA, 94143 United States
| | - Sumanth Gollapudi
- Department of Pathology, University of California San Francisco, San Francisco, CA, 94143 United States
| | - Alexandra Butzmann
- Department of Pathology, University of California San Francisco, San Francisco, CA, 94143 United States
| | - Diwash Jangam
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, 94305 United States
| | - Olga K Weinberg
- Department of Pathology, University of Texas Southwestern, Dallas, TX, 75235 United States
| | - Tracy I George
- Department of Pathology, University of Utah Health, Salt Lake City, UT, 84132 United States
| | - James L Zehnder
- Department of Pathology, Stanford University School of Medicine, Stanford, CA, 94305 United States
| | - Robert S Ohgami
- Department of Pathology, University of Utah Health, Salt Lake City, UT, 84132 United States
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Bhurosy T, Marium A, Karaye IM, Chung T. Where there are fumes, there may be lung cancer: a systematic review on the association between exposure to cooking fumes and the risk of lung cancer in never-smokers. Cancer Causes Control 2023; 34:509-520. [PMID: 37031313 DOI: 10.1007/s10552-023-01686-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/19/2023] [Indexed: 04/10/2023]
Abstract
PURPOSE Lung cancer in never-smokers (LCINS) is the seventh leading cause of cancer, and exposure to cooking fumes has recently emerged as a potential risk factor. This systematic review is the first to summarize and evaluate the relationship between exposure to cooking fumes and the risk of LCINS. METHODS This study conducted an online literature search of PubMed, CINAHL, and PsychInfo databases. Inclusion criteria were original research articles published in English, that assessed the relationship between exposure to cooking fumes and the risk of lung cancer between 1 January 2012 and 6 December 2022, and that included never-smokers. RESULTS Thirteen case-control studies and three prospective cohort studies, focusing mostly on women with LCINS, met the inclusion criteria. Seven case-control studies reported an association between exposure to cooking oil fumes and an increased risk of LCINS. Two case-control studies found that using a fume extractor was associated with a decreased risk of LCINS. In other case-control studies, coal use was linked to an increased risk of LCINS, and participants who did not use a ventilator in their kitchens had a higher risk for LCINS. Poor ventilation [Adjusted Hazard Ratio (AHR) = 1.49; 95% CI: 1.15, 1.95] and poor ventilation in combination with coal use (AHR = 2.03; 95% CI: 1.35, 3.05) were associated with an increased risk for LCINS in one prospective cohort study. CONCLUSION The evidence reviewed underscores the need to develop culturally-tailored interventions that improve access to affordable and clean fuel through engaging relevant stakeholders.
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Affiliation(s)
- Trishnee Bhurosy
- Department of Population Health, Hofstra University, Hempstead, NY, 11549, USA.
| | - Amatul Marium
- Department of Population Health, Hofstra University, Hempstead, NY, 11549, USA
- Consumer Safety Office, Food and Drug Administration, Jamaica, NY, 11433, USA
| | - Ibraheem M Karaye
- Department of Population Health, Hofstra University, Hempstead, NY, 11549, USA
| | - Tammy Chung
- Center for Population Behavioral Health, Rutgers the State University of New Jersey, New Brunswick, NJ, 08901, USA
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Ochman B, Kiczmer P, Ziora P, Rydel M, Borowiecki M, Czyżewski D, Drozdzowska B. Incidence of Concomitant Neoplastic Diseases, Tumor Characteristics, and the Survival of Patients with Lung Adenocarcinoma or Squamous Cell Lung Carcinoma in Tobacco Smokers and Non-Smokers-10-Year Retrospective Single-Centre Cohort Study. Cancers (Basel) 2023; 15:cancers15061896. [PMID: 36980781 PMCID: PMC10046928 DOI: 10.3390/cancers15061896] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/17/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023] Open
Abstract
Changes in smoking trends and changes in lifestyle, together with worldwide data regarding the incidence of lung cancer in the group of patients with no previous history of smoking, leads to consideration of the differences in the course of the disease, the time of cancer diagnosis, the survival rate, and the occurrence of comorbidities in this group of patients. This study aimed to determine the occurrence of non-smokers among patients undergoing anatomical resection of the lung tissue due to lung carcinoma and to investigate the differences between the course of lung cancer, survival, and the comorbidities in the groups of patients with lung cancer depending on the history of tobacco smoking. The study included a cohort of 923 patients who underwent radical anatomical resection of the lung tissue with lung primary adenocarcinoma or squamous cell carcinoma. The Chi2 Pearson's test, the t-test, the Mann-Whitney U test, the Kaplan-Meier method, the Log-rank test with Mantel correction, and the Cox proportional hazard model were used for data analysis. We observed a significantly higher mean age of smoking patients compared to the mean age of non-smoking patients. The coexistence of former neoplastic diseases was significantly more frequent in the group of non-smokers compared to the group of smoking patients. We did not observe differences depending on smoking status in the tumor stage, grade, vascular and pleural involvement status in the diagnostic reports. We did not observe differences in the survival between smokers vs. non-smokers, however, we revealed better survival in the non-smoker women group compared to the non-smoker men group. In conclusion, 22.11% of the patients undergoing radical anatomical resection of the lung tissue due to lung cancers were non-smokers. More research on survival depending on genetic differences and postoperative treatment between smokers and non-smokers is necessary.
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Affiliation(s)
- Błażej Ochman
- Students' Scientific Society, Department of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Paweł Kiczmer
- Department of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Paweł Ziora
- Department of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Mateusz Rydel
- Department of Thoracic Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Maciej Borowiecki
- Students' Scientific Society, Department of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Damian Czyżewski
- Department of Thoracic Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Bogna Drozdzowska
- Department of Pathomorphology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
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Cheng ES, Velentzis LS, Weber M, Steinberg J, Canfell K, Yu XQ. Female reproductive and hormonal factors and lung cancer mortality among never-smokers: A prospective cohort study of 287 408 Chinese women. Int J Cancer 2023; 152:2528-2540. [PMID: 36916124 DOI: 10.1002/ijc.34508] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/20/2023] [Accepted: 02/23/2023] [Indexed: 03/15/2023]
Abstract
There is growing, but inconsistent evidence suggesting oestrogen may play a key role in lung cancer development, especially among never-smoking women for whom lung cancer risk factors remain largely elusive. Using the China Kadoorie Biobank, a large-scale prospective cohort with 302 510 women aged 30 to 79 years recruited from 10 regions in China during 2004 to 2008, we assessed the risk of lung cancer death among self-reported never-smoking women who were cancer-free at baseline, in relation to age at menarche, age at menopause, time since menopause, prior use of oral contraceptives (OCP), number of livebirths, breastfeeding and age at first livebirth. Women were followed up to December 31, 2016 with linkage to mortality data. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression, adjusting for key confounders including several socio-demographic, environmental and lifestyle factors. Among 287 408 never-smoking women, 814 died from lung cancer with a median follow-up of 10.3 years. Women who had used OCP within 15 years prior to baseline had a significantly higher hazard of lung cancer death compared with never-users: HR = 1.85 (95% CI: 1.14-3.00) and risk increased by 6% with each additional year of use: HR = 1.06 (1.01-1.10). Among parous women, the hazard of lung cancer death increased by 13% with each single livebirth: HR = 1.13 (1.05-1.23); and among post-menopausal women, the risk increased by 2% with each year since menopause: HR = 1.02 (1.01-1.04). These results suggest that reproductive factors which were proxies for lower endogenous oestrogen level, for example, longer duration of OCP use, could play a role in lung cancer development.
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Affiliation(s)
- Elvin S Cheng
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Louiza S Velentzis
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Marianne Weber
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Julia Steinberg
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
| | - Karen Canfell
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Xue Qin Yu
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, New South Wales, Australia
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Identification of potential tumor antigens and immune subtypes for lung adenocarcinoma. Med Oncol 2023; 40:100. [PMID: 36809467 DOI: 10.1007/s12032-023-01973-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/05/2023] [Indexed: 02/23/2023]
Abstract
In lung adenocarcinoma (LUAD), tumor antigens and immune phenotypes are important for cancer immunotherapy. This study aims to identify potential tumor antigens and immune subtypes for LUAD. In this study, the gene expression profiles and related clinical data of LUAD patients were collected from the TCGA and the GEO database. Then, we first identified four genes with copy number variation and mutation related to the survival of LUAD patients, in which FAM117A, INPP5J, and SLC25A42 were screened as potential tumor antigens. The expressions of these genes were significantly correlated with the infiltration of B cells CD4+ T cells and dendritic cells using TIMER and CIBERSORT algorithms. LUAD patients were divided into three immune clusters: C1(immune-desert), C2(immune-active), and C3(inflamed) using the Non-negative matrix factorization algorithm by using survival-related immune genes. The C2 cluster showed favorable overall survival compared to C1 and C3 clusters in both TCGA and two GEO LUAD cohorts. Different immune cell infiltration patterns, immune-associated molecular characteristics, and drug sensitivity were found among the three clusters. Moreover, different positions in the immune landscape map exhibited different prognostic characteristics using dimensionality reduction, providing further evidence of the immune clusters. The Weighted Gene Co-Expression Network Analysis was used to identify the co-expression modules of these immune genes. the three subtypes were significantly positively correlated with the turquoise module gene list, indicating a good prognosis with high scores. We hope that the identified tumor antigens and immune subtypes can be used for immunotherapy and prognosis in LUAD patients.
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Moorthi S, Paguirigan A, Ko M, Pettinger M, Hoge ACH, Nag A, Patel NA, Wu F, Sather C, Fitzgibbon MP, Thorner AR, Anderson GL, Ha G, Berger AH. Somatic mutation but not aneuploidy differentiates lung cancer in never-smokers and smokers. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.01.05.522947. [PMID: 36712079 PMCID: PMC9881937 DOI: 10.1101/2023.01.05.522947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Lung cancer in never-smokers disproportionately affects older women. To understand the mutational landscape of this cohort, we performed detailed genome characterization of 73 lung adenocarcinomas from participants of the Women’s Health Initiative (WHI). We find enrichment of EGFR mutations in never-/light-smokers and KRAS mutations in heavy smokers as expected, but we also show that the specific variants of these genes differ by smoking status, with important therapeutic implications. Mutational signature analysis revealed signatures of clock, APOBEC, and DNA repair deficiency in never-/light-smokers; however, the mutational load of these signatures did not differ significantly from those found in smokers. Last, tumors from both smokers and never-/light-smokers shared copy number subtypes, with no significant differences in aneuploidy. Thus, the genomic landscape of lung cancer in never-/light-smokers and smokers is predominantly differentiated by somatic mutations and not copy number alterations.
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Kim MH, Park S, Park YR, Ji W, Kim SG, Choo M, Hwang SS, Lee JC, Kim HR, Choi CM. Stratifying non-small cell lung cancer patients using an inverse of the treatment decision rules: validation using electronic health records with application to an administrative database. BMC Med Inform Decis Mak 2023; 23:3. [PMID: 36609301 PMCID: PMC9825000 DOI: 10.1186/s12911-022-02088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 12/15/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND To validate a stratification method using an inverse of treatment decision rules that can classify non-small cell lung cancer (NSCLC) patients in real-world treatment records. METHODS (1) To validate the index classifier against the TNM 7th edition, we analyzed electronic health records of NSCLC patients diagnosed from 2011 to 2015 in a tertiary referral hospital in Seoul, Korea. Predictive accuracy, stage-specific sensitivity, specificity, positive predictive value, negative predictive value, F1 score, and c-statistic were measured. (2) To apply the index classifier in an administrative database, we analyzed NSCLC patients in Korean National Health Insurance Database, 2002-2013. Differential survival rates among the classes were examined with the log-rank test, and class-specific survival rates were compared with the reference survival rates. RESULTS (1) In the validation study (N = 1375), the overall accuracy was 93.8% (95% CI: 92.5-95.0%). Stage-specific c-statistic was the highest for stage I (0.97, 95% CI: 0.96-0.98) and the lowest for stage III (0.82, 95% CI: 0.77-0.87). (2) In the application study (N = 71,593), the index classifier showed a tendency for differentiating survival probabilities among classes. Compared to the reference TNM survival rates, the index classification under-estimated the survival probability for stages IA, IIIB, and IV, and over-estimated it for stages IIA and IIB. CONCLUSION The inverse of the treatment decision rules has a potential to supplement a routinely collected database with information encoded in the treatment decision rules to classify NSCLC patients. It requires further validation and replication in multiple clinical settings.
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Affiliation(s)
- Min-Hyung Kim
- grid.38142.3c000000041936754XDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA USA ,grid.31501.360000 0004 0470 5905Department of Preventive Medicine and Family Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Sojung Park
- grid.411076.5Department of Respiratory and Critical Care Medicine, College of Medicine, Ewha Womans University Medical Center, Seoul, Republic of Korea
| | - Yu Rang Park
- grid.15444.300000 0004 0470 5454Department of Biomedical System Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Wonjun Ji
- grid.267370.70000 0004 0533 4667Department of Respiratory and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seul-Gi Kim
- grid.267370.70000 0004 0533 4667Department of Respiratory and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Minji Choo
- grid.267370.70000 0004 0533 4667Department of Respiratory and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea ,grid.31501.360000 0004 0470 5905Department of Epidemiology, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Seung-Sik Hwang
- grid.31501.360000 0004 0470 5905Department of Epidemiology, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jae Cheol Lee
- grid.267370.70000 0004 0533 4667Department of Oncology, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
| | - Hyeong Ryul Kim
- grid.267370.70000 0004 0533 4667Department of Thoracic and Cardiovascular Surgery, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea
| | - Chang-Min Choi
- grid.267370.70000 0004 0533 4667Department of Respiratory and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea ,grid.267370.70000 0004 0533 4667Department of Oncology, College of Medicine, Asan Medical Center, University of Ulsan, Seoul, Republic of Korea ,grid.267370.70000 0004 0533 4667Department of Pulmonary and Critical Care Medicine, Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-Ro 43-Gil, Songpa–gu, Seoul, 05505 South Korea
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Lee WK, Myong J, Kwag E, Shin Y, Son JW, Yoo BC, Kim BS, Yoo HS, Choi JJ. Comparison of Plasma Metabolites From Patients With Non-Small Cell Lung Cancer by Erlotinib Treatment and Skin Rash. Integr Cancer Ther 2023; 22:15347354231198090. [PMID: 37750513 PMCID: PMC10524077 DOI: 10.1177/15347354231198090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/26/2023] [Accepted: 08/14/2023] [Indexed: 09/27/2023] Open
Abstract
Erlotinib is a necessary anticancer treatment for non-small cell lung cancer (NSCLC) patients yet it causes severe side effects such as skin rash. In this study, researchers compared the untargeted compound profiles before and after erlotinib administration to observe changes in blood metabolites in NSCLC patients. The levels of 1005 substances changed after taking erlotinib. The levels of 306 and 699 metabolites were found to have increased and decreased, respectively. We found 5539 substances with peak area differences based on the presence of skin rash. Carbohydrate, amino acid, and vitamin metabolic pathways were altered in response to the onset of erlotinib-induced skin rash. Finally, this study proposed using plasma metabolites to identify biomarker(s) induced by erlotinib, as well as target molecule(s), for the treatment of dermatological toxic effects.
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Affiliation(s)
- Won Kil Lee
- Daejeon University, Daejeon, Republic of Korea
| | - Jisoo Myong
- Daejeon University, Seoul, Republic of Korea
| | - Eunbin Kwag
- Daejeon University, Daejeon, Republic of Korea
| | | | - Ji Woong Son
- Konyang University Hospital, Daejeon, Republic of Korea
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Pinheiro PS, Callahan KE, Medina HN, Koru-Sengul T, Kobetz EN, Gomez SL, de Lima Lopes G. Lung cancer in never smokers: Distinct population-based patterns by age, sex, and race/ethnicity. Lung Cancer 2022; 174:50-56. [PMID: 36334356 DOI: 10.1016/j.lungcan.2022.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Epidemiological patterns for lung cancer among never smokers (LCNS) are largely unknown, even though LCNS cases comprise 15% of lung cancers. Past studies were based on epidemiologic or health system cohorts, and not fully representative of the underlying population. The objective was to analyze rates (and trends) of LCNS by sex, age group, and race and ethnicity based on all-inclusive truly population-based sources. MATERIALS AND METHODS Individual-level data from 2014 to 2018 on smoking status among microscopically-confirmed lung cancer cases from Florida's cancer registry were combined with population denominators adjusted with NHIS data on smoking prevalence to compute population-based LCNS incidence rates and rate ratios. Incidence rates and proportional mortality were ranked against other cancers. Joinpoint regression analyses examined trends. RESULTS Proportions of LCNS ranged from 9% among White men to 83% among Chinese women. Overall, LCNS was 13% (IRR 1.13, 95%CI 1.08-1.17) more common among men than women, but variation occurred by age group, with female rates exceeding male in younger ages. Age-adjusted rates per 100,000 were highest among Asian/Pacific Islander (API) men and women (15.3 and 13.5, respectively) and Black populations (14.6, 12.9), intermediate for White (13.2, 11.8) and lowest among the Hispanic population (12.1, 10.6). Among API women, LCNS was the second leading cause of cancer death, surpassed only by breast cancer. LCNS trends were stable over time. CONCLUSION LCNS is the 11th most frequently occurring cancer in men and 8th in women. LCNS differences by race/ethnicity are small, within a 15% range of the White population's rates. Surprisingly, API men and women have the highest LCNS rates and proportional mortality. As smoking prevalence decreases in the US, LCNS cases will inevitably increase, warranting inquiry into risk factors across the lifespan.
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Affiliation(s)
- Paulo S Pinheiro
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, FL, United States; Department of Public Health Sciences, University of Miami School of Medicine, Miami, FL, United States.
| | - Karen E Callahan
- School of Public Health, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Heidy N Medina
- Department of Public Health Sciences, University of Miami School of Medicine, Miami, FL, United States
| | - Tulay Koru-Sengul
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, FL, United States; Department of Public Health Sciences, University of Miami School of Medicine, Miami, FL, United States
| | - Erin N Kobetz
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, FL, United States; Department of Public Health Sciences, University of Miami School of Medicine, Miami, FL, United States
| | - Scarlett Lin Gomez
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, CA, United States
| | - Gilberto de Lima Lopes
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, FL, United States
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Trojnar A, Domagała-Kulawik J, Sienkiewicz-Ulita A, Zbytniewski M, Gryszko GM, Cackowski MM, Dziedzic M, Woźnica K, Orłowski TM, Dziedzic DA. Sex differences in clinico-pathologic characteristics and long-term survival among 17,192 surgically treated NSCLC patients: Nationwide population-based propensity score-matching study. Surg Oncol 2022; 45:101873. [DOI: 10.1016/j.suronc.2022.101873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
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Muacevic A, Adler JR, Mehta A. Lung Cancer in Non-Smokers: Clinicopathological and Survival Differences from Smokers. Cureus 2022; 14:e32417. [PMID: 36644085 PMCID: PMC9833623 DOI: 10.7759/cureus.32417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Background Lung cancer in non-smokers is a clinically distinct entity based on unique epidemiology, clinicopathology, genetics, treatment response, and outcome. Data from Indian centres are scarce. The objective of this study was to compare the frequency, clinical characteristics, driver mutations, and survival of non-smoking and smoking lung cancer patients treated at a tertiary cancer centre in North India. Methodology Two years of data on 724 consecutive lung cancer patients were assessed. Clinical, demographics, smoking history, and EGFR and ALK mutation test results were collected. Descriptive and inferential statistics were applied. Survival analysis was performed using the Kaplan-Meier method. Results Non-smokers comprised 40.9% of the study sample. Non-smokers were more likely than smokers to experience disease onset at a younger age (P = 0.004) and metastasis (P < 0.001). The tumor histology showed significant differences (P < 0.001), with non-smokers more likely to be diagnosed with adenocarcinoma (77.4%), while squamous and small cell histologies were commonly found among smokers (37.6% and 13.8%, respectively). The EGFR mutation and ALK rearrangement rates in the cohort were 23.3% and 10.1%, respectively, and were more frequent in non-smoking patients. Overall, 10-year survival was 7%, with a significantly better survival rate of non-smokers than smokers (median survival time of 15.13 vs 10.17 months; P = 0.012). Conclusions About four out of 10 patients diagnosed with lung cancer at our centre were non-smokers. They were more often young, diagnosed at an advanced stage, with predominantly adenocarcinoma histology, and had a threefold higher frequency of EGFR mutations than smokers. In our cohort, non-smokers appear to be a targetable group with better survival than smokers.
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Candal-Pedreira C, Ruano-Ravina A, Pérez-Ríos M. Is lung cancer in never smokers still an unknown disease? Transl Cancer Res 2022; 11:4223-4227. [PMID: 36644195 PMCID: PMC9834589 DOI: 10.21037/tcr-22-2345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/17/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Cristina Candal-Pedreira
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain;,Health Research Institute of Santiago de Compostela (IDIS-Instituto de Investigación Sanitaria de Santiago de Compostela), Santiago de Compostela, Spain
| | - Alberto Ruano-Ravina
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain;,Health Research Institute of Santiago de Compostela (IDIS-Instituto de Investigación Sanitaria de Santiago de Compostela), Santiago de Compostela, Spain;,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Madrid, Spain
| | - Mónica Pérez-Ríos
- Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain;,Health Research Institute of Santiago de Compostela (IDIS-Instituto de Investigación Sanitaria de Santiago de Compostela), Santiago de Compostela, Spain;,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Madrid, Spain
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41
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Zhang Z, Zhang X, Gao Y, Chen Y, Qin L, Wu IX. Risk factors for the development of lung cancer among never smokers: A systematic review. Cancer Epidemiol 2022; 81:102274. [PMID: 36209662 DOI: 10.1016/j.canep.2022.102274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/26/2022] [Accepted: 10/01/2022] [Indexed: 11/29/2022]
Abstract
This review aimed to summarize the up-to-date evidence on non-genetic factors for the development of never smoking lung cancer (NSLC) and to explore reasons behind the conflicting results. Relevant literature was searched in three electronic databases (PubMed, Embase and Web of Science) from 1 January 2000-31 July 2022. Cohort studies that investigated non-genetic risk factors for primary lung cancer in never smokers were included. The effect of non-genetic factors about NSLC were summarized with pooled relative risk (RR) and 95 % confidence intervals (CIs) through meta-analysis or narrative description when unexplained statistical heterogeneity was observed. The Newcastle-Ottawa Scale was used to appraise the methodological quality of included studies. Sixty cohort studies were included, covering population from Asia, Europe and America. Most included studies (42, 70.0 %) were of high methodological quality. Over 50 years old (RR = 5.26), environmental tobacco smoke (Pooled RR = 1.30), Chronic obstructive pulmonary disease (COPD) (RR = 2.67), family history of lung cancer (Pooled RR = 1.83) and higher level of neutrophil-lymphocyte ratio (RR = 1.73) increased the risk of NSLC. Dairy foods consumption (RR = 0.79), isoflavone intake (Pooled RR = 0.65), and riboflavin intake (RR = 0.62) decreased the risk among female population. Inconsistency or unclear definition for never smokers and risk factors could be observed in included studies. Most life behavior factors associated with NSLC can be modified through lifestyle changes. Future cohort studies are suggested to adopt a clearer definition on never smokers and exposure, conducting subgroup analysis when evidence indicating there is heterogeneity between genders, and explore dose-response relationship between the identified factors and NSLC.
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Affiliation(s)
- Zixuan Zhang
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Xuewei Zhang
- Health Management Center, Xiangya Hospital, Central South University, Changsha, China; Centre for Medical Genetics & Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
| | - Yinyan Gao
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Yancong Chen
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Lang Qin
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Irene Xy Wu
- Xiangya School of Public Health, Central South University, Changsha, China; Hunan Provincial Key Laboratory of Clinical Epidemiology, China.
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Shan L, Zhang L, Zhu X, Wang Z, Fang S, Lin J, Wang J, Li N, Liu H, Zhang X, Feng Y, Liu J, Pan J, Ye G, Yu X, Tufman A, Katalinic A, Goldmann T, Petersen F, Jiang J, Geng G, Yu X. Chinese never smokers with adenocarcinoma of the lung are younger and have fewer lymph node metastases than smokers. Respir Res 2022; 23:293. [PMID: 36309662 PMCID: PMC9617301 DOI: 10.1186/s12931-022-02199-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/25/2022] [Indexed: 11/25/2022] Open
Abstract
Background Lung cancers arising in never smokers have been suggested to be substantially different from lung cancers in smokers at an epidemiological, genetic and molecular level. Focusing on non-small cell lung cancer (NSCLC), we characterized lung cancer patients in China looking for demographic and clinical differences between the smoking and never-smoking subgroups. Methods In total, 891 patients with NSCLC, including 841 with adenocarcinoma and 50 with squamous cell carcinoma, were recruited in this study. Association of smoking status with demographic and clinical features of NSCLC was determined, and risk factors for lymph node metastasis and TNM stage were evaluated using Multivariate logistic regression analysis. Results In patients with adenocarcinoma, never smokers showed a younger age at diagnosis (54.2 ± 12.7vs. 59.3 ± 9.4, padjusted<0.001), a lower risk for lymph node metastasis than smokers (7,6% vs. 19.5%, padjusted<0.001) and less severe disease as indicated by lower percentages of patients with TNM stage of III or IV (5.5% vs. 14.7%, padjusted<0.001 ). By contrast, these associations were not observed in 50 patients with squamous cell carcinoma. Multivariate logistic regression analysis showed that smoking status was a risk factor for lymph node metastasis (OR = 2.70, 95% CI: 1.39–5.31, p = 0.004) but not for TNM stage (OR = 1.18, 95% CI: 0.09–14.43, p = 0.896) in adenocarcinoma. Conclusion This study demonstrates that lung adenocarcinoma in never smokers significantly differ from those in smokers regarding both age at diagnosis and risk of lymph node metastasis, supporting the notion that they are distinct entries with different etiology and pathogenesis. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-02199-z.
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43
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Quinn ZL, Barta JA, Johnson JM. Molecular lung cancer: How targeted therapies and personalized medicine are re-defining cancer care. Am J Med Sci 2022; 364:371-378. [PMID: 35469765 DOI: 10.1016/j.amjms.2022.04.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/25/2022] [Accepted: 04/15/2022] [Indexed: 01/25/2023]
Abstract
Lung cancer remains the leading cause of cancer death in the United States and is unfortunately still frequently diagnosed in the metastatic setting, where the disease is considered incurable. Nearly 30% of these cancers may be driven by specific mutations that promote tumor growth and proliferation. These mutations are observed more frequently in young patients without significant smoking history and in certain racial and ethnic backgrounds. The past 15 years have marked a revolution for patients with molecularly driven lung cancer as novel, oral, targeted therapies have been developed that demonstrate superior activity with substantially better toxicity profiles in comparison to chemotherapy. Consideration of molecular testing for a driver mutation is imperative for all providers caring for patients with a new suspected lung cancer diagnosis, as discovery of an actionable mutation will have dramatic implications in regards to patient survival and quality of life.
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Affiliation(s)
- Zachary L Quinn
- Department of Medical Oncology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Julie A Barta
- Department of Medicine, Jane and Leonard Korman Respiratory Institute, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jennifer M Johnson
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Philadelphia, PA, USA.
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Lewandowska A, Lewandowski T, Zych B, Papp K, Zrubcová D, Apay SE, Nagórska M. Risk Factors for the Diagnosis of Lung Cancer in Poland: A Large-Scale, Population-Based Case-Control Study. Asian Pac J Cancer Prev 2022; 23:3299-3307. [PMID: 36308352 PMCID: PMC9924324 DOI: 10.31557/apjcp.2022.23.10.3299] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Lung cancer is one of the most common and deadly malignant neoplasms. Currently, it is one of the main causes of cancer deaths worldwide. The study aimed to identify and evaluate patient characteristics, demographic and lifestyle factors that are associated with lung cancer at diagnosis. METHODS The study included 400 patients diagnosed with lung cancer and 400 within the control group. The research was based on a clinical, direct, individual, structured, in-depth and focused interview. Assessment of activity and BMI was used according to WHO recommendations, as well as the expert system. RESULTS The mean age of the patients was 74.53 ± 7.86 years, while in the control group 59.5 (7.93). There was a strong positive relationship between the incidence of tuberculosis and chronic obstructive pulmonary disease and the risk of lung cancer (p <0.001). The risk of lung cancer was significant in the case of smoking 20 or more than 20 cigarettes a day and smoking for more than 20 years (p = 0.01). CONCLUSIONS Active and passive smoking, are a leading risk factor for lung cancer, which shows that understanding of the long-term and fatal effects of smoking is still very low in society. No significant correlation has been found between lifestyle and risk of lung cancer. However, there was a strong positive correlation between tuberculosis and chronic obstructive pulmonary disease and the risk of lung cancer. Occupation is a predisposing factor for lung cancer occurrence.
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Affiliation(s)
- Anna Lewandowska
- Institute of Healthcare, State School of Technology and Economics, 37-500 Jaroslaw, Poland. ,For Correspondence:
| | - Tomasz Lewandowski
- Institute of Technical Engineering, State School of Technology and Economics in Jaroslaw, 37-500 Jaroslaw, Poland.
| | - Barbara Zych
- Institute of Health Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland.
| | - Katalin Papp
- Faculty of Health, University of Debrecen, Sóstói út 2-4 4400 Nyíregyháza, Hungary.
| | - Dana Zrubcová
- Faculty of Social Sciences and Health Care Constantine the Philosopher, University in Nitra, Kraskova 1 949 74 Nitra, Slovak Republic.
| | - Serap Ejder Apay
- Faculty of Health Science, Midwifery Department, Ataturk University, Bölümü 25240 Erzurum, Turkey.
| | - Małgorzata Nagórska
- Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszow, Poland.
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45
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Sipilä LJ, Seppä K, Aavikko M, Ravantti J, Heikkinen S, Aaltonen LA, Pitkäniemi J. Sex-specific familial aggregation of cancers in Finland. Sci Rep 2022; 12:15126. [PMID: 36068325 PMCID: PMC9448814 DOI: 10.1038/s41598-022-19039-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/23/2022] [Indexed: 12/24/2022] Open
Abstract
Despite the fact that the effect of sex on the occurrence of cancers has been studied extensively, it remains unclear whether sex modifies familial aggregation of cancers. We explored sex-specific familial aggregation of cancers in a large population-based historical cohort study. We combined cancer and population registry data, inferring familial relationships from birth municipality-surname-sex (MNS) combinations. Our data consisted of 391,529 incident primary cancers in 377,210 individuals with 319,872 different MNS combinations. Cumulative sex-specific numbers of cancers were compared to expected cumulative incidence. Familial cancer risks were similar between the sexes in our population-wide analysis. Families with concordant cancer in both sexes exhibited similar sex-specific cancer risks. However, some families had exceptionally high sex-specific cumulative cancer incidence. We identified six families with exceptionally strong aggregation in males: three families with thyroid cancer (ratio between observed and expected incidence 184.6; 95% credible interval (95% CI) 33.1–1012.7, 173.4 (95% CI 65.4–374.3), and 161.4 (95% CI 29.6–785.7), one with stomach (ratio 14.4 (95% CI 6.9–37.2)), colon (ratio 15.5 (95% CI 5.7–56.3)) cancers and one with chronic lymphocytic leukaemia (ratio 33.5 (95% CI 17.2–207.6)). Our results imply that familial aggregation of cancers shows no sex-specific preference. However, the atypical sex-specific aggregation of stomach cancer, colon cancer, thyroid cancer and chronic lymphocytic leukaemia in certain families is difficult to fully explain with present knowledge of possible causes, and could yield useful knowledge if explored further.
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Affiliation(s)
- Lauri J Sipilä
- Department of Medical and Clinical Genetics, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland.,Applied Tumor Genomics Research Program, Research Programs Unit, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland.,Finnish Cancer Registry, Unioninkatu 22, 00130, Helsinki, Finland
| | - Karri Seppä
- Finnish Cancer Registry, Unioninkatu 22, 00130, Helsinki, Finland
| | - Mervi Aavikko
- Department of Medical and Clinical Genetics, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland.,Applied Tumor Genomics Research Program, Research Programs Unit, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland.,Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Janne Ravantti
- Department of Medical and Clinical Genetics, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland.,Applied Tumor Genomics Research Program, Research Programs Unit, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland.,Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, 00014, Helsinki, Finland
| | - Sanna Heikkinen
- Finnish Cancer Registry, Unioninkatu 22, 00130, Helsinki, Finland
| | - Lauri A Aaltonen
- Department of Medical and Clinical Genetics, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland.,Applied Tumor Genomics Research Program, Research Programs Unit, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, PO Box 63, 00014, Helsinki, Finland
| | - Janne Pitkäniemi
- Finnish Cancer Registry, Unioninkatu 22, 00130, Helsinki, Finland. .,Health Sciences Unit, Faculty of Social Sciences (Health Sciences), Tampere University, Tampere, Finland. .,Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland. .,Institute for Statistical and Epidemiological Cancer Research, Finnish Cancer Registry, Unioninkatu 22, 00130, Helsinki, Finland.
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Trefzer TB, Schneider MA, Jechow K, Chua RL, Muley T, Winter H, Kriegsmann M, Meister M, Eils R, Conrad C. Intratumoral Heterogeneity and Immune Modulation in Lung Adenocarcinoma in Female Smokers and Never Smokers. Cancer Res 2022; 82:3116-3129. [PMID: 35819252 PMCID: PMC9437562 DOI: 10.1158/0008-5472.can-21-3836] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/13/2022] [Accepted: 07/08/2022] [Indexed: 01/07/2023]
Abstract
SIGNIFICANCE Single-cell analysis of healthy lung tissue and lung cancer reveals distinct tumor cell populations, including cells with differential immune modulating capacity between smokers and never smokers, which could guide future therapeutic strategies.
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Affiliation(s)
- Timo B. Trefzer
- Charité - Universitätsmedizin Berlin and Berlin Institute of Health, Digital Health Center, Berlin, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marc A. Schneider
- Translational Research Unit, Thoraxklinik, Heidelberg University Hospital, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - Katharina Jechow
- Charité - Universitätsmedizin Berlin and Berlin Institute of Health, Digital Health Center, Berlin, Germany
| | - Robert Lorenz Chua
- Charité - Universitätsmedizin Berlin and Berlin Institute of Health, Digital Health Center, Berlin, Germany
| | - Thomas Muley
- Translational Research Unit, Thoraxklinik, Heidelberg University Hospital, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - Hauke Winter
- Translational Lung Research Center Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), Heidelberg, Germany.,Department of Surgery, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany
| | - Mark Kriegsmann
- Translational Lung Research Center Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), Heidelberg, Germany.,Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Michael Meister
- Translational Research Unit, Thoraxklinik, Heidelberg University Hospital, Heidelberg, Germany.,Translational Lung Research Center Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), Heidelberg, Germany
| | - Roland Eils
- Charité - Universitätsmedizin Berlin and Berlin Institute of Health, Digital Health Center, Berlin, Germany.,Health Data Science Unit, Heidelberg University Hospital and BioQuant, Heidelberg, Germany
| | - Christian Conrad
- Charité - Universitätsmedizin Berlin and Berlin Institute of Health, Digital Health Center, Berlin, Germany.,Corresponding Author: Christian Conrad, Charité - Universitätsmedizin Berlin and Berlin Institute of Health, Digital Health Center, Kapelle-Ufer 2, Berlin 10117, Germany. Phone: 4930-4505-43097; E-mail:
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47
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Sodhi A, Pisani M, Glassberg MK, Bourjeily G, D'Ambrosio C. Sex and Gender in Lung Disease and Sleep Disorders: A State-of-the-Art Review. Chest 2022; 162:647-658. [PMID: 35300976 PMCID: PMC9808608 DOI: 10.1016/j.chest.2022.03.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/08/2022] [Accepted: 03/08/2022] [Indexed: 01/13/2023] Open
Abstract
The terms sex and gender often are used interchangeably, but have specific meaning when it comes to their effects on lung disease. Ample evidence is now available that sex and gender affect the incidence, susceptibility, presentation, diagnosis, and severity of many lung diseases. Some conditions are more prevalent in women, such as asthma. Other conditions are seen almost exclusively in women, like lymphangioleiomyomatosis. Some life stages-such as pregnancy-are unique to women and can affect the onset and course of lung disease. Clinical presentation may differ as well, such as higher number of exacerbations experienced by women with COPD and greater cardiovascular morbidity in women with sleep-disordered breathing. In addition, response to therapy and medication safety may also differ by sex, and yet, pharmacogenomic factors often are not addressed adequately in clinical trials. Various aspects of lung and sleep biology and pathobiology are impacted by female sex and female reproductive transitions. Differential gene expression or organ development can be impacted by these biological differences. Understanding these differences is the first step in moving toward precision medicine for women. This article is a state-of-the-art review of specific effects of sex and gender focused on epidemiology, disease presentation, risk factors, and management of lung diseases. Pathobiological mechanisms explaining sex differences in these diseases are beyond the scope of this article. We review the literature and focus on recent guidelines about using sex and gender in research. We also review sex and gender differences in lung diseases.
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Affiliation(s)
- Amik Sodhi
- Division of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin, Madison, WI
| | - Margaret Pisani
- Division of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, CT
| | - Marilyn K Glassberg
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Arizona College of Medicine Phoenix, Phoenix, AR
| | - Ghada Bourjeily
- Division of Pulmonary, Critical Care and Sleep Medicine, Brown University, Providence, RI
| | - Carolyn D'Ambrosio
- Division of Pulmonary, Critical Care and Sleep Medicine, Yale University School of Medicine, New Haven, CT.
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48
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de Alencar VTL, Figueiredo AB, Corassa M, Gollob KJ, Cordeiro de Lima VC. Lung cancer in never smokers: Tumor immunology and challenges for immunotherapy. Front Immunol 2022; 13:984349. [PMID: 36091058 PMCID: PMC9448988 DOI: 10.3389/fimmu.2022.984349] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/27/2022] [Indexed: 12/16/2022] Open
Abstract
Lung cancer is the second most common and the most lethal malignancy worldwide. It is estimated that lung cancer in never smokers (LCINS) accounts for 10-25% of cases, and its incidence is increasing according to recent data, although the reasons remain unclear. If considered alone, LCINS is the 7th most common cause of cancer death. These tumors occur more commonly in younger patients and females. LCINS tend to have a better prognosis, possibly due to a higher chance of bearing an actionable driver mutation, making them amenable to targeted therapy. Notwithstanding, these tumors respond poorly to immune checkpoint inhibitors (ICI). There are several putative explanations for the poor response to immunotherapy: low immunogenicity due to low tumor mutation burden and hence low MANA (mutation-associated neo-antigen) load, constitutive PD-L1 expression in response to driver mutated protein signaling, high expression of immunosuppressive factors by tumors cells (like CD39 and TGF-beta), non-permissive immune TME (tumor microenvironment), abnormal metabolism of amino acids and glucose, and impaired TLS (Tertiary Lymphoid Structures) organization. Finally, there is an increasing concern of offering ICI as first line therapy to these patients owing to several reports of severe toxicity when TKIs (tyrosine kinase inhibitors) are administered sequentially after ICI. Understanding the biology behind the immune response against these tumors is crucial to the development of better therapeutic strategies.
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Affiliation(s)
- Viviane Teixeira L. de Alencar
- Medical Oncology Department, Grupo Carinho de Clínicas Oncológicas, São José dos Campos, Brazil
- *Correspondence: Viviane Teixeira L. de Alencar,
| | - Amanda B. Figueiredo
- Translational Immuno-oncology Laboratory, Albert Einstein Research and Education Center, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Center for Research in Immuno-oncology (CRIO), Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Marcelo Corassa
- Medical Oncology Department, A C Camargo Cancer Center, São Paulo, Brazil
| | - Kenneth J. Gollob
- Translational Immuno-oncology Laboratory, Albert Einstein Research and Education Center, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Center for Research in Immuno-oncology (CRIO), Hospital Israelita Albert Einstein, São Paulo, Brazil
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Vogtmann E, Hua X, Yu G, Purandare V, Hullings AG, Shao D, Wan Y, Li S, Dagnall CL, Jones K, Hicks BD, Hutchinson A, Caporaso JG, Wheeler W, Sandler DP, Beane Freeman LE, Liao LM, Huang WY, Freedman ND, Caporaso NE, Sinha R, Gail MH, Shi J, Abnet CC. The Oral Microbiome and Lung Cancer Risk: An Analysis of 3 Prospective Cohort Studies. J Natl Cancer Inst 2022; 114:1501-1510. [PMID: 35929779 PMCID: PMC9664178 DOI: 10.1093/jnci/djac149] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/08/2022] [Accepted: 08/01/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Previous studies suggested associations between the oral microbiome and lung cancer, but studies were predominantly cross-sectional and underpowered. METHODS Using a case-cohort design, 1306 incident lung cancer cases were identified in the Agricultural Health Study; National Institutes of Health-AARP Diet and Health Study; and Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Referent subcohorts were randomly selected by strata of age, sex, and smoking history. DNA was extracted from oral wash specimens using the DSP DNA Virus Pathogen kit, the 16S rRNA gene V4 region was amplified and sequenced, and bioinformatics were conducted using QIIME 2. Hazard ratios and 95% confidence intervals were calculated using weighted Cox proportional hazards models. RESULTS Higher alpha diversity was associated with lower lung cancer risk (Shannon index hazard ratio = 0.90, 95% confidence interval = 0.84 to 0.96). Specific principal component vectors of the microbial communities were also statistically significantly associated with lung cancer risk. After multiple testing adjustment, greater relative abundance of 3 genera and presence of 1 genus were associated with greater lung cancer risk, whereas presence of 3 genera were associated with lower risk. For example, every SD increase in Streptococcus abundance was associated with 1.14 times the risk of lung cancer (95% confidence interval = 1.06 to 1.22). Associations were strongest among squamous cell carcinoma cases and former smokers. CONCLUSIONS Multiple oral microbial measures were prospectively associated with lung cancer risk in 3 US cohort studies, with associations varying by smoking history and histologic subtype. The oral microbiome may offer new opportunities for lung cancer prevention.
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Affiliation(s)
- Emily Vogtmann
- Correspondence to: Emily Vogtmann, PhD, MPH, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, MSC 9768, Bethesda, MD 20892, USA (e-mail: )
| | | | - Guoqin Yu
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Vaishnavi Purandare
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Autumn G Hullings
- Nutrition Department, University of North Carolina, Chapel Hill, NC, USA
| | - Dantong Shao
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yunhu Wan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA,Frederick National Laboratory for Cancer Research/Leidos Biomedical Research Laboratory, Inc, Frederick, MD, USA
| | - Shilan Li
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA,Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University Medical Center, Washington, DC, USA
| | - Casey L Dagnall
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA,Frederick National Laboratory for Cancer Research/Leidos Biomedical Research Laboratory, Inc, Frederick, MD, USA
| | - Kristine Jones
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA,Frederick National Laboratory for Cancer Research/Leidos Biomedical Research Laboratory, Inc, Frederick, MD, USA
| | - Belynda D Hicks
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA,Frederick National Laboratory for Cancer Research/Leidos Biomedical Research Laboratory, Inc, Frederick, MD, USA
| | - Amy Hutchinson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA,Frederick National Laboratory for Cancer Research/Leidos Biomedical Research Laboratory, Inc, Frederick, MD, USA
| | - J Gregory Caporaso
- Center for Applied Microbiome Science, Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, AZ, USA
| | | | - Dale P Sandler
- Epidemiology Branch, Chronic Disease Epidemiology Group, National Institute for Environmental Health Science, Research Triangle Park, NC, USA
| | - Laura E Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Linda M Liao
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Neal D Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Neil E Caporaso
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Rashmi Sinha
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Mitchell H Gail
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Jianxin Shi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Christian C Abnet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
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Jeon DS, Kim JW, Kim SG, Kim HR, Song SY, Lee JC, Ji W, Choi CM, Kim HC. Sex differences in the characteristics and survival of patients with non-small-cell lung cancer: A retrospective analytical study based on real-world clinical data of the Korean population. Thorac Cancer 2022; 13:2584-2591. [PMID: 35906163 PMCID: PMC9475225 DOI: 10.1111/1759-7714.14594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose This study aimed to investigate the differences in characteristics, clinical stages, treatment modalities, and survival outcomes in patients with non‐small‐cell lung cancer (NSCLC) based on sex differences using Korean nationwide registry data. Methods We analyzed the data of 8650 patients diagnosed with NSCLC between 2014 and 2017, obtained from the Korean Association for Lung Cancer Registry (KALC‐R). The Cox proportional hazard model was used to define the differences in survival based on sex. Propensity score matching was used to adjust for differences between men and women. Results Of a total of 10 943 patients, 8650 (79.1%) were diagnosed with NSCLC, of whom 68.7% were men and 31.3% were women. For NSCLC, the median age was higher (69.0 vs. 67.0, p < 0.001) and the proportion of ever‐smokers (84.5% vs. 10.8%, p < 0.001) was higher in men. Adenocarcinoma (55.5% vs. 90.4%, p < 0.001) and stage I NSCLC (26.3% vs. 41.3%, p < 0.001) were more common in women. Survival was significantly lower in men with NSCLC (hazard ratio [HR] 1.493 [95% confidence interval, CI 1.238–1.800], p < 0.001) even after adjusting for meaningful clinical variables, and in the matched cohort (HR 1.339 [1.075–1.667], p = 0.009). Similarly, survival was significantly lower in men with stage IV adenocarcinoma after adjusting for other clinical variables (HR 1.493 [1.238–1.800], p < 0.001) and in the matched cohort (HR 1.339 [1.075–1.667]; p = 0.009). Conclusions Male patients with NSCLC had poorer prognosis, not only after variable adjustments for prognostic factors, but also in the matched cohort.
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Affiliation(s)
- Da Som Jeon
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jin Woo Kim
- Respiratory and Pulmonary Disease Laboratory, Biomedical Research Center, Asan Medical Center, Seoul, South Korea
| | - Seul Gi Kim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hyeong Ryul Kim
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Si Yeol Song
- Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jae Cheol Lee
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Wonjun Ji
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Chang-Min Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.,Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ho Cheol Kim
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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