Impact of smoking on metabolic changes and effectiveness of drugs used for lung cancer

The association between postdiagnosis smoking cessation and survival in advanced non-small cell lung cancer patients in Southern Taiwan: A retrospective cohort study

Objectives

Smoking is a major lung cancer risk factor. Studies show that smoking after lung cancer diagnosis is associated with an increased risk of developing other cancers and shorter survival. The purpose of this study was to examine the association between postdiagnosis smoking cessation and survival in patients with advanced non-small cell lung cancer (NSCLC).

Materials and Methods

A retrospective cohort study was conducted. Data were collected between January 2014 and December 2019 in three hospitals in Southern Taiwan. Patient data were collected from the hospitals' databases, and the correlation between smoking status and patient survival was analyzed using Kaplan-Meier curves and Cox proportional hazards regression modeling.

Results

A total of 681 patients with advanced NSCLC were included in this study. The numbers (percentage) of ex-smokers and current smokers were 334 (49%) and 347 (51%), respectively. More than half of the patients in this study continued to smoke postdiagnosis advanced NSCLC. Furthermore, ex-smokers had lower mortality risk, even though this was not statistically significant (P = 0.212). The results of this study suggest that older than 65 years, men, Eastern Cooperative Oncology Group performance score of 3 and higher, history of chronic disease, receive chemotherapy, and targeted therapy are correlated with and have predictive effects on advanced NSCLC survival.

Conclusion

There is no significant difference between postdiagnosis smoking cessation and survival in patients with advanced NSCLC. The reason for this finding may be due to lower survival rates after diagnosis with advanced NSCLC, and the benefits of smoking cessation cannot be seen immediately.

Role of SOX Protein Groups F and H in Lung Cancer Progression

Simple Summary

The expression of SOX proteins has been demonstrated in many tissues at various stages of embryogenesis, where they play the role of transcription factors. The SOX18 protein (along with SOX7 and SOX17) belongs to the SOXF group and is mainly involved in the development of the cardiovascular system, where its expression was found in the endothelium. SOX18 expression was also demonstrated in neoplastic lines of gastric, pancreatic and colon adenocarcinomas. The prognostic role of SOX30 expression has only been studied in lung adenocarcinomas, where a low expression of this factor in the stromal tumor was associated with a worse prognosis for patients. Because of the complexity of non-small-cell lung cancer (NSCLC) development, the role of the SOX proteins in this malignancy is still not fully understood. Many recently published papers show that SOX family protein members play a crucial role in the progression of NSCLC.

Abstract

The SOX family proteins are proved to play a crucial role in the development of the lymphatic ducts and the cardiovascular system. Moreover, an increased expression level of the SOX18 protein has been found in many malignances, such as melanoma, stomach, pancreatic breast and lung cancers. Another SOX family protein, the SOX30 transcription factor, is responsible for the development of male germ cells. Additionally, recent studies have shown its proapoptotic character in non-small cell lung cancer cells. Our preliminary studies showed a disparity in the amount of mRNA of the SOX18 gene relative to the amount of protein. This is why our attention has been focused on microRNA (miRNA) molecules, which could regulate the SOX18 gene transcript level. Recent data point to the fact that, in practically all types of cancer, hundreds of genes exhibit an abnormal methylation, covering around 5–10% of the thousands of CpG islands present in the promoter sequences, which in normal cells should not be methylated from the moment the embryo finishes its development. It has been demonstrated that in non-small-cell lung cancer (NSCLC) cases there is a large heterogeneity of the methylation process. The role of the SOX18 and SOX30 expression in non-small-cell lung cancers (NSCLCs) is not yet fully understood. However, if we take into account previous reports, these proteins may be important factors in the development and progression of these malignancies.

Integrative analysis of genomic alteration, immune cells infiltration and prognosis of lung squamous cell carcinoma (LUSC) to identify smoking-related biomarkers

Lung squamous cell carcinoma (LUSC) is the most common histologic type of smoking-related non-small cell lung cancer (NSCLC). However, there are no identified potential biomarkers for smoking-related LUSC diagnosis and prognosis. Especially, the characteristics of genetic alteration and tumor microenvironment induced by cigarette smoking remain unknown. Here, we performed integrative analysis of 463 LUSC with smoking history information from The Cancer Genome Atlas (TCGA). Non-smokers had the best prognosis, and current reformed smokers had better overall survival (OS) than current smokers in all and stage I-II cohort. Then, pathway enrichment analysis might suggest that smoking may play a role in regulating tumor metabolism and invasion and metastasis via those pathways. We constructed an eight-gene signature and identified WNT7A, Solute carrier-7A5 (SLC7A5) and Brain‑type glycogen phosphorylase (PYGB), which may be served as biomarkers related to the smoking. Notably, the single copy deletion of WNT7A and SLC17A5 and the low-level amplification of PYGB may be related to the epigenetic mechanism of smoking on tumorigenesis. We also estimated the relative proportion of 24 immune cell subtypes within tumor microenvironment in different smoking status. Interestingly, we found NK cells activated, NK cells resting and endothelial cells might play an important role in immunologic dysfunction and harmful tumor microenvironment induced by cigarette smoking. Our research has identified potential biomarkers for smoking-related LUSC diagnosis and prognosis, which would help to further understand the pathogenesis of LUSC.