Current status of research and treatment for non-small cell lung cancer in never-smoking females

Abstract

Lung cancer is the leading cause of cancer-related deaths worldwide with over 1 million deaths each year. The overall prognosis of lung cancer patients remains unsatisfactory, with a 5-year overall survival rate of less than 15%. Although most lung cancers are a result of smoking, approximately 25% of lung cancer cases worldwide are not attributable to tobacco use. Notably, more than half of the lung cancer cases in women occur in non-smokers. Among non-small-cell lung cancer (NSCLC) cases, cigarette-smokers have a greater association with squamous cell carcinoma than adenocarcinoma, which is more common in non-smokers. These findings imply that specific molecular and pathological features may associate with lung adenocarcinoma arising in non-smoker female patients. Over the past decade, whole genome sequencing and other '-omics' technologies led to the discovery of pathogenic mutations that drive tumor cell formation. These technological developments may enable tailored patient treatments throughout the course of their disease, potentially leading to improved patient outcomes. Some clinical and laboratory studies have shown success outcomes using epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKI) in patients with EGFR mutations and ALK rearrangements, respectively. In fact, these 2 mutations are predominantly present in female non-smokers with adenocarcinoma. Immunotherapy has also recently emerged as a major therapeutic modality in NSCLC. In this review, we summarize the current understanding of NSCLC biology and new therapeutic molecular targets, focusing on the pathogenesis of non-smoker female NSCLC patients.

Clinical significance of EGFR mutation types in lung adenocarcinoma: A multi-centre Korean study

“…This result is supported by the fact that 73.2% of EGFR positive patients received TKI treatment in our study. Additionally, never-smoker lung cancer, especially of adenocarcinoma histology, was highly associated with female sex of East Asian ethnicity and higher prevalence of genomic alterations [36], which was in accordance with our findings. Our study demonstrated significant differences in survival curves amongst the four EGFR mutation sites, with a good prognosis in patients with E19 dels and relatively adverse prognosis in patients with an E21 mutation.…”

Artificial neural networks improve LDCT lung cancer screening: A comparative validation study

“…Among the 5 of 8 lung cancer cases in the validation cohort, the ANN could identify all (100%) of these patients who had pulmonary lesions and initially presented with GGNs <20 mm, which were nally con rmed as adenocarcinoma. In several studies performed in Asian cohorts, the majority of lung cancer patients were non-smokers with pulmonary adenocarcinoma spectrum lesions, which typically presented as pure GGNs or partially solid nodules [33,34]. The current literature shows that larger GGNs (variable cut-off, range 10.5~15.0 mm) tend to be more aggressive or appear as invasive pulmonary adenocarcinoma [35,36].…”

Clinical Significance of Epithelial–Mesenchymal Transition–Related Molecules in Lung Adenocarcinoma

“…Tyrosine kinase inhibitors are used in patients with EGFR mutations and ALK rearrangements. In addition, immunotherapy has also recently become a major therapeutic modality in nsclc [20][21][22] . Despite that progress, 5-year survival in lung adenocarcinoma is less than 12%-15% 23 .…”