Expert consensus on perioperative treatment for non-small cell lung cancer

Duan, Jianchun; Tan, Fengwei; Bi, Nan; Chen, Chun; Chen, Ke-Neng; Cheng, Ying; Chu, Qian; Hu, Jie; Huang, Yunchao; Jiang, Tao; Long, Hao; Lu, Yuanzheng; Shi, Meiqi; Wang, Jialei; Wang, Qiming; Yang, Fan; Yang, Nong; Yao, Yu; Ying, Jianming; Zhou, Cai-cun; Zhou, Qing; Zhou, Qinghua; Bongiolatti, Stefano; Brunelli, Alessandro; Fiorelli, Alfonso; Gobbini, Elisa; Gridelli, Cesare; John, Thomas; Kim, Jae Jun; Lin, Steven H.; Metro, Giulio; Minervini, Fabrizio; Novoa, Nuria M.; Owen, Dwight H.; Rodriguez, Maria Alma; Sakanoue, Ichiro; Scarci, Marco; Suda, Kenichi; Tabbò, Fabrizio; Tam, Terence Chi Chun; Tsuchida, Masanori; Uchino, Junichi; Voltolini, Luca; Wang, Jie; Gao, Shugeng

doi:10.21037/tlcr-22-527

Cited by 10 publications

(6 citation statements)

References 49 publications

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“…For Her‐2‐positive tumors with largest diameter >1 cm, chemotherapy + targeted therapy was recommended before surgery. For luminal A/B with positive lymph nodes or the largest diameter of primary tumor >5 cm, chemotherapy was recommended before surgery. Management of lung cancer in our hospital: 7–11 Except for stage IA peripheral lung cancer without enlarged hilar lymph node, preoperative biopsy pathological diagnosis and treatment‐related molecular screening were required for all suspected lung cancers. Quantitative (TNM staging) diagnosis included chest contrast CT, bronchoscopy, brain MRI, liver and supraclavicular ultrasound, and, most importantly, routine positron emission tomography (PET)‐CT. For suspicious enlarged lymph nodes in the bilateral supraclavicular region, bilateral mediastinum or hilum, especially with the primary lesion located in the center, endobronchial ultrasound (EBUS) biopsy was required. Stage I lung cancer patients underwent surgery directly.…”

Section: Methodsmentioning

confidence: 99%

“…For luminal A/B with positive lymph nodes or the largest diameter of primary tumor >5 cm, chemotherapy was recommended before surgery. Management of lung cancer in our hospital: 7 , 8 , 9 , 10 , 11 Except for stage IA peripheral lung cancer without enlarged hilar lymph node, preoperative biopsy pathological diagnosis and treatment‐related molecular screening were required for all suspected lung cancers. Quantitative (TNM staging) diagnosis included chest contrast CT, bronchoscopy, brain MRI, liver and supraclavicular ultrasound, and, most importantly, routine positron emission tomography (PET)‐CT.…”

Section: Methodsmentioning

confidence: 99%

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Considerations for multidisciplinary management of synchronous primary breast cancer and primary lung cancer – Analysis of thirty‐one patients

Chen,

Fang,

Yan

2024

Thoracic Cancer

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BackgroundThe simultaneous (synchronous) presence of primary breast cancer and primary lung cancer diagnosed in a single individual is not an uncommon phenomenon. However, reference data for treatment strategy is scarce and “chaotic”. In the present study we discuss the management strategy for this group of patients.MethodsWe retrospectively reviewed patients in the primary breast cancer database of the Breast Center and the primary lung cancer database of the Thoracic Surgery Department I of Peking University Cancer Hospital. Patients with synchronous primary breast cancer and primary lung cancer who underwent surgery between December 2010 and December 2023 were included in the study. The sequence of outpatient visits, recommendations of multidisciplinary teams, perioperative treatment, and surgical procedures were reviewed. Meanwhile, survival analysis based on propensity score matching with 1:1 ratio was performed between the 31 patients and those with lung cancer only during the same period.ResultsA total of 31 patients with synchronous primary breast cancer and primary lung cancer were identified; all of the patients were women. The average age was 61 years. A total of 24 of the patients had visited the breast center first, and routine chest computed tomography (CT) showed evidence of primary lung cancer. The other seven patients had visited the thoracic surgery clinic first, and routine positron emission tomography (PET)‐CT revealed the coexistence of primary breast cancer. All the patients had multidisciplinary team consultations, after which 20 patients were recommended to have preoperative treatment for breast cancer, two patients were recommended to have preoperative treatment for lung cancer, and nine patients were recommended to undergo surgery directly. After surgery, 23 patients received postoperative adjuvant treatment for breast cancer, and no patients needed postoperative adjuvant treatment for lung cancer. Survival analysis showed that there was no significant difference between the 31 patients and those with lung cancer only.ConclusionRoutine chest CT is needed for breast cancer patients before surgery, and PET‐CT is required for the accurate staging of lung cancer patients. A multidisciplinary expert team should manage synchronous primary breast cancer and primary lung cancer. Emphasis should be placed on patients who need preoperative treatment before surgery. Particularly, for patients who need preoperative chemotherapy, a regimen should be chosen that balances the treatment of lung cancer and breast cancer.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Considerations for multidisciplinary management of synchronous primary breast cancer and primary lung cancer – Analysis of thirty‐one patients

Chen,

Fang,

Yan

2024

Thoracic Cancer

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“…Due to the lack of specific symptoms and detection indicators in the early stages of NSCLC, most patients are already in the middle and advanced stages when they are clinically diagnosed ( Vinas et al, 2016 ). The overall survival of NSCLC patients has significantly increased in recent years under the combined effect of thoracoscopic surgery, targeted therapy, and immunotherapy and the improvement in overall survival has also been closely related to the increased use of screening ( Chang et al, 2021 ; Liang et al, 2021 ; Duan et al, 2022 ). At present, platinum-based chemotherapy is still the standard treatment regimen for patients with advanced NSCLC.…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetics, tissue distribution, and antitumor activity of a novel compound, NY-2, in non-small cell lung cancer

Zhang

Chang

et al. 2023

Front. Pharmacol.

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Introduction: ZLDI-8, which has a relatively strong antitumor activity, is an inhibitor of ADAM-17 and acts on the Notch signaling pathway. To further optimize its structure and improve its activity, a series of derivatives of ZLDI-8 was synthesized. NY-2 was the most effective derivative based on preliminary activity screening in vitro, with no obvious toxicity after administration in vivo.Method: The study aimed to determine the pharmacokinetics, tissue distribution, hepatotoxicity, nephrotoxicity, and antitumor activity of compound NY-2 on non-small cell lung cancer (NSCLC) in vitro and in vivo.Results: The in vivo pharmacokinetics parameters of NY-2 were better than those of ZLDI-8. The tissue distribution analysis showed that tail vein injection of 6 mg/kg of NY-2 in rats resulted in the highest concentration in the lung, so we hypothesized that NY-2 might be effective in the treatment of non-small cell lung cancer. In vitro assays showed that NY-2 significantly inhibited tumor colony formation, invasion, and migration and increased LDH activity and apoptosis in a concentration-dependent manner in non-small cell lung cancer cells. NY-2 also inhibited the formation of lung metastases without significant toxicity to major organs in nude mice.Conclusion: Compared with the parent compound, ZLDI-8, the activity and safety of NY-2 were higher. NY-2 acts on ADAM17 and simultaneously affects the downstream Notch1 and integrinβ1 signaling pathways resulting in antitumor activity. Thus, NY-2 could be a potential antitumor agent, inhibiting the organization and development of non-small cell lung cancer.

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“…The landscape of resectable non-small cell lung cancer (NSCLC) has changed dramatically in recent years, with the advent of neoadjuvant chemotherapy and evaluation of immunotherapy and targeted therapy in adjuvant and neoadjuvant settings. An international expert consensus, authored by Duan et al ( 1 ), saliently summarises the existing therapeutic options for patients with resected NSCLC and the key trials supporting them, as well as recommendations on patient evaluation, selection and monitoring. It alludes also to the areas of active research to further improve outcomes.…”

mentioning

confidence: 99%