Abstract
Designing optimal (neo)adjuvant therapy is a crucial aspect of the treatment of non-small-cell lung carcinoma (NSCLC). Standard methods of chemotherapy, radiotherapy, and immunotherapy represent effective strategies for treatment. However, in some cases with high metastatic activity and high levels of circulating tumour cells (CTCs), the efficacy of standard treatment methods is insufficient and results in treatment failure and reduced patient survival. CTCs are seen not only as an isolated phenomenon but also a key inherent part of the formation of metastasis and a key factor in cancer death. This review discusses the impact of NSCLC therapy strategies based on a meta-analysis of clinical studies. In addition, possible therapeutic strategies for repression when standard methods fail, such as the administration of low-toxicity natural anticancer agents targeting these phenomena (curcumin and flavonoids), are also discussed. These strategies are presented in the context of key mechanisms of tumour biology with a strong influence on CTC spread and metastasis (mechanisms related to tumour-associated and -infiltrating cells, epithelial–mesenchymal transition, and migration of cancer cells).
Highlights
Lung cancer is a harmful and dangerous oncological disease responsible for frequent cancer-related deaths [1,2]
These findings suggest that analysing the epidermal growth factor receptor (EGFR) gene in circulating tumour cells (CTCs) represents a promising method for the design and management of Non-small-cell lung cancer (NSCLC) therapy, especially in the case of tyrosine kinase inhibitor (TKI) therapy (Table 2)
CTCs are a potential biomarker for NSCLC diagnosis and play key roles in tumour spread
Summary
Lung cancer is a harmful and dangerous oncological disease responsible for frequent cancer-related deaths [1,2]. Sienel et al found that disseminated cancer cells are detectable in approximately 20% of patients with operable NSCLC who have poor clinical outcomes [9] This finding implies that determining CTC levels can provide useful information about the efficacy of surgery and predict the need for adjuvant therapy. The counts for all controls (healthy subjects and patients with other lung diseases) were under the designated limit In such cases, detection of CTCs is most likely a false positive result due to the extremely large numbers of blood cells in the samples [21,22]. This robust approach can analyse numerous cancer biomarkers This strategy effectively enables the determination of tumour properties, mainly metastatic activity and drug resistance, and significantly increases the clinical potential of CTC count. Liquid biopsies can dynamically and noninvasively interrogate the whole molecular landscape of tumours
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