Lung Cancer Patients Research Articles

CTNI-81. PROPOSAL FOR A PHASE IB PILOT CLINICAL TRIAL TO STUDY SAFETY AND IMPROVING ANTI-NEOPLASTIC ADVERSE EFFECTS BY ADDITION OF NATURAL MARINE PRODUCT FUCOIDAN TO THE STANDARD THERAPY FOR PATIENTS WITH NEWLY DIAGNOSED GLIOBLASTOMA (GBM)

Abstract INTRODUCTION GBM is the most aggressive primary brain tumor. Despite standard of care (SOC) with the Stupp protocol and tumor treating fields (TTFs), survival remains poor. In addition, SOC treatment is associated with 96% any adverse effects (AE) and 25% severe AEs (Chinot et al, NEJM 2014), which affects quality of life (QOL) and can lead to early treatment termination. Therefore, novel therapies are needed and minimization of chemoradiation-related AEs is crucial. Marine natural product, fucoidan, may have an important role in oncological management as tumor-directed therapy and as a protectant against chemoradiation-related AEs. Fucoidan is a seaweed-derived sulfated polysaccharide. Mounting evidence garnered from randomized clinical trials for colon, head and neck, and lung cancer patients suggests that fucoidan can improve certain AEs associated with chemoradiation. Furthermore, data gleaned from multiple studies have shown that fucoidan is tolerable with a good safety profile. HYPOTHESIS Fucoidan is safe in combination with chemoradiation and chemotherapy and improves treatment related AE profile. Fucoidan may improve survival outcome in GBM patients by augmenting cytotoxic effects, inhibiting angiogenesis, and improving the tolerability of SOC therapy. METHOD 12 newly diagnosed GBM patients will be enrolled. A Fucoidan-based product will be administered orally at the established dose for cancer patients daily with concurrent chemoradiation therapy and adjuvant chemotherapy over 6 months. Patients will be evaluated weekly to monthly for AEs and QOL scoring; laboratory and brain MRI monitoring will be performed per SOC guidelines. NK cell activity, proinflammatory cytokines, including interleukin (IL)-1β, will be measured. POTENTIAL OUTCOME This pilot study may establish a foundation for future larger randomized clinical trials to treat brain cancer more effectively by adding nature products.

CTNI-83. PROPOSAL FOR A PILOT PHASE 1B CLINICAL TRIAL WITH ADDITION OF NATURAL MARINE PRODUCT FUCOIDAN TO ANTI-NEOPLASTIC THERAPY FOR PATIENTS WITH RECURRENT GLIOBLASTOMA (RGBM) TO IMPROVE FATIGUE AND OTHER HEALTH-RELATED QUALITY OF LIFE (HRQOL) SYMPTOMS

Abstract BACKGROUND Recurrent Glioblastoma (rGBM) has poor outcome with limited treatment options. rGBM causes significant fatigue and other health-related quality of life (HRQOL) symptoms secondary to tumor progression and anti-neoplastic therapies. More than 80% of brain tumor patients were found to experience fatigue during anti-neoplastic therapy and the incidence of cancer related fatigue may reach 89-94% among patients with rGBM. Therefore, improvement of fatigue and HRQOL in rGBM patients are crucial. Marine natural product, fucoidan, available as health supplement in the US, was found to play important roles in oncological management as supportive therapy against cancer and chemoradiation-related adverse effects and as a potential anti-neoplastic therapy. Fucoidan is a seaweed-derived sulfated polysaccharide. Data resulted from randomized clinical trials for colon, head and neck, and lung cancer patients suggest that fucoidan can improve cancer and chemotherapy or chemoradiation therapy related negative symptoms. In addition, Tachikawa et al. reported >50% tumor regression and increased natural killer (NK) cell activity in sarcoma-transplanted mice treated with Fucoidan. In Vitro anticancer investigation found that Fucoidan fractions clearly suppressed the growth of GBM U-251MG cancer cells. Multiple studies have also shown that fucoidan is tolerable with a good safety profile. METHOD 18 rGBM patients will be enrolled. Fucoidan based product will be administered orally at established dose for cancer patients daily with anti-neoplastic therapy over 6 months. Patients will be evaluated monthly for AEs and HRQOL score; laboratory and brain MRI monitoring will be performed per SOC guidelines. NK cell activity will be measured. POTENTIAL OUTCOME Fucoidan is safe and has good tolerability in combination with anti-neoplastic therapy for rGBM and improves fatigue and other HRQOL symptoms by ameliorating tumor progression and treatment related negative impact. Fucoidan may also improve survival in rGBM patients by improving the tolerability of anti-tumor therapy, augmenting cytotoxic effects, and inhibiting angiogenesis.

Changes in soluble PD-L1 levels in patients with advanced non-small cell lung cancer

Abstract Soluble programmed death-1 ligand (sPD-L1) in the serum of non-small cell lung cancer (NSCLC) patients is a crucial factor in disease prognosis and an indicator for immunotherapy response. This study aimed to evaluate changes in sPD-L1 levels in advanced NSCLC patients. Between May 2018 and October 2022, 80 patients with advanced-stage NSCLC and 30 healthy volunteers participated in a prospective study. The findings revealed a significant rise in sPD-L1 concentration in the lung cancer group compared to the normal control group (1.08 vs. 0.42, p < 0.001). No apparent correlation was found between sPD-L1 concentration and membrane-bound programmed death-1 ligand (mPD-L1) expression. The optimal diagnostic threshold for sPD-L1 was set at 0.92 ng/mL, showing a sensitivity of 56.25% and specificity of 77.33%, with an area under the curve (AUC) of 0.743 (p = 0.001). Although increased sPD-L1 levels were prevalent in individuals with advanced age, prolonged disease duration, large tumor size, and finger clubbing, these associations did not reach statistical significance (p > 0.05). In conclusion, sPD-L1 levels significantly increased in advanced NSCLC patients compared to controls (p < 0.05), with no association observed with mPD-L1 (p = 0.304). The study suggests that sPD-L1 concentration can be a specific biomarker for guiding the diagnosis of advanced NSCLC, with a recommended cutoff value of 0.92 ng/mL, demonstrating a sensitivity of 56.25% and specificity of 77.33% (p = 0.001). Importantly, no apparent relationship was established between sPD-L1 levels and clinical or paraclinical characteristics in advanced NSCLC patients.

Quality of Life and Symptom Burden in Non-Small-Cell Lung Cancer Patients Receiving Second-Line Chemotherapy Compared with Immunotherapy

Background and Objectives: The burdened symptomatology accompanying advanced non-small-cell lung cancer (NSCLC) is associated with poor prognosis and lower quality of life (QoL). Although both chemotherapy and immunotherapy increase survival, they are still associated with reduced functionality due to their toxicity. This study aimed to estimate the QoL and symptom burden of NSCLC patients receiving second-line chemotherapy compared to patients receiving second-line immunotherapy. Materials and Methods: This comparative, prospective study, conducted from January 2020 to December 2021, included 111 NSCLC patients who were divided into two groups: 61 patients receiving second-line chemotherapy and 50 patients receiving second-line immunotherapy. Patients’ QoL and symptom burden were estimated using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ C-30) (value range 0–100) from treatment cycle 1 to 6. Results: The QoL (mean score > 50) and functionality dimensions (mean score > 50) were moderate to good in both treatment groups, while the symptom burden did not appear to be a serious problem (mean score < 50). From cycle 3 to cycle 5, QoL was significantly better in the immunotherapy group. From cycle 3, the role and social functioning scores were higher in the immunotherapy group, while emotional and cognitive functioning were higher from cycle 2 (p <0.05). The chemotherapy group experienced higher levels of nausea/vomiting, constipation and financial difficulties in all the cycles (p < 0.05). Fatigue and appetite loss were significantly greater from cycle 2 and insomnia was significantly greater from cycle 3. On the contrary, the immunotherapy group experienced higher levels of diarrhea in cycles 5 and 6 (p < 0.05). Conclusions: Although both therapy groups did not report significantly impaired QoL and severe symptoms, it seems that QoL improved in the immunotherapy group, which reported a lower symptom burden compared to the chemotherapy group.

A head-to-head comparison of [68Ga]Ga-DOTA-FGFR1 and [18F]FDG PET/CT in the diagnosis of lung cancer.

This study aimed to compare the diagnostic value of [68Ga]Ga-DOTA-FGFR1 and [18F]FDG PET/CT in the evaluation of lung cancer patients. A prospective study was conducted between March 2023 and July 2023. Patients with high clinical suspicion of lung cancer were recruited. Each participant underwent PET/CT scanning using [68Ga]Ga-DOTA-FGFR1 and [18F]FDG within 6 days. Histopathology and clinical follow-up results serve as reference criteria for final diagnosis. We used a paired samples t-test or a Wilcoxon signed-rank test to compare the uptake of [68Ga]Ga-DOTA-FGFR1 and [18F]FDG. The diagnostic performance between the two tracers was compared using the McNemar χ² test. A total of 101 participants were included (mean age 63.267 ± 9.344 [range 39-86 years]). In benign lung lesions, [68Ga]Ga-DOTA-FGFR1 had lower TBR and SUVmax than [18F]FDG (2.924 vs. 5.705, P < 0.001;1.395 vs. 4.014, P < 0.001). The TBR of [68Ga]Ga-DOTA-FGFR1 in benign lymph nodes was also lower than [18F]FDG (0.880 vs. 1.25, P < 0.001). [68Ga]Ga-DOTA-FGFR1 had a higher diagnostic specificity for primary tumors than [18F]FDG (52% vs. 28%, P = 0.031). The specificity, accuracy, and PPV of [68Ga]Ga-DOTA-FGFR1 for detecting lymph node metastasis were 82.54%, 78.66%, and 53.73%, respectively, higher than that of [18F]FDG (53.80%, P < 0.001, 63.15%, P < 0.001 and 38.35%, P = 0.003). However, its sensitivity in the diagnosis of lymph node and distant metastasis was not as good as [18F]FDG PET/CT (P < 0.001, P = 0.016, respectively). There was a significant correlation between [68Ga]Ga-DOTA-FGFR1 uptake and FGFR1 expression (Spearman r = 0.6901, p < 0.0001). [68Ga]Ga-DOTA-FGFR1 PET/CT had higher specificity than [18F]FDG PET/CT for the detection of primary lung cancer. In addition, [68Ga]Ga-DOTA-FGFR1 PET/CT also had higher diagnostic accuracy, specificity, and NPV for lymph node metastasis, but its diagnostic sensitivity for metastatic lesions was lower than [18F]FDG PET/CT. Therefore, [68Ga]Ga-DOTA-FGFR1 can be used as an effective supplement to [18F]FDG to a certain extent.

Antibiotic adoption effects on nutrition and quality of life in lung cancer patients undergoing radiotherapy and chemotherapy: A meta-analysis.

Lung cancer (LC) is one of the leading causes of death worldwide. Treatment methodologies such as chemotherapy and radiotherapy have improved patient survival rates. Nevertheless, these treatments can also lead to adverse reactions and impact patients' nutritional status and quality of life (QOL). Antibiotics are commonly used for treating infections, but there is still controversy regarding their potential adverse effects on LC patients. This work aimed to investigate the impact of antibiotic adoption on the nutritional status and QOL of LC patients undergoing radiotherapy or chemotherapy, providing valuable insights for the clinical management of LC. A meta-analysis approach was employed to comprehensively evaluate the relationship by synthesizing relevant literature. Published studies were identified through searches in databases such as PubMed, EMBASE, Cochrane Library, Web of Science, and CNKI. The inclusion criteria encompassed randomized controlled trials, cohort studies, and cross-sectional studies. Assessment indicators included patient weight, BMI, hemoglobin levels, and QOL. Meta-analysis was conducted using software such as the Cochrane Collaboration and RevMan5.3. Heterogeneity was evaluated using the Higgins I2 index, where values between 25% and 50% indicate moderate heterogeneity, and values greater than 50% indicate substantial heterogeneity. 12 eligible studies involving 1,917 patients were finally included. LC patients who received antibiotics during radiotherapy or chemotherapy were found to have a higher risk of malnutrition. The antibiotic group exhibited a more significant decrease in body mass index (BMI) (P< 0.05) and lower serum albumin levels (P< 0.05) versus the control (C) group. Additionally, the overall QOL scores in the antibiotic group were dramatically lower than those in the C group, showing a significant difference with P< 0.05. Sensitivity analysis indicated that the overall conclusions of this work were robust and unbiased. Antibiotics in LC patients undergoing radiotherapy or chemotherapy may increase the risk of malnutrition and decrease their QOL. Hence, physicians should carefully consider antibiotics and take necessary preventive measures and supportive treatments to improve LC patients' nutritional status and QOL.

Analysis of the nursing effect of five-tone therapy combined with acupoint massage on chemotherapy of lung cancer.

The use of complementary therapies to relieve the side effects of chemotherapy in lung cancer patients is becoming increasingly popular. Practices from traditional Chinese medicine, such as acupoint massage and five-tone therapy, have demonstrated potential in alleviating symptoms such as nausea and vomiting experienced during chemotherapy. This study aims to determine the effectiveness of combining five-tone therapy with acupoint massage in reducing chemotherapy-related symptoms in lung cancer patients. The main objective is to determine how these complementary therapies affect the quality of life and well-being of people undergoing chemotherapy for lung cancer. In this paper, 80 patients diagnosed with lung cancer who needed chemotherapy drugs were randomly divided into 2 groups, 40 patients. The first was treatment; the second was control. Chemotherapy drugs were combined with a 5-hydroxytryptamine blocker (granisetron), and acupoint massage was combined with pentatone therapy to prevent nausea, vomiting, and other gastrointestinal reactions. A 5-hydroxytryptamine blocker (granisetron) was combined with chemotherapy drugs to prevent nausea, vomiting, and other gastrointestinal reactions. Moreover, the difference in treatment effect was observed. Among 40 cases in treatment, 13 cases were clinically controlled, 15 cases were markedly effective, 9 cases were effective, and 3 cases were ineffective. The total effective rate was 92.50%; among 40 cases in control, 6 cases were clinically controlled, 16 cases were markedly effective, 12 cases were practical, and 6 cases were invalid. The total effective rate was 85.00%. By integrating traditional Chinese medicine techniques, healthcare professionals can augment the supportive care offered to those undergoing chemotherapy for lung cancer.

RIPK2 and lysosomal pathway: Unveiling a new mechanism for lung cancer metastasis

BackgroundThis study aims to explore the role of RIPK2 in lung cancer metastasis and its potential mechanisms. MethodsThe expression levels of RIPK2 in lung cancer patients and cell lines were detected by immunohistochemistry, qRT-PCR, and Western blot. RIPK2 expression was knocked down using siRNA technology, and its effects on the proliferation, migration, and invasion capabilities of lung cancer cells were assessed through CCK-8, EdU, colony formation, and Transwell assays. Furthermore, by overexpressing RIPK2 and LAMP2, the regulatory effect of RIPK2 on the lysosomal pathway and its mechanism of action in lung cancer metastasis were investigated. ResultsThe results showed that the expression of RIPK2 was significantly increased in lung cancer patients and cell lines. Knockdown of RIPK2 significantly inhibited the migration, invasion, and proliferation capabilities of lung cancer cells, while overexpression of RIPK2 promoted these malignant behaviors. Further studies found that RIPK2 promoted lung cancer metastasis by inhibiting LAMP2 expression, thereby suppressing the lysosomal pathway and altering the tumor microenvironment. Additionally, overexpression of LAMP2 could reverse the promotive effects of RIPK2 overexpression on the malignant behaviors of lung cancer cells. ConclusionThis study reveals for the first time that RIPK2 promotes lung cancer metastasis by inhibiting LAMP2 expression, thereby suppressing the lysosomal pathway and altering the tumor microenvironment. In the future, targeted therapy against RIPK2 and LAMP2 may become an effective means to inhibit lung cancer metastasis.

Neoadjuvant immune checkpoint inhibitor reduced recurrence in operable NSCLC patients with pathological complete response: a retrospective analysis

BackgroundThis study aimed to evaluate if neoadjuvant immune checkpoint inhibitor (ICI) plus chemotherapy (CT) reduced tumor recurrence after surgery than neoadjuvant CT alone in non–small cell lung cancer (NSCLC) patients with pathologic complete response (pCR).MethodsFrom January 1st 2019 to April 30th 2022, 16 NSCLC patients with pCR who received both neoadjuvant ICI and CT were designated as ICI/CT group. Another 8 patients, who received neoadjuvant CT alone, were designated as CT group. The tumor recurrence and patients’ survival status were analyzed.ResultsSquamous cell carcinoma was the predominant histology type in both groups. The CT group had higher percentage of patients who received adjuvant CT than the ICI/CT group (100% vs. 75%, p = 0.046). All patients had been followed up for at least 20 months. At 20 months after surgery, the ICI/CT group had a tumor recurrence rate of 6.25%, which was significantly lower than 37.5% recurrence rate of the CT group. One patient of the CT group died of gastrointestinal hemorrhage and severe anemia at 11 months after surgery, and no patient in the ICI/CT group died. During adjuvant therapy, the ICI/CT group had significantly lower risk of anemia (12.5% vs. 50%) than the CT group (p = 0.046).ConclusionThe study found that in NSCLC patients with pCR, neoadjuvant ICI reduced tumor recurrence rate. This indicated that like in advanced stage NSCLC, the ICI might bring similar long-term anti-tumor effect in operable NSCLC patients.

Electrochemical Biosensors in Diagnostic Medicine: Detecting Lung Cancer Biomarkers – A Comprehensive Review

AbstractElectrochemical biosensors use biomolecules, such as proteins, enzymes, and antibodies, to translate the analytical signals detected in a sample. They have diverse applications including pesticide detection in agriculture, water analysis in various sectors, and biomedical and forensic diagnostics. With the estimated number of cancer cases in the US in 2024 being over two million, particularly lung cancer, which is notoriously difficult to diagnose early, the integration of biosensors into the Point‐of‐care Testing (PoCT) strategy can significantly improve the detection of cancer biomarkers, contributing to early diagnosis and successful treatment. Three‐dimensional (3D) printing is a promising alternative for reducing production costs and customizing devices in various ways. This review highlights recent trends and research on the development of electrochemical biosensors for early detection of lung cancer. These biosensors are expected to be more sensitive and selective for a variety of real samples and are precise, accurate, and stable during their commercialization. Significant progress has been made in the development of electrochemical devices for the early diagnosis of lung cancer, with various biomarker anchoring and detection strategies addressed throughout the study. Overcoming these challenges is key to advancing the use of these biosensors, thus improving diagnostic accuracy and enabling the successful treatment of lung cancer patients.

Enhancing Lung Cancer Screening with Bidirectional LSTM and GRU Models

Abstract. This study aims to enhance lung cancer patient screening by developing and evaluating bidirectional Long Short-Term Memory (LSTM) and bidirectional Gated Recurrent Unit (GRU) models using the Lung Cancer dataset from Kaggle. The dataset includes 16 features related to patient symptoms and lung cancer status, providing a broad spectrum of symptoms to improve model accuracy. The research advances Artificial Intelligence (AI)-driven healthcare by integrating these sophisticated machine learning techniques into diagnostic processes. The methodology involves four main steps: preprocessing the dataset for model compatibility, defining the model architecture with bidirectional LSTM and GRU layers and evaluating its performance. The results show an overall accuracy of 52.17%, with accuracy, recall, and F1 scores for both cancerous and non-cancerous categories around 50%. Despite the hybrid model's average performance, it establishes a basis for future enhancements. Optimizing model parameters and exploring additional other techniques to improve prediction accuracy and clinical applicability will be done in the future.

Effects of combined anesthesia on pulmonary oxygenation function, hemodynamics, and respiratory compliance in elderly patients undergoing pulmonary lobectomy for lung cancer.

Traditional general anesthesia in elderly lung cancer patients undergoing pulmonary lobectomy may lead to hemodynamic fluctuations and postoperative complications. To optimize anesthesia efficacy, this study explores the application of combined anesthesia (general anesthesia combined with thoracic paravertebral block) in such surgeries. We evaluated the improvement of pulmonary oxygenation function, hemodynamic stability, and respiratory compliance in elderly lung cancer patients undergoing pulmonary lobectomy with combined anesthesia. This retrospective study analyzed 100 elderly lung cancer patients who underwent pulmonary lobectomy at our hospital from February 2020 to December 2023. Patients were divided into 2 groups: the control group received general anesthesia, while the treatment group received combined anesthesia (general anesthesia plus thoracic paravertebral block). By comparing intraoperative hemodynamic parameters, postoperative pulmonary oxygenation function, respiratory compliance, cognitive function, sleep quality, and postoperative complication rates between the 2 groups, we assessed the application efficacy of combined anesthesia. Compared to the control group, the treatment group exhibited better hemodynamic stability intraoperatively, significantly improved postoperative pulmonary oxygenation function and respiratory compliance. Additionally, patients in the treatment group showed faster recovery of cognitive function, better sleep quality, and a relatively lower incidence of postoperative complications. Combined anesthesia demonstrates unique advantages in pulmonary lobectomy for elderly lung cancer patients, optimizing intraoperative hemodynamic stability, promoting postoperative pulmonary function recovery, accelerating cognitive function recovery, improving sleep quality, and potentially reducing the risk of postoperative complications. This finding provides a new effective strategy for anesthesia management in elderly lung cancer patients.

Effects of spot size errors in DynamicARC pencil beam scanning proton therapy planning.

Spot size stability is crucial in pencil beam scanning (PBS) proton therapy, and variations in spot size can disrupt dose distributions. Recently, a novel proton beam delivery method known as DynamicARC PBS scanning has been introduced. The current study investigates the dosimetric impact of spot size errors in DynamicARC proton therapy for head and neck (HNC), prostate, and lung cancers.&#xD;Approach: Robustly optimized DynamicARC proton therapy plans were created for HNC (n=4), prostate (n=4), and lung (n=4) cancer patients. Spot size errors of ±10%, ±15%, and ±20% were introduced, and their effects on target coverage (D95% and D99%), homogeneity index (HI), and organ-at-risk (OAR) doses were analyzed across different cancer sites.&#xD;Main Results: HNC and lung cancer plans showed greater vulnerability to spot size errors, with reductions in target coverage of up to 4.8% under -20% spot size errors. Dose homogeneity was also more affected in these cases, with HI degrading by 0.12 in lung cancer. Prostate cancer demonstrated greater resilience to spot size variations, even under errors of ±20%. For spot size errors ±10%, the oral cavity, parotid glands, and constrictor muscles experienced Dmean deviations within ±1.2%, while deviations were limited to ±0.5% for D10% of the bladder and rectum and ±0.3% for V20Gy(RBE) of the lungs. The robustness analysis indicated that lung cancer plans were most susceptible to robustness reductions caused by spot size errors, while HNC plans demonstrated moderate sensitivity. Conversely, prostate cancer plans demonstrated high robustness, experiencing only minimal reductions in target coverage.&#xD;Significance: While the ±10% spot size tolerance is appropriate in the majority of the cases, lung cancer plans may require more stringent criteria. As DynamicARC becomes clinically available, measuring spot size errors in practice will be essential to validate these findings and refine tolerance thresholds for clinical use.

Development of pituitary dysfunction and destructive thyroiditis is associated with better survival in non-small cell lung cancer patients treated with programmed cell death-1 inhibitors: a prospective study with immortal time bias correction

Development of pituitary dysfunction and destructive thyroiditis is associated with better survival in non-small cell lung cancer patients treated with programmed cell death-1 inhibitors: a prospective study with immortal time bias correction

Impact of bone metastasis on prognosis in non-small cell lung cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis

Impact of bone metastasis on prognosis in non-small cell lung cancer patients treated with immune checkpoint inhibitors: a systematic review and meta-analysis

TtAgo-coupled-multiplex-digtal-RPA-CRISPR/Cas12a (TCMDC) for EGFR mutations detection

Epidermal Growth Factor Receptor (EGFR) is an important target for the early evaluation, treatment, and postoperative follow-up in non-small cell lung cancer (NSCLC). Current detection technologies suffer from extended detection time and high rate of false positive amplification. Therefore, the development of rapid, highly sensitive and specific detection methods is of great significance for improving the diagnosis and treatment of lung cancer. In this study, we proposed a fast and sensitive detection method termed Thermus thermophilus Argonaute (Ttago)-Coupled-Multiplex-digital-recombinase polymerase amplification (RPA)-Clustered regularly interspaced short palindromic repeats (CRISPR)/Cas12a (TCMDC) detection method, integrating EGFR mutation template enrichment. Based on the cleavage principle of TtAgo, the wild type (WT) template was enriched under the action of double-guide DNA. Two CRISPR RNAs, not restricted by protospacer adjacent motif (PAM) sites, were introduced to target EGFR genes. By combining RPA with CRISPR-Cas12a, we established a single-pot, ultra-sensitive (1 copy, 0.1 %), and visually detectable method for EGFR detection. We further verified the feasibility of this approach using clinical serum samples from lung cancer patients, achieving rapid (within 1 h) and visual detection of EGFR, thereby presenting a promising clinical tool for the detection of lung cancer.

Application of CT-based foundational AI and radiomics models for prediction of outcome for non-small-cell lung cancer patients treated on the NRG/RTOG 0617 clinical trial

Abstract Objectives To apply CT-based foundational artificial intelligence (AI) and radiomics models for predicting overall survival (OS) for patients with locally advanced non-small cell lung cancer (NSCLC). Methods Data for 449 patients retrospectively treated on the NRG Oncology/Radiation Therapy Oncology Group (RTOG) 0617 clinical trial were analyzed. Foundational AI, radiomics and clinical features were evaluated using univariate cox regression and correlational analyses to determine independent predictors of survival. Several models were fit using these predictors and model performance was evaluated using nested cross-validation and unseen independent test datasets via area under receiver-operator-characteristic curves, AUC’s. Results For all patients, the combined foundational AI and clinical models achieved AUCs of 0.67 for the Random Forest (RF) model. The combined radiomics and clinical models achieved RF AUCs of 0.66. In the low-dose arm, foundational AI alone achieved AUC of 0.67, while AUC for the ensemble radiomics and clinical models was 0.65 for the support vector machine (SVM). In the high-dose arm, AUC values were 0.67 for combined radiomics and clinical models and 0.66 for the foundational AI model. Conclusions This study demonstrated encouraging results for application of foundational AI and radiomics models for prediction of outcomes. More research is warranted to understand the value of ensemble models toward improving performance via complementary information. Advances in knowledge Using foundational AI and radiomics-based models we were able to identify significant signatures of outcomes for NSCLC patients retrospectively treated on a national cooperative group clinical trial. Associated models will be important for application toward prospective patients.

Ultrasensitive In2O3-Based Nanoflakes for Lung Cancer Diagnosis and the Sensing Mechanism Investigated by Operando Spectroscopy.

Rapid gas sensing with high sensitivity and selectivity is pivotal in advanced production, in smart living, and increasingly in medical health applications. This study presents a novel Pt@InNiOx nanoflake isoprene sensor that achieves an exceptionally low limit of detection (LOD) at 2 ppb, the lowest reported for isoprene sensors to date. Notably, it exhibits high selectivity and remarkable antihumidity capacity, thus meeting the stringent requirements for lung cancer screening. To unravel the sensing mechanism, we fabricate an operando DRIFTS-Raman cell coupled to online electrical measurements. It reveals that the ultrasensitive performance of Pt@InNiOx nanoflakes stems from the activated conjugated structure of isoprene by Pt nanoclusters and from the enhanced isoprene adsorption and electron interaction due to the nanoflake morphology. The p-n junction constructed by doping Ni maintains Fermi level equilibrium, shielding it from humidity interference. Practically, we integrate these ultrasensitive Pt@InNiOx nanoflakes into a miniaturized portable electronic device that successfully distinguishes lung cancer patients with expiratory isoprene below 40 ppb, from the healthy population with isoprene above 60 ppb, enabling an accurate diagnosis in clinics. Our work not only provides a breakthrough in low-cost, noninvasive cancer screening through breath analysis but also advances the rational design of cutting-edge gas sensing materials.

Case report: A golden tail of immunotherapy: significant tail effect in a chemotherapy-resistant advanced pulmonary sarcomatoid carcinoma patient treated by Sintilimab combined with Anlotinib

Tail effect is a unique phenomenon in immunotherapy characterized by the prolonged maintenance of therapeutic efficacy. It can be observable even after treatment cessation. Immunotherapy has gradually become a vital regimen for the treatment of advanced lung cancer patients, among which immune-combined therapies based on immune checkpoint inhibitors (ICIs) have been applied clinically and demonstrates considerable clinical efficacy. In this case report, the patient was pathologically diagnosed with pulmonary sarcomatoid carcinoma (PSC), a rare and highly aggressive subtype of non-small cell lung cancer (NSCLC) known for its poor prognosis due to high invasiveness and metastatic potential. After developing resistance to chemotherapy, the patient was treated with a combined regimen of sintilimab and anlotinib, leading to initial clinical improvement. Following just three cycles of this regimen, treatment was discontinued, and the patient was discharged. Remarkably, over the subsequent months, the patient exhibited a significant tail effect, evidenced by sustained therapeutic stability, continuous tumor regression, stable low levels of serum carcinoembryonic antigen (CEA), and further improvement in clinical symptoms. Tail effect is a golden tail of immunotherapy. This case illustrates that the tail effect of immunotherapy can offer substantial survival benefits for patients with unresectable advanced lung cancer who have failed chemotherapy.

The clinical pathway in China county for lung cancer diagnosis and treatment (2024 edition)

Standardizing the diagnosis and treatment of lung cancer is a key measure to improve the survival rate of lung cancer patients and reduce the mortality rate. However, county hospitals generally face the problem of inaccessibility to advanced diagnostic and treatment technologies. Therefore, when developing quality control standards and clinical diagnosis and treatment specifications, it is necessary to combine the actual situation of county hospitals and formulate specific recommendations. The recommendations of treatment measures also need to consider the approval status of indications and whether it is included in the National Reimbursement Drug List (NRDL), to ensure the access to medicines. To address the above issues, based on the existing guidelines at home and abroad and the clinical work characteristics of county hospitals, the " the clinical pathway in China county for lung cancer diagnosis and treatment (2024 edition)" has been updated on the basis of the first edition. This pathway elaborated on the imaging diagnosis, pathological diagnosis, molecular testing, precision medicine, and developed different diagnosis and treatment processes for different types of lung cancer patients. Consistent with the first pathway, this update still divides the recommendations for diagnosis and treatment of clinical scenarios into basic strategies and optional strategies for elaboration. The basic strategies are the standards that county hospitals must meet, while the optional strategies provide more choices for hospitals, which are convenient for county doctors to put into clinical practice. All the recommended diagnostic and treatment plans strictly refer to existing guidelines and consensus. Compared to the first edition, based on the latest high-level evidence-based medicine and the approval status of indications, the pathway has updated the diagnosis and treatment recommendations for lung cancer under different pathological types, TNM classification, and molecular classification in basic and optional strategies.