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Matsumura S, Ano S, Kikuchi N, Masuda M, Osawa H, Kondo Y, Ishii Y, Hizawa N. A case of epidermal growth factor receptor tyrosine kinase inhibitor effectiveness in epidermal growth factor receptor mutation-positive squamous cell carcinoma. SAGE Open Med Case Rep 2023; 11:2050313X231159504. [PMID: 36890803 PMCID: PMC9986888 DOI: 10.1177/2050313x231159504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 02/07/2023] [Indexed: 03/07/2023] Open
Abstract
A 71-year-old non-smoker woman was admitted to our hospital because of left front chest pain. A computed tomography scan showed a large mass of >7.0 cm in the lower left part of the lung and multiple organ metastases in the liver, brain, bone, and left adrenal gland. Pathological analysis of a resected specimen obtained by bronchoscopy revealed keratinization. In addition, p40 was positive and thyroid transcription factor-1, synaptophysin, CD56, and chromogranin A were negative by immunohistochemistry. Programmed cell death ligand 1 expression was 1%-10%, and exon 19 deletion was detected. We diagnosed the patient with stage IVB lung squamous cell carcinoma and administered osimertinib. Osimertinib was later replaced with afatinib because of grade 3 skin rash. Overall, the size of the cancer was decreased. Furthermore, her symptoms, laboratory data, and computer tomographic findings markedly improved. In summary, we experienced a case of epidermal growth factor receptor-positive lung squamous cell carcinoma that was responsive to epidermal growth factor receptor tyrosine kinase inhibitors.
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Affiliation(s)
- Sosuke Matsumura
- Department of Respiratory Medicine, University of Tsukuba, Tsukuba, Japan
| | - Satoshi Ano
- Department of Respiratory Medicine, University of Tsukuba, Tsukuba, Japan.,Department of Respiratory Medicine, National Hospital Organization Kasumigaura Medical Center, Tsuchiura, Japan
| | - Norihiro Kikuchi
- Department of Respiratory Medicine, National Hospital Organization Kasumigaura Medical Center, Tsuchiura, Japan
| | - Michiko Masuda
- Department of Respiratory Medicine, National Hospital Organization Kasumigaura Medical Center, Tsuchiura, Japan
| | - Hajime Osawa
- Department of Respiratory Medicine, National Hospital Organization Kasumigaura Medical Center, Tsuchiura, Japan
| | - Yuzuru Kondo
- Department of Diagnostic Pathology, National Hospital Organization Kasumigaura Medical Center, Tsuchiura, Japan
| | - Yukio Ishii
- Department of Respiratory Medicine, National Hospital Organization Ibarakihigashi National Hospital, Tokai, Japan
| | - Nobuyuki Hizawa
- Department of Respiratory Medicine, University of Tsukuba, Tsukuba, Japan
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Yan T, Ma G, Wang K, Liu W, Zhong W, Du J. The Immune Heterogeneity Between Pulmonary Adenocarcinoma and Squamous Cell Carcinoma: A Comprehensive Analysis Based on lncRNA Model. Front Immunol 2021; 12:547333. [PMID: 34394068 PMCID: PMC8358782 DOI: 10.3389/fimmu.2021.547333] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/13/2021] [Indexed: 01/31/2023] Open
Abstract
Adenocarcinoma (AD) and squamous cell carcinoma (SCC) are both classified as major forms of non-small cell lung cancer, but differences in clinical prognoses and molecular mechanisms are remarkable. Recent studies have supported the importance of understanding immune status in that it influences clinical outcomes of cancer, and immunotherapies based on the theory of “immune editing” have had notable clinical success. Our study aimed to identify specific long non-coding (lnc) RNAs that control key immune-related genes and to use them to construct risk models for AD and SCC. Risk scores were used to separate patients into high- and low-risk groups, and we validated the prognostic significance of both risk scores with our own cohorts. A Gene Set Enrichment Analysis suggested that the immune responses of patients in the AD high-risk group and the SCC low-risk group tended to be weakened. Evaluation of immune infiltration revealed that the degree of infiltration of dendritic cells is of particular importance in AD. In addition, prediction of responses to immune checkpoint inhibitor (ICI) treatments, based on the T Cell Immune Dysfunction and Exclusion and immunophenoscore models, indicated that deterioration of the immune microenvironment is due mainly to T cell exclusion in AD patients and T cell dysfunction in SCC patients and that high-risk patients with SCC might benefit from ICI treatment. The prediction of downstream targets via The Cancer Proteome Atlas and RNA-seq analyses of a transfected lung cancer cell line indicated that the lncRNA LINC00996 is a potential therapeutic target in AD.
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Affiliation(s)
- Tao Yan
- Institute of Oncology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Guoyuan Ma
- Department of Thoracic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Kai Wang
- Institute of Oncology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Weidong Liu
- Department of Interventional Radiology, Shandong Medical Imaging Research Institute Affiliated to Shandong University, Jinan, China
| | - Weiqing Zhong
- Department of Radiology, The Fourth People's Hospital of Jinan, Jinan, China
| | - Jiajun Du
- Institute of Oncology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Thoracic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
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Jinru XMS, Yu YMS, Bo JMD, Linxue QMD, Xian-Quan SP. Identification of Key Genes Between Lung Adenocarcinoma and Lung Squamous Cell Carcinoma by Bioinformatics Analysis. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY 2020. [DOI: 10.37015/audt.2020.200011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Li M, Zhan C, Sui X, Jiang W, Shi Y, Yang X, Feng M, Wang J, Wang Q. A Proposal to Reflect Survival Difference and Modify the Staging System for Lung Adenocarcinoma and Squamous Cell Carcinoma: Based on the Machine Learning. Front Oncol 2019; 9:771. [PMID: 31475114 PMCID: PMC6702456 DOI: 10.3389/fonc.2019.00771] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 07/30/2019] [Indexed: 12/16/2022] Open
Abstract
Objective: To propose modifications to refine prognostication over anatomic extent of the current tumor, node, and metastasis (TNM) staging system of non-small cell lung cancer (NSCLC) for a better distinction, and reflect survival differences of lung adenocarcinoma and squamous cell carcinoma. Study Design: Three large cohorts were included in this study. The training cohort consisted of 124,788 patients in the Surveillance, Epidemiology, and End Results (SEER) database (2006-2015). The validation cohort consisted of 4,247 patients from the Zhongshan Hospital, Fudan University (FDZSH; 2005-2014), and People's Hospital, Peking University (PKUPH; 2000-2017). The algorithm generated a hierarchical clustering model based on the unsupervised learning for survival data using Kaplan-Meier curves and log-rank test statistics for recursive partitioning and selection of the principal groupings. Results: In the modified staging system, adenocarcinoma cases are usually at a lower stage than the squamous cell carcinoma cases of the same TNM, reflecting a better outcome of adenocarcinoma than that of squamous cell carcinoma. The C-index of the modified staging system was significantly superior to that of the staging system [SEER cohort: 0.722, 95% CI, (0.721-0.723) vs. 0.643, 95% CI, (0.640-0.647); FDZSH cohort: 0.720, 95% CI, (0.709-0.731) vs. 0.519, 95% CI, (0.450-0.586); and PKUPH cohort: 0.730, 95% CI, (0.705-0.735) vs. 0.728, 95% CI, (0.703-0.753)]. Conclusion: Survival differences between lung adenocarcinoma and squamous cell carcinoma have been reflected accurately and reliably in the modified staging system based on the machine learning. It may refine prognostication over anatomic extent.
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Affiliation(s)
- Ming Li
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Cheng Zhan
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xizhao Sui
- Department of Thoracic Surgery, People's Hospital, Peking University, Beijing, China
| | - Wei Jiang
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yu Shi
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaodong Yang
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mingxiang Feng
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jun Wang
- Department of Thoracic Surgery, People's Hospital, Peking University, Beijing, China
| | - Qun Wang
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
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Evans M, O'Sullivan B, Smith M, Hughes F, Mullis T, Trim N, Taniere P. Large-Scale EGFR Mutation Testing in Clinical Practice: Analysis of a Series of 18,920 Non-Small Cell Lung Cancer Cases. Pathol Oncol Res 2018; 25:1401-1409. [PMID: 30094734 DOI: 10.1007/s12253-018-0460-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Accepted: 07/31/2018] [Indexed: 12/13/2022]
Abstract
We make use of a very large dataset of non-small cell lung cancer specimens to examine the molecular epidemiology of EGFR mutations, particularly with respect to rare and compound mutations, and to non-adenocarcinoma histological subtypes. We also demonstrate the feasibility of large-scale EGFR mutation screening using the full range of specimens encountered in routine practice. We retrospectively reviewed 18,920 unselected EGFR mutation results from our centre between July 2009 and October 2016, using Qiagen's therascreen EGFR RGQ PCR Kit. Mutation rates were correlated with patient demographics and tumour histology. Our testing success rate was 93.9%, with similar success rates using histological and cytological specimens. Rare, potentially-targetable mutations accounted for 9.5% of all mutations detected. We identified a 2.5% mutation rate in tumours diagnosed as squamous cell carcinomas. There was a trend towards increasing EGFR mutation rates with increasing age, and while Del19 was the commonest mutation in the young, L858R predominated in the elderly. We found that EGFR mutation heterogeneity is rare within tumours and between primary and metastatic deposits. Our data demonstrate that large-scale, reflex EGFR mutation testing is feasible and affordable in the context of a publicly-funded health system. Furthermore, we have shown that the use of techniques sensitive only to classical mutations and selection of patients on the grounds of age, sex and histology denies patients access to potentially beneficial TKI therapy.
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Affiliation(s)
- Matthew Evans
- Molecular Pathology Diagnostic Service, University Hospital Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, B15 2GW, UK.
| | - Brendan O'Sullivan
- Molecular Pathology Diagnostic Service, University Hospital Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, B15 2GW, UK
| | - Matthew Smith
- Molecular Pathology Diagnostic Service, University Hospital Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, B15 2GW, UK
| | - Frances Hughes
- Molecular Pathology Diagnostic Service, University Hospital Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, B15 2GW, UK
| | - Tina Mullis
- Molecular Pathology Diagnostic Service, University Hospital Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, B15 2GW, UK
| | - Nicola Trim
- Molecular Pathology Diagnostic Service, University Hospital Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, B15 2GW, UK
| | - Philippe Taniere
- Molecular Pathology Diagnostic Service, University Hospital Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, B15 2GW, UK
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Gong J, Zhang H, He L, Wang L, Wang J. Increased Expression of Long Non-Coding RNA BCAR4 Is Predictive of Poor Prognosis in Patients with Non-Small Cell Lung Cancer. TOHOKU J EXP MED 2017; 241:29-34. [PMID: 28077810 DOI: 10.1620/tjem.241.29] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Lung cancer is the most common human cancer, and the majority of lung cancer cases are categorized as non-small cell lung cancer (NSCLC). Long non-coding RNAs (lncRNAs) play key roles in the development and progression of human cancers. LncRNA breast cancer anti-estrogen resistance 4 (BCAR4) has been identified as an oncogenic lncRNA involved in the progression of breast cancer and osteosarcoma. However, the clinical significance of the lncRNA BCAR4 in NSCLC remains largely unclear. In the present study, real-time quantitative reverse transcriptase-polymerase chain reaction was used to examine the relative level of lncRNA BCAR4 in 68 cases of NSCLC tissues and their adjacent non-tumor tissues. Our data showed that the expression level of lncRNA BCAR4 was significantly higher in NSCLC tissues compared to their matched non-tumor tissues. Moreover, BCAR4 expression was significantly upregulated in NSCLC cell lines, when compared to the normal human bronchial epithelial cell line BEAS-2B. In addition, the BCAR4 expression was associated with the lymph node metastasis, distant metastasis and clinical stage, but not with the age, sex, tumor size, histological grade, and histological type. The increased expression of BCAR4 was significantly associated with poorer 5-year overall survival rate of NSCLC patients. Multivariate survival analysis indicated that BCAR4 was an independent prognostic factor for NSCLC patients. Taken together, our study suggests that the upregulation of lncRNA BCAR4 expression plays a promoting role in the malignant progression of NSCLC. Thus, BCAR4 is a potential biomarker for NSCLC progress and a therapeutic target for NSCLC.
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Affiliation(s)
- Jianhua Gong
- Department of Respiratory Medicine, Jingzhou Central Hospital
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Ding X, Wang L, Liu X, Sun X, Yu J, Meng X. Genetic characterization drives personalized therapy for early-stage non-small-cell lung cancer (NSCLC) patients and survivors with metachronous second primary tumor (MST): A case report. Medicine (Baltimore) 2017; 96:e6221. [PMID: 28272214 PMCID: PMC5348162 DOI: 10.1097/md.0000000000006221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
RATIONALE The pathogenesis and progression of lung cancer is a complicated process in which many genes take part. But molecular gene testing is typically only performed in advanced-stage non-squamous non-small-cell lung cancer (NSCLC). The value of tyrosine kinase inhibitors (TKI) administration is not widely recognized with respect to early-stage NSCLC. PATIENT CONCERNS Here, we present a case of a man, heavy smoker who initially presented with stage IA lung adenocarcinoma (LADC). Three years after a lung lobectomy, he was diagnosed with advanced lung squamous cell carcinoma (SCC), according to laboratory, imaging, and pathological examinations. DIAGNOSES The case initially had an early-stage LADC with an L858R epidermal growth factor receptor (EGFR) mutation. A subsequent advanced SCC bearing EGFR L858R/T790M mutations occurred 3 years after surgery. INTERVENTIONS The comprehensive therapy we utilized, including surgical resection for the early-stage lesion and GP chemotherapy and local radiotherapy as the first line therapy along with gefitinib maintenance treatment for the advanced metachronous second primary tumors (MST). OUTCOMES The synthetical therapy, have resulted in our patient with remaining alive and progression free for 4.5 years. LESSONS This case suggests that changes in molecular pathology should be monitored closely throughout cancer progression to guide personalized therapy and improve prognosis. We further review administration of TKI to early-stage NSCLC and to the metachronous second primary tumors (MST) in survivors.
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Affiliation(s)
- Xingchen Ding
- Department of Oncology, Weifang Medical University, Weifang
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Science
| | - Linlin Wang
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Science
- Department of Oncology, Shandong University
- Department of Radiation Oncology, Jinan Central Hospital, Jinan, China
| | - Xijun Liu
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Science
| | - Xindong Sun
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Science
| | - Jinming Yu
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Science
| | - Xue Meng
- Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Science
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