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      Exploring histopathological and serum biomarkers in lung adenocarcinoma: Clinical applications and translational opportunities (Review)

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          Abstract

          Lung cancer represents one of the most common neoplasms and the main cause of cancer-associated death worldwide. Its relationship with different risk factors such as tobacco, which is its main etiological factor, has been clearly established and despite the numerous advances achieved in the diagnosis, treatment and follow-up of these patients, the life expectancy of these patients is notably limited. Furthermore, its treatment is not exempt from comorbidities and frequently it neither provides optimal control of the disease nor improve the quality of life of these patients. Despite the possibility of performing screening tests in patients at risk, their implementation in daily clinical practice is complex and most of them are diagnosed at an advanced stage of their disease where systemic radiotherapy or chemotherapy treatments slightly improve their prognosis. Lung adenocarcinoma is the most representative type of lung cancer, with specific epidemiological, molecular and clinical features. Thus, a growing number of studies are being conducted to find potential therapeutic targets based on the study of different molecular pathways, improving the outcome for these patients. In addition, a broad spectrum of serological, immunohistochemical and genetic markers are being evaluated for use in the screening and follow-up of these patients in daily clinical practice, but unlike for other tumors, they are currently not implemented in the early diagnosis of the disease. Therefore, the aim of the present review was to summarize the main advances that have occurred in the development of serological and histological markers and their therapeutic implications in patients diagnosed with lung adenocarcinoma, explaining the limitations that have been observed and analyzing the future perspectives in the clinical management of this disease.

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          Most cited references114

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            Pembrolizumab versus Chemotherapy for PD-L1–Positive Non–Small-Cell Lung Cancer

            Pembrolizumab is a humanized monoclonal antibody against programmed death 1 (PD-1) that has antitumor activity in advanced non-small-cell lung cancer (NSCLC), with increased activity in tumors that express programmed death ligand 1 (PD-L1).
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              Pembrolizumab plus Chemotherapy in Metastatic Non–Small-Cell Lung Cancer

              First-line therapy for advanced non-small-cell lung cancer (NSCLC) that lacks targetable mutations is platinum-based chemotherapy. Among patients with a tumor proportion score for programmed death ligand 1 (PD-L1) of 50% or greater, pembrolizumab has replaced cytotoxic chemotherapy as the first-line treatment of choice. The addition of pembrolizumab to chemotherapy resulted in significantly higher rates of response and longer progression-free survival than chemotherapy alone in a phase 2 trial.
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                Author and article information

                Journal
                Int J Oncol
                Int J Oncol
                IJO
                International Journal of Oncology
                D.A. Spandidos
                1019-6439
                1791-2423
                December 2022
                20 October 2022
                20 October 2022
                : 61
                : 6
                : 154
                Affiliations
                [1 ]Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcala, Alcala de Henares, 28801 Madrid, Spain
                [2 ]Ramon and Cajal Institute of Sanitary Research, 28034 Madrid, Spain
                [3 ]Cancer Registry and Pathology Department, Prince of Asturias University Hospital, 28806 Madrid, Spain
                [4 ]Oncology Service, Prince of Asturias University Hospital, Alcala de Henares, 28806 Madrid, Spain
                [5 ]Oncology Service, Guadalajara University Hospital, 19002 Guadalajara, Spain
                [6 ]Pathological Anatomy Service, Central University Hospital of Defence-UAH Madrid, Alcala de Henares, 28801 Madrid, Spain
                [7 ]Immune System Diseases-Rheumatology, Oncology Service an Internal Medicine, University Hospital Príncipe de Asturias, Alcala de Henares, 28806 Madrid, Spain
                Author notes
                Correspondence to: Professor Miguel A. Ortega, Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Ctra, Madrid-Barcelona km 33.6, 28801 Madrid, Spain, E-mail: miguelangel.ortega@ 123456edu.uah.es
                Article
                ijo-61-6-05444
                10.3892/ijo.2022.5444
                9635864
                36263628
                03c11441-0034-4a60-b8bd-81de32e5513f
                Copyright: © Ortega et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

                History
                : 29 July 2022
                : 04 October 2022
                Funding
                Funded by: Comunidad de Madrid
                Award ID: B2017/BMD-3804 MITIC-CM
                The study was supported by the Comunidad de Madrid (grant no. B2017/BMD-3804 MITIC-CM) and the patronage program HALEKULANI, S. L.
                Categories
                Articles

                lung adenocarcinoma,serological markers,histological markers,circulating tumor cells,microrna

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