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Context: Non-Small Cell Lung Cancer (NSCLC) is the most common lung cancer type, with 80-85% prevalence. Usually, NSCLC is treated by chemotherapy and radiotherapy in collaboration with gefitinib or other anticancer drugs. Those treatments have many adverse effects, such as shortness of breath, bleeding, fever, hair loss, and radiation pneumonitis. Lack of treatment options and numerous mutations greatly contribute to lung cancer's shocking death toll. Therefore, potential EGFR mutant inhibitors need to be analyzed. Aims: To identify potential inhibitors of an epidermal growth factor receptor (EGFR) mutant derived from Calophyllum inophyllum L. leaf using an in silico approach. Methods: In silico analysis and literature study were carried out. Secondary metabolite compounds from C. inophyllum were obtained through the PubChem database, and their biological activity and ADMET were analyzed. Molecular docking with EGFR wild-type (5FED) and mutant (5HG7) was carried out using PyRx. Furthermore, amino acid residues were analyzed using Discovery Studio. Results: Based on overall screening and molecular docking, a non-toxic compound with a low binding affinity with EGFR mutant protein is 4-[2-(4-nitrophenyl)ethylcarbamoyl]benzenesulfonyl. Moreover, interactions and hydrogen bonds at Ala743, Gly796, Leu718, Phe856, Leu844, and Val726 are known to play a crucial role in ATP binding inhibition toward the tyrosine kinase domain, resulting in EGFR mutant inhibition. Conclusions: 4-[2-(4-nitrophenyl)ethylcarbamoyl]benzenesulfonyl is one of the potential candidates as an EGFR mutant protein by ATP binding inhibition. However, in vitro and in vivo research needs to be performed to confirm these results.

Resumen: El cáncer de pulmón es el primer cáncer en incidencia y en mortalidad a nivel mundial. El tipo histológico más frecuente es el cáncer pulmonar de células no pequeñas (CPCNP). En etapa temprana, la resección es el tratamiento curativo estándar, pero la recaída es alta, lo que se podría explicar por enfermedad micrometastásica. La quimioterapia adyuvante y neoadyuvante tienen un escaso beneficio en sobrevida libre de enfermedad y sobrevida global, por lo que se han estudiado nuevas estrategias. Los inhibidores de puntos de control inmunitario (ICI) actúan aumentando la vigilancia del sistema inmune. Se utilizan hace años en CPCNP etapa avanzada, sin embargo, nuevos esquemas en etapa temprana, ya sea en adyuvancia, neoadyuvancia o ambas, han demostrado un importante beneficio en los desenlaces estudiados. Esta revisión tiene por objetivo describir la racionalidad biológica de los ICI en CPCNP en etapa temprana y discutir sobre los ensayos y desenlaces. Abstract: Worldwide, lung cancer is the first cancer in incidence and mortality. The most common histological type is non-small cell lung cancer (NSCLC). At an early stage, resection is the standard curative treatment, but relapse is high, which could be explained by micrometastatic disease. Adjuvant and neoadjuvant chemotherapy have little benefit in disease-free survival and overall survival, which is why new strategies have been studied. Immune checkpoint inhibitors (ICI) act by increasing the surveillance of the immune system. They have been used for years in advanced stage NSCLC, however, new schemes in earlier stages, be it as adjuvant therapy, neoadjuvant therapy or both, have demonstrated an important benefit in the endpoints studied. This review aims to describe the biologic rationale of ICIs in early-stage NSCLC and discuss the selected trials and endpoints.

Introduction: The EBUS has been the focus of numerous studies aiming to evaluate its utility and diagnostic performance across various pathologies. Objective: Identification of the node characteristics evaluated in the Endobronchial Ultrasound (EBUS) procedure and their relationship with malignancy diagnosis in patients at the National Cancer Institute of Colombia from January 1st, 2017, to March 31st, 2021. Methods: Observational cross-sectional analytical study. Data collection involved non-probabilistic consecutive case sampling among individuals meeting the inclusion criteria. Results: A total of 75 patients underwent the EBUS procedure. Our findings revealed six predictors of malignancy based on sonographic features of biopsy nodes, including nodes larger than 1 cm, poorly defined margins, heterogeneous echogenicity, absence of a central hilar structure, presence of signs indicating necrosis or coagulation, and the presence of a ganglion conglomerate. Conclusions: This study showed that endobronchial ultrasonography has several sonographic characteristics at the time of evaluating mediastinal nodes that could predict malignant and benign pathology.

Introduction: Lung cancer (LC) is a disease with a great impact worldwide in the number of deaths and health costs. The high incidence and mortality of this disease associated with late diagnosis and the improved prognosis with early detection determine that it is a pathology that can benefit from early detection. Low radiation dose tomography (LDCT) demonstrated a method that can be performed periodically to a group of people at high risk of developing CP and thus reduce mortality from this disease. However, this benefit is such when it is developed under an organized program with multidisciplinary participation specialized in lung cancer. Methods: It is proposed to determine basic guidelines for the development of early detection of lung cancer in Latin America so that it can be carried out uniformly, with the lowest risk and the maximum expected benefit. The main publications referring to this topic were analyzed, considering the diversity of care and access in Latin America. Result: Minimum requirements are developed for the implementation of a program. Discussion: The number of programs in the region is small and depends more on individual efforts than on general health policies. We consider that these guidelines can serve as support for the development of more programs in the region and in a more homogeneous way.

Introduction: Bilothorax is a rare condition defined by the presence of bile in the pleural space. Currently, there are around 70 cases described in the literature. It remains relatively unknown and, therefore, little suspected. This entity is usually the result of an iatrogenic injury, often secondary to surgery or trauma to the biliary tract, leading to the formation of a pleurobiliary fistula. Clinical case: We present the case of a patient with probable metastatic lung cancer to the pleura and liver who, due to extensive liver disease, developed bilothorax as a complication. Conclusion: This case highlights the importance of having a high degree of suspicion for bilothorax in patients presenting with pleural effusion caused by lung cancer with extensive metastatic liver disease. Although it is a rare diagnosis, bilothorax can cause significant respiratory complications and morbidity.

Context: In the last decade, resistance to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in lung cancer cases has been widespread. The discovery and development of new drugs need to be done to overcome the case. Aims: To develop lung anticancer candidates with benzylidene hydrazine benzamides derivatives that can inhibit the growth of human lung cancer cell line A459. Methods: The in silico approach method, along with the QSAR technique, plays an important role in the process of discovery and development of new drugs. In this study, we focused on developing benzylidene hydrazine benzamides derivatives that are much more potent by making the best QSAR equation of 11 benzylidene hydrazine benzamides that have been tested in vitro for its anticancer activity against human lung cancer cell line A459. Results: The best QSAR equation was obtained from benzylidene hydrazine benzamides derivatives as anticancer activity against human lung cancer cell line A459, with PIC50 = 0.738 (± 0.217) Log S – 0.031 (± 0.007) rerank + 0.017 (± 0.016) MR -1.359 ± (1.381) (n = 11; Sig = 0.003; r = 0.921; R2 = 0.849; F= 13.096; Q2 = 0.61). Conclusions: The best QSAR equation can be a tool to obtain a new chemical structure model with more potential and reduce trials and errors.

Lung cancer persists as a significant global health dilemma, characterized by elevated incidence and mortality rates worldwide. Despite recent strides in diagnostic methodologies, screening approaches, and therapeutic modalities, lung cancer retains its status as the foremost cause of cancer-related fatalities internationally. The disease is predominantly categorized into two primary forms: small-cell carcinomas and the notably more prevalent non-small-cell carcinomas, constituting approximately 85% of cases. While smoking stands as the primary risk factor for lung cancer, accounting for 80-90% of related deaths, other factors such as dietary habits, air pollution, genetic predisposition, and prior lung conditions play substantial roles. Diagnostic procedures encompass a range of techniques, including radiography, sputum cytology, bronchoscopy, biomarker analysis, among others. The imperative for progress and refinement in diagnostic tools, especially for early detection and monitoring in high-risk demographics, underscores the urgency. Continual research and enhancement of surgical, systemic, and localized treatments are indispensable in the battle against lung cancer. Despite advancements, challenges persist in achieving timely diagnoses, particularly in high-risk groups, and augmenting overall survival rates. This comprehensive review delves into current research advancements in lung cancer, with specific focus on classification, patient well-being, risk factors, diagnostic methodologies, and treatment options.

This review explores the intricate relationship between dietary factors and lung cancer risk based on a thorough examination of relevant literature and articles. The findings highlight a significant association between specific dietary elements and lung cancer risk. Increased intake of fiber, fruit, and vitamin C is linked to a notable 9% reduction in risk, particularly for squamous cell carcinoma. Notably, vegetables exhibit a risk reduction for current smokers, while offal, red meat, and processed meat may elevate risk, especially in heavy smokers. Contradictory evidence surrounds dairy products, with fermented dairy inversely correlated. Beer and cider consumption are associated with an increased risk, primarily among current smokers. In contrast, avocados demonstrate a promising link to decreased lung cancer risk. Vitamin K intake shows an inverse relationship, particularly in males and ever smokers. High retinol intake may elevate risk, potentially modifying the effects of tobacco exposure. Nuts consumption is significantly linked to reduced lung cancer risk and overall cancer mortality. Dietary polyunsaturated fatty acids (PUFA) demonstrate a noteworthy risk reduction for lung cancer, with supplementation improving overall survival in patients with the disease. Palmitic acid, a component of saturated fatty acids, is implicated in promoting lung metastasis, emphasizing the intricate nature of dietary influences on cancer. In summary, while lung cancer is primarily associated with tobacco smoking, this review underscores the multifaceted interplay between diet and lung cancer risk. Further research is crucial to unravel underlying mechanisms and provide definitive evidence on the impact of specific dietary factors, emphasizing the importance of continued exploration in this complex field.

Introduction: Lung cancer is characterized by the highest mortality among cancers and is the second most frequently diagnosed type of cancer in the world. Targeted therapies are a promising therapeutic option for patients with this disease, however, one of the most common and most malignant mutations (KRAS) remains a challenge. Purpose: The aim of this study is to bring closer the problem of the KRAS mutation, in particular KRASG12C, and to present the most important information about the compounds created for therapies targeted at it. For a better understanding of the issue, the study contains information about the mechanisms of both mutation and drugs, as well as the most important statistical data and research results. Materials and methods: The review was based on articles available in the PubMed database. Conclusions: Two drugs targeting KRASG12C (sotorasib and adagrasib) have proven their clinical effectiveness and represent a milestone in the development of targeted therapies for lung cancer with this mutation. However, they are not without side effects, and the emerging resistance and presence of commutations that reduce drug potency continue to challenge the scientific community. Research is underway to refine therapies using existing inhibitors as well as to develop further compounds targeting KRASG12C.

Resumen: Objetivo: En España, debido a la falta de datos, se creó un registro de cáncer de pulmón, el Registro de Tumores Torácicos (RTT), el cual debería demostrar su comparabilidad con los datos poblacionales para tener una representatividad adecuada. Con esta finalidad, se comparan las características sociodemográficas del RTT con los datos de incidencia de la Red de Registros de Cáncer (REDECAN) y de mortalidad del Instituto Nacional de Estadística (INE). Método: Se utilizaron las fuentes de datos de cáncer de pulmón disponibles hasta el momento: REDECAN e INE. De cada fuente se recogieron los casos de cáncer de pulmón globales y desagregados por sexo y por grupos de edad, y se compararon los datos para el periodo 2017-2020. Se calcularon las proporciones por sexo y grupo de edad del RTT respecto a ambas bases de datos (que recogen incidencia y mortalidad), para el periodo completo de estudio y desglosado por año. Resultados: Se incluyeron 17.109 casos incidentes de cáncer de pulmón incluidos en el RTT, 58.668 casos incidentes estimados de REDECAN y 88.083 muertes entre 2017 y 2020 del INE. En cuanto al sexo, las proporciones son muy similares entre las tres fuentes y las diferencias no superan el 4%. En cuanto a la edad, las diferencias no son elevadas, siendo mayores para los datos de mortalidad en el grupo de mayor edad del INE frente al RTT. Conclusiones: El RTT parece ser representativo de los casos de cáncer de pulmón diagnosticados en España para los años 2019 y 2020, tanto por sexo como por edad. Esto permite poder caracterizar con exactitud el estado de esta enfermedad, primera causa de muerte por cáncer en España, y que el análisis de resultados que se vayan a obtener del RTT pueda ser aplicado a los casos de cáncer de pulmón diagnosticados en nuestro país. Abstract: Objective: In Spain, due to the lack of data at national level a lung cancer registry, the Thoracic Tumour Registry (TTR), was created. Such registry should demonstrate comparability with population-based data to ensure representativeness at population level. The aim is to compare the socio-demographic characteristics of the TTR with incidence data from the Red de Registros de Cáncer (REDECAN) and mortality data from the Instituto Nacional de Estadística (INE). Method: Lung cancer data sources available to date, REDECAN and INE, were used. Lung cancer cases overall and disaggregated by sex and age groups were collected from each source of information and data were compared for the period 2017-2020. Sex and age group proportions of TTR were calculated for both databases (which collect incidence and mortality data), for the entire study period and broken down by year. Results: A total of 17,109 incident lung cancer cases from the TTR, 58,668 estimated incident cases from REDECAN and 88,083 deaths registered from INE between 2017 and 2020 were included. In terms of sex, the proportions are very similar between the three sources and the differences do not exceed 4%. In terms of age, the differences are not large, being larger for mortality data in the older age group from the INE versus the TTR. Conclusions: The TTR seems to be representative of lung cancer cases diagnosed in Spain between 2019 and 2020, both by sex and age. This allows us to accurately characterise the status of this disease, which is the leading cause of cancer death in Spain, and that the analysis of results obtained from the RTT can be applied to cases of lung cancer diagnosed in our country.

Resumen: La evidencia científica durante las últimas 2 décadas respalda que la aplicación de técnicas de cribado de cáncer de pulmón mediante tomografía computarizada (TC) de tórax de baja dosis de radiación contribuye a una reducción significativa de la mortalidad, gracias al diagnóstico en estadios potencialmente curativos. En referencia a dicho diagnóstico, existen además métodos novedosos en estudio, como la biopsia líquida, la identificación del microbioma pulmonar y la utilización de técnicas de inteligencia artificial, que desempeñarán un papel clave en un futuro próximo. En la actualidad, existe una tendencia hacia el tratamiento con cirugías cada vez menos invasivas (segmentectomía vs. lobectomía) basada en 2 ensayos clínicos recientes en tumores periféricos menores de 2 cm. A pesar de mostrar similar supervivencia, todavía existe controversia debido a la incertidumbre en cuanto a la tasa de recidiva y reserva funcional. En cuanto a la terapia adyuvante, la inmunoterapia sola o combinada con quimioterapia ofrece resultados alentadores en estadios resecables del cáncer de pulmón localmente avanzado, con respuestas patológicas completas y mejoría en la supervivencia. Tras el tratamiento con cirugía, a pesar de que no hay evidencia sólida del seguimiento a largo plazo de estos pacientes, en la práctica clínica se recomienda la realización de TC periódicas durante los primeros años.En conclusión, en el cáncer de pulmón existen avances importantes, que han mejorado las técnicas diagnósticas utilizando nuevas tecnologías y programas de cribado. Además, el tratamiento de este cáncer cada vez es más personalizado y todo ello se traduce en una mejora de la supervivencia de los pacientes. Abstract: Over the past 2 decades, scientific evidence has strongly supported the use of low-radiation dose chest computed tomography (CT) as a screening technique for lung cancer. This approach has resulted in a significant reduction in mortality rates by enabling the detection of early-stage lung cancer amenable to potentially curative treatments. Regarding diagnosis, there are also novel methods under study, such as liquid biopsy, identification of the pulmonary microbiome, and the use of artificial intelligence techniques, which will play a key role in the near future. At present, there is a growing trend towards less invasive surgical procedures, such as segmentectomy, as an alternative to lobectomy. This procedure is based on 2 recent clinical trials conducted on peripheral tumors measuring less than 2 cm. Although these approaches have demonstrated comparable survival rates, there remains controversy due to uncertainties surrounding recurrence rates and functional capacity preservation. With regard to adjuvant therapy, immunotherapy, either as a monotherapy or in conjunction with chemotherapy, has shown encouraging results in resectable stages of locally advanced lung cancer, demonstrating complete pathologic responses and improved overall survival.After surgery treatment, despite the lack of solid evidence for long-term follow-up of these patients, clinical practice recommends periodic CT scans during the early years.In conclusion, there have been significant advances in lung cancer that have improved diagnostic techniques using new technologies and screening programs. Furthermore, the treatment of lung cancer is increasingly personalized, resulting in an improvement in the survival of patients.

Lung cancer is a global health scourge; Cuba and within it the province of Camagüey, do not escape this phenomenon. In this sense, a research +development study is developed that should lead to the establishment of psychosocial intervention strategies with a gender approach aimed at patients diagnosed in the Manuel Ascunce Domenech and María Curie hospitals that involve those affected by this situation of health of the Camagüey municipality in the period from January 2021 to June 2022, which determines that 192 individuals are assumed as a population, of them 75 women and 11 men. Therefore, the objective of this work is aimed at exposing the initial results of the theoretical approach to the subject, based on a documentary review.

Introduction: Lung cancer is the most diagnosed type of cancer and the leading cause of death around the world. The most important risk factor for lung cancer is tobacco smoking. However, there are a lot of other lung cancer risk factors, which include: second-hand smoke exposure, environmental exposures (indoor and outdoor air pollution), occupational exposures, genetic predisposition, and previous lung disease. In this study, we would like to present the actual state of knowledge about the influence of radon as well as other indoor air pollutants on the prevalence of lung cancer. State of knowledge: We analyzed nineteen studies in terms of the impact of indoor air pollution on morbidity and mortality caused by lung cancer. The authors of the included studies agree that both radon and other household air pollution (HAP) increase risk of the lung cancer. HAPs are formed during the combustion of solid fuels (i.e. charcoal, wood). Indoor air pollution can cause in the lungs chronic inflammation, cells damage and their proliferation, depletion of antioxidants, impairment of defense mechanisms, production of reactive oxygen species as well as genetic mutations. Radon, on the other hand, emits alpha radiation, which can affect the respiratory epithelium and produce various cytotoxic and genotoxic effects, which promote carcinogenesis. The risk of lung cancer rises by approximately 6-16% per 100 Bq/m3 increase in long-time average residential radon concentration. Conclusions: Radon and other indoor air pollutants are crucial lung cancer risk factors. It is essential to reduce HAPs production, especially in rural areas, where many people still use coal, wood, or straw for household heating and cooking. Moreover, there are regions where is a need to improve ventilation as well as to switch to clean fuel sources, such as gas and electricity. These activities will contribute to reducing the concentration of HAPs in buildings and decreasing the risk of lung cancer.

According to the Centers for Disease Control and Prevention, there is an annual rate of 7 million deaths because of tobacco use, and this rate is expected to step up to 8 million deaths in 2030 by virtue of smoking-related health complications. Furthermore, it is pathetic to know that almost more than 23% of high school students use tobacco, which if continued at the current rate; about 5.6 million teenagers would be vulnerable to death as mentioned by the World Health Organization. On the other hand, smokers do not only harm themselves but also increase the incidence of pneumonia, asthma, and bronchitis for passive smokers, which by the way contribute to the development of lung cancer and cardiovascular diseases. Moreover, infant death syndrome and slow-growing lung cancer are prevalent in children with continuous exposure to second-hand smoke. These adverse effects emerge from the complex mixture of chemicals present in submicron-sized particles suspended in cigarette smoke like carbon monoxide, benzene, nitrogen oxides, and other gases. Thus, it seems that tobacco smoking has been spreading worldwide as an epidemic with devastating lethal disorders represented in diverse pulmonary, neurological, and cardiovascular-related diseases. Wherefore, this paper discusses the harmful effects of tobacco smoke on human health in accordance with the modern advanced genetic technologies used in exploratory investigations for the relation between smoking and the emergence of human diseases.

Introduction and Objectives: Exposure to secondhand smoke (SHS) causes cardiovascular disease, respiratory disease, and cancer. The aim of this study was to estimate the mortality attributed to SHS in people aged ≥ 35 years in Spain and its autonomous communities (AC) by sex from 2016 to 2021., Methods: Estimates of SHS-attributable mortality were calculated by applying the prevalence-dependent method where SHS exposure was derived from the adjustment of small-area models and based on the calculation of population-attributed fractions. Sex, age group, AC, and cause of death (ischemic heart disease and lung cancer) were included. The estimates of attributed mortality are presented with their 95% confidence interval (95%CI). Crude and age-standardized rates were estimated for each sex and AC., Results: From 2016 to 2021, SHS exposure caused 4,970 (95%CI, 4,787-5,387) deaths, representing 1.6% of total mortality for ischemic heart disease and lung cancer. The burden of attributed mortality differed widely among the AC, with Andalusia having the highest burden of attributed mortality (crude rate: 46.6 deaths per 100 000 population in men and 17.0/100 000 in women). In all the AC, the main cause of death in both sexes was ischemic heart disease. The highest burden of mortality was observed in nonsmokers., Conclusions: The burden of SHS-attributable mortality was high and varied geographically. The results of this study should be considered to advance tobacco control legislation in Spain., (Copyright © 2024 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Trisegmentectomy, or resection of the upper subdivision of the left upper lobe with preservation of the lingula, is considered by some authors to be equivalent to right upper lobectomy with middle lobe preservation. Our objective was to compare survival and recurrence after trisegmentectomy versus left upper lobectomy procedures registered in the Spanish Video-Assisted Thoracic Surgery group (GEVATS) database., Methods: We compared mortality, survival and recurrence in patients with left upper lobectomy or trisegmentectomy after propensity score matching for the following variables: age, smoking habit, tumor size, histologic type, radiological density of tumor, surgical access, forced expiratory volume in one second, diffusing capacity of the lungs for carbon monoxide, hypertension, chronic heart failure, ischemic heart disease, arrhythmia, stroke, peripheral vascular disease, diabetes and pre-surgery nodal status by positron emission tomography/computed tomography., Results: A total of 540 left upper lobectomies and 83 trisegmentectomies were registered in the GEVATS database. After propensity score matching, 134 left upper lobectomies and 67 trisegmentectomies were selected. Survival outcomes were similar, but differences were found for recurrence (21.5% for trisegmentectomies vs. 35.4% for left upper lobectomies, p=0.05). Moreover, the recurrence patterns differed, with the lobectomy group showing a greater tendency to distant dissemination., Conclusions: Trisegmentectomy and left upper lobectomy show similar 5-year survival rates. In our database, recurrence after trisegmentectomy was lower than after left upper lobectomy, while the recurrence pattern differed among the 2 surgical approaches, with a greater tendency to distant metastasis after left upper lobectomy., (Copyright © 2024 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.)

Objective: The expression level of programmed death ligand 1 (PD-L1) is the only approved biomarker for predicting response to immunotherapy, yet its efficacy is not always consistent. Lactate dehydrogenase (LDH) has been associated with tumor aggressiveness and poorer prognosis across various cancer types and may serve as a useful biomarker for monitoring treatment response. The objective of this study is to analyze the relationship between LDH levels prior to the start of treatment with immune checkpoint inhibitors (ICIs) and clinical outcomes in patients with non-small cell lung cancer (NSCLC)., Method: A retrospective study was conducted including patients diagnosed with NSCLC who were treated with at least three cycles of immunotherapy. Data on demographics, clinical and pathological characteristics, treatment received, pre-treatment LDH levels, and clinical outcomes such as treatment response and overall survival (OS) were analyzed., Results: A total of 181 patients diagnosed with NSCLC were included. Elevated pre-treatment LDH levels (more than 244 U/l) were associated with significantly reduced OS. The median survival was 548 days in patients with LDH less than 244 U/l, compared to 332 days in those with LDH more than 244 U/l (p = 0.037). Among men, OS was greater in the LDH less than 244 U/l group (623 days) versus 332 days in the LDH more than 244 U/l group (p = 0.043). In patients with metastatic disease, OS was higher in those with LDH less than 244 U/l (474 days) compared to 249 days in those with LDH more than 244 U/l (p = 0.023). In patients receiving both immunotherapy and chemotherapy, OS was greater in those with LDH less than 244 U/l (623 days) compared to 281 days in the LDH more than 244 U/l group (p = 0.042)., Conclusions: High levels of LDH prior to the start of treatment with ICIs are associated with lower treatment efficacy and a worse prognosis of the disease, especially in male, metastatic patients with a PD-L1 expression level less than 1%., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

Objectives: Lung cancer is the leading cause of cancer death and the second most common cancer in both sexes worldwide, with tobacco being its main risk factor. The aim of this study is to establish the temporal relationship between smoking prevalence and lung cancer mortality in Spain., Methods: To model the time dependence between smoking prevalence and lung cancer mortality, a distributed lag non-linear model was applied adjusting for sex, age, year of mortality and population at risk. Smoking prevalence data from 1991-2020 were used. Considering a maximum lag of 25 years, mortality data from 2016-2020 were included. The effect of prevalence on mortality for each lag is presented in terms of relative risk (RR). To identify the lag at which smoking prevalence has the greatest effect on mortality, the RR of the different lags were compared., Results: The optimal lag observed between smoking prevalence and lung cancer mortality in Spain was 15 years. The maximum RR was 2.9 (95%CI: 2.0-4.3) for a prevalence of 71% and a 15-year lag. The RR was 1.8 for a prevalence of 33%, an approximate median value between 1991-2020, and a 15-year lag., Conclusions: In Spain, lung cancer mortality is affected by smoking prevalence 15 years prior. Knowing the evolution of the smoking prevalence series in a country and establishing a lag time is essential to predict how lung cancer incidence and mortality will evolve., (Copyright © 2024 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.)

Background: The treatment of lung cancer has witnessed significant progress, leading to improved survival rates among patients. It is important to assess the individual contributions of non-small cell lung cancer (NSCLC) and small-cell lung cancer (SCLC) to overall lung-cancer incidence and mortality trends based population, especially sex difference., Methods: We analyzed lung cancer mortality based on subtype, gender, and calendar year. The Joinpoint software was used to identify any changes in incidence and trends in mortality., Results: Incidence and incidence-based mortality declined from 2001 to 2019 both NSCLC and SCLC annually. The most significant decrease occurred between 2016 and 2019 with annual percent change of 5.71%. From 2012 to 2016, the incidence-based mortality of SCLC in women changed by 2.7% in tandem with incidence decreased 2.84%. Remarkably, the incidence-based mortality for women declined notably by 5.23% between 2016 and 2019, even as the incidence showed a less extent of decreasing (-2.59%). The survival rate for women was 15.2% in 2001, 19.3% in 2016, it had increased to 21.3% in 2018 but similar trends not in men. The survival curve showed the change in survival outcomes over time among men and women (median overall survival: 13 vs 23months) receiving immunotherapy for SCLC., Conclusion: Population-level mortality from NSCLC and SCLC in the United States fell sharply from 2016 to 2019 as incidence deceased, and survival improved substantially. Our analysis suggests that approval for and use of immunotherapy may explain the mortality reduction observed during this period, with significant benefits especially for SCLC patient in women., (Copyright © 2024 The Author(s). Published by Elsevier España, S.L.U. All rights reserved.)

Immune checkpoint inhibitors have opened an era of lung cancer therapy. However, a notable disparity exists in the efficacy of immunotherapy among individual patients. The tertiary lymphoid structure (TLS) is an ectopic lymphocyte aggregation that appears under pathological conditions and is the primary site of action for anti-tumor immunity. It is commonly reported that the presence of TLS within the tumor microenvironment (TME) relates to a favorable clinical prognosis and an excellent response to immunotherapy in lung cancer patients. A thorough understanding of TLS and its dynamic changes in TME has become an attractive focus for optimizing immunotherapy strategies for lung cancer. In this review, we comprehensively generalize the composition, formation, mechanism, detection methods of TLS, and summarize the role of TLS in lung cancer immunotherapy. Finally, induction of TLS is also discussed, which may provide more effective therapeutic strategies for lung cancer therapy., (Copyright © 2024 The Authors. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Early detection is crucial to improve lung cancer survival rates. Delays in diagnosis might negatively impact the prognosis of the disease. This study aims to analyze the diagnostic delay in lung cancer patients and describe if there is an association between delay and survival., Methods: The data source used was the Thoracic Tumor Registry of the Spanish Lung Cancer Group. This analysis was restricted to lung cancer cases with information on the first date of consultation by symptoms and date of diagnosis. The delay was calculated as the number of days between the two dates. A descriptive analysis was performed, and ordinal logistic regressions were fitted with delay as the dependent variable. Kaplan-Meier survival analysis and Cox regression were performed., Results: 22,755 lung cancer cases were included. Never smokers were 1.16 (95%CI: 1.06-1.27) times more likely to register longer delay than smokers. Stage 0-I-II cases had a 3.09 (95%CI: 2.88-3.32) higher risk of longer delay compared to III-IV stages. Overall, 5-year survival rate after diagnosis was 23.64% (95%CI: 22.88-24.41). In those categorized as having the shortest delay 5-year survival was 17.67% (95%CI: 16.31-19.07) and in the extreme delay it was 32.98% (95%CI: 31.28-34.69) (p<0.001). Adjusted mortality risk was higher in those with the shortest delay (HR 1.36, CI95%: 1.30-1.43) in comparison with the extreme delay., Conclusions: Diagnostic delay is short among Spanish lung cancer patients, indicating a relatively quick diagnostic process. Extreme delays appear to be associated with higher survival rates, possibly attributed to slow-growing tumors, earlier stage at diagnosis or basically the natural history of this disease., (Copyright © 2024 The Author(s). Published by Elsevier España, S.L.U. All rights reserved.)

Lung cancer remains the leading cause of cancer-related deaths worldwide, mainly due to late diagnosis and the presence of metastases. Several countries around the world have adopted nation-wide LDCT-based lung cancer screening that will benefit patients, shifting the stage at diagnosis to earlier stages with more therapeutic options. Biomarkers can help to optimize the screening process, as well as refine the TNM stratification of lung cancer patients, providing information regarding prognostics and recommending management strategies. Moreover, novel adjuvant strategies will clearly benefit from previous knowledge of the potential aggressiveness and biological traits of a given early-stage surgically resected tumor. This review focuses on proteins as promising biomarkers in the context of lung cancer screening. Despite great efforts, there are still no successful examples of biomarkers in lung cancer that have reached the clinics to be used in early detection and early management. Thus, the field of biomarkers in early lung cancer remains an evident unmet need. A more specific objective of this review is to present an up-to-date technical assessment of the potential use of protein biomarkers in early lung cancer detection and management. We provide an overview regarding the benefits, challenges, pitfalls and constraints in the development process of protein-based biomarkers. Additionally, we examine how a number of emerging protein analytical technologies may contribute to the optimization of novel robust biomarkers for screening and effective management of lung cancer., (Copyright © 2024 The Authors. Published by Elsevier España, S.L.U. All rights reserved.)

Lung cancer is one of the most common causes of cancer death in men and women worldwide. Various combinations of surgery, chemotherapy, radiation therapy and immunotherapy are currently used to treat lung cancer. However, the prognosis remains relatively poor due to the higher frequency of tumor mutational burden (TMB). Nuclear factor E2-related factor 2 (NFE2L2/NRF2) is often considered a primary regulator of the expression of antioxidant enzymes and detoxification proteins and is involved in cytoprotection. On the contrary, NRF2 is even known to induce metastasis and support tumor progression. Kelch-like ECH-associated protein 1 (KEAP1) plays an important role in negatively regulating NRF2 activity via CUL3-mediated ubiquitinylation and successive proteasomal degradation. Extensive research has shown that the genetic alterations of KEAP1/NFE2L2/CUL3 genes lead to increased expression of NRF2 and its target genes in lung cancer. Thus, these studies provide ample evidence for the dual role of NRF2 in lung cancer. In this review, we discussed the mechanistic insights into the role of NRF2 signaling in therapy resistance by focusing on cell lines, mouse models, and translational studies in lung cancer. Finally, we highlighted the potential therapeutic strategies targeting NRF2 inhibition, followed by the discussion of biomarkers related to NRF2 activity in lung cancer. Overall, our article exclusively discusses in detail the NRF2 signaling pathway in resistance to therapy, especially immunotherapy, and its therapeutic avenue in the treatment of lung cancer., (Copyright © 2024 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.)

Lung cancer remains the leading cause of cancer-related deaths worldwide. According to the American Cancer Society (ACS), it ranks as the second most prevalent type of cancer globally. Recent findings have highlighted bidirectional gut-lung interactions, known as the gut-lung axis, in the pathophysiology of lung cancer. Probiotics are live microorganisms that boost host immunity when consumed adequately. The immunoregulatory mechanisms of probiotics are thought to operate through the generation of various metabolites that impact both the gut and distant organs (e.g., the lungs) through blood. Several randomized controlled trials have highlighted the pivotal role of probiotics in gut health especially for the prevention and treatment of malignancies, with a specific emphasis on lung cancer. Current research indicates that probiotic supplementation positively affects patients, leading to a suppression in cancer symptoms and a shortened disease course. While clinical trials validate the therapeutic benefits of probiotics, their precise mechanism of action remains unclear. This narrative review aims to provide a comprehensive overview of the present landscape of probiotics in the management of lung cancer., (Copyright © 2024 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.)

Cancer is one of the main dead causes worldwide. It is re- sponsible for an approximate of 1 out of 6 deaths globally and lung cancer is along breast cancer, the most common types of cancer in the population, which confirms the importance of studies associated with it. This work presents an approach toward lung cancer histological tissue images segmentation based on colour. The proposed method for the segmentation is K-means clustering, providing promising results that may become as an assistance for pathologists, as it can help them reduce the time consumed reviewing the slides and giving a more objective perspective in order to provide a diagnose and specific treatment.

Background: Against limited effectiveness of known oncological treatment such as chemio-and radiotherapy or surgery, new ways of treatment, such as for example immunotherapy has developed. Usage of immune checkpoint inhibitors (ICPIs), resulting in overactivation of immune system, may significantly raise efficacy of oncological treatment, but simultaneously predispose to occurrence various autoimmunological health complications. Adverse actions of the therapy may affect multiple organs and systems, with the presented example of immune-related neurological complication, myasthenia gravis. This relatively rare condition may be severe, life-threatening illness. Case report: We present a case of 66-year-old male patient diagnosted with a large tumor histopathologically assessed as squamous cell carcinoma. Due to ineffectiveness of implemented chemio- and radiotherapy, he was qualified for anti-PD1 immunotherapy with nivolumab. General treatment tolerance was very good with positive antineoplastic effect. Autoimmune hypothyroidism has emerged, therefore levothyroxine therapy has been implemented. After about a year of using immunotherapy, significant weakness and decrease in muscle strength has appeared, subsequently, immunotheraphy-related myasthenia gravis was raised. Improvement in the patient's condition was achieved after initiating pyridostigmine treatment. Cessation of antineoplastic treatment wasn’t necessary, what is unusual. Conclusions: Undeniably myastenia gravis may determine serious, life-threatening adverse effect of immunotherapy. Usually requires withdrawal of applied antioncological treatment, and should be treated with immunomodulators, immunosuppressants or intravenous immunoglobulins or plasmaphaeresis, however – as we present- in some cases may be properly cured only with pyridostygmine.

Background: Lung cancer has been at the forefront of cancers with the highest incidence and mortality rates. Nowadays, there are available more effective forms of treatment such as immunotherapy. In the case of cancer cells expressing the PD-L1 receptor, pembrolizumab, atezolizumab and nivolmab are of particular use. While these drugs have the great benefit of stabilizing the disease, they are not without side effects, especially inflammatory changes in the joints. The aim of the study is to show the risk of immunotherapy in the form of exacerbation of inflammatory symptoms in patients with rheumatoid arthritis (RA) as a concomitant disease. Case report: Lung cancer (PD-L1 +) was diagnosed in three patients with a history of RA. After meeting the criteria of the drug program, the patients started molecularly targeted therapy with pembrolizumab and atezolizumab. The applied treatment brought a great benefit in the form of stabilization the neoplastic disease. Over time an exacerbation of inflammatory changes within the joints was noted, which significantly impeded everyday functioning in two patients. Due to this situation, immunotherapy was discontinued. Conlusions: Studies show that as many as 1/4 of patients treated with PD-L1 inhibitors experience side effects related to the autoimmune system. In the case of people suffering from RA, the use of immunotherapy may intensify inflammatory changes and increase pain, which significantly reduce the quality of life. Therefore, the risk of RA exacerbation as a side effect of biological therapy for lung cancer treatment should be popularized. This awareness will enable quick intervention and minimize the number of interrupted immunotherapies.

Introduction: In recent years, target therapies to specific molecular alterations in advanced non–small cell lung cancer (NSCLC) have been identified and have shown superior efficacy compared to non-targeted treatments. Anaplastic lymphoma kinase (ALK) is one of the therapeutic targets; nevertheless, ALK diagnosis is not performed in all NSCLC patients in Spain. The objective of this study is to estimate in monetary terms the benefit for the Spanish society of ALK diagnosis in advanced NSCLC patients. Methods: A cost-benefit analysis of ALK diagnosis vs. non-diagnosis in advanced NSCLC patients was carried out from the Spanish social perspective, with a time horizon of 5 years. Costs, benefits and the cost-benefit ratio weremeasured. The analysis has considered the overall survival in advanced NSCLC patients treated with the ALKtyrosine kinase inhibitor (TKI) alectinib. The natural history of NSCLC was simulated using a Markov model. A 3% discount rate was applied to both costs and benefits. The result was tested using a deterministic sensitivity analysis. Results: The cost of ALK diagnosis vs. non-diagnosis in the base case would be €10.19 million, generating benefits of €11.71 million. The cost-benefit ratio would be €1.15. In the sensitivity analysis, the cost-benefit ratio could range from €0.89 to €2.10. Conclusions: The results justify the universal application of ALK diagnosis in advanced NSCLC, which generates a benefit for Spanish society that outweighs its costs and allows optimal treatment with targeted therapies for these patients.

Context: Lung cancer is a type of cancer that causes the most deaths worldwide. The most common type of lung cancer is non-small cell lung cancer (NSCLC). Sea urchin (Arbacia lixula) has high potential as an anti-NSCLC agent. Aims: To analyze the anticancer activity of peptides from A. lixula coelomic fluid in inhibiting the activity of NSCLC-related proteins. Methods: Peptide modeling was performed using the PEP-FOLD3 web server. Proteins that have a crucial role in NSCLC progression were determined using KEGG pathway database. 3D protein structures such as EGFR, PI3K, BRAF V600E, and JAK3 were taken from the RCSB PDB database. Docking was performed using Autodock Vina software. Docking results analysis was carried out using Discovery Studio 2019 software. Results: Some peptides bind to the active sites with low binding affinity. Peptide 10 binds to the active site of the EGFR with a binding affinity of -9 kcal/mol. Peptide 5 binds to the active sites of PI3K and BRAF V600E with binding affinity of -8.2 and -8.1 kcal/mol, respectively. Peptide 11 binds to the active site of JAK3 with a binding affinity of -8.1 kcal/mol. All of these peptides have lower binding affinity than ATP as the native ligand. Besides, these peptides also produce more hydrogen bonds than ATP, so they are predicted to be more stable. Conclusions: Peptides 10, 5, and 11 have high potential as anti-NSCLC agents because they can inhibit the activity of proteins that play an essential role in the growth of NSCLC, namely EGFR, PI3K, BRAF V600E, and JAK3 through the competitive ATP inhibitor mechanism.

Lung cancer is the most common malignant tumour in Poland and the first cause of death among oncological diseases. This article presents the main factors causing lung cancer, the course of the disease and health consequences. The most important nursing problems have been identified, taking into account the individual nursing plan. Nursing actions were proposed to adapt the patient to the new situation, to improve his physical and psychological condition and to educate the patient and his family.

Background: In the reported case, our patient with lung cancer diagnosed as squamous cell carcinoma (SqCC) achieved eight times longer progression-free time (PFT; 25.3 months) than that obtained in the median of randomized clinical trials (3.5 months). Case Report: A 61-year-old man presented for treatment due to a long-lasting cough and a type of pain in the chest, in good general condition. The patient had a smoking history when he was young. Computed tomography (CT) showed a lesion larger than 70 x 60 mm. The diagnosis was made on the basis of the bronchoscopic material. The prognosis was unfavorable and the tumor was inoperable. In the first line of treatment, chemotherapy with cisplatin was started. Due to the progression, second-line immunotherapy with Nivolumab was administered, and was continued for a longer period of time. Treatment was well tolerated and there were no side effects reported. Therapy was however interrupted due to the patient's deteriorating condition and progression in the follow up CT examination. Finally the patient was qualified for palliative treatment with chemotherapy and zoledronic acid. Opioid medications were used to treat pain. Conclusion: The patient lived for over 4 years, including over 2 years without progression. It therefore seems that there is a group of patients who respond exceptionally well to immunotherapy, but the identification of predictors requires further research.

Introduction: Lung cancer is the number-one cause of death due to neoplasms worldwide. The 5-year overall survival rate is only 22%. In advanced stages, the therapeutic options are limited to chemotherapy, radiotherapy, molecularly targeted therapy and immunotherapy. Phytocannabinoids, the components of Cannabis sativa, their synthetic derivatives and endogenous cannabinoids have demonstrated anticancer activity in various common cancers - breast, prostate, colorectal and lung cancers, among others. The aim of this review was to assess the potential value of cannabinoids in the treatment of lung cancer. State of knowledge: The majority of preclinical studies demonstrates that cannabinoids inhibit lung cancer cell viability both in vitro and in vivo. The main mechanism of anticancer activity is the induction of apoptosis, triggered by activation of CB1, CB2 and TRPV1 receptors or independently via other pathways. Cannabinoids influence the components of the tumour microenvironment - cancer associated fibroblasts, macrophages and lymphokine-activated-killer cells. Cannabinoids alter leukocyte infiltration into anti-cancer proportions, inhibit expression of EGFR and PAI-1 and increase the expression of TIMP-1. As a result they induce cytotoxicity, decrease proliferation, migration and invasive potential of lung cancer cells, suppress angiogenesis and metastasis forming. Patients with advanced lung cancer may also benefit from analgesic, antiemetic and appetite improving properties of cannabinoids. Summary: Cannabinoids can be a supplementary agent in systemic anticancer therapeutic regimen in the future. The exact mechanisms of action, specific doses in anticancer treatment, routes of administration and interactions with other anticancer drugs has yet to be determined. Thus the clinical studies on cannabinoids in lung cancer should be performed in the future.

Resumen: El pseudoaneurisma consiste en una dilatación de un vaso, debida a la disrupción de todas las capas de la pared vascular y que está contenida por los tejidos circundantes. Puede aparecer en cualquier localización, y cuando lo hace en vasos de gran calibre como la aorta, es necesario el diagnóstico precoz puesto que el riesgo de ruptura es elevado como resultado de la alta tensión que soporta la pared.Presentamos un caso poco frecuente consistente en la aparición de pseudoaneurismas en la aorta ascendente asociados a un adenocarcinoma de pulmón. En estos casos, la prueba de imagen que aporta más información es la angio-tomografía computarizada (angio-TC) torácica, que permitirá hacer un diagnóstico diferencial con otras entidades. El tratamiento de elección es quirúrgico con reparación endovascular torácica aórtica (TEVAR). Abstract: A pseudoaneurysm is the dilation of a vessel due to disruption of all wall layers, which is only contained by the perivascular connective tissue. Pseudoaneurysms can appear in any location, but early diagnosis is necessary when located at large vessels, such as aorta, because of the high risk of rupture due to increased wall afterload.We report a rare case of multiple pseudoaneurysms at the ascending aorta associated with lung adenocarcinoma. In these cases, thoracic angio-computed tomography (angio-CT) is the preferred imaging test, because it allows optimal differential diagnosis with other diseases. Surgical thoracic endovascular aortic repair is the treatment of choice (TEVAR).

Chosen cutoff for cytokeratin 19 fragment antigen (CYFRA 21-1) as a tumor biomarker considerably influences its diagnostic and prognostic usefulness. The aim of the present study is to determine an optimal cutoff value for diagnostic validity of CYFRA 21-1 by Lumipulse ® technology in patients with suspected cancer and also to determine if CYFRA 21-1 levels provide prognostic value.

According to WHO, clean air is considered as one of the basic criterion influencing human health. Airborne particulate matters (PM) 2,5 are mixtures of organic and inorganic particles smaller than 2.5 µm. They have broad negative effect on health especially on respiratory and cardiovascular system. They could increase the sensitivity to air ways infections, worsen: allergic diseases, hypertension, myocardial infarction and also increase the risk of neoplastic diseases. NO2 pollution arises mainly during burning of fossil fuels, which is mainly related to road transport. On the basis of numerous scientific research, it is believed that the long term exposure to NO2 could increase inflammation and eventually lead to higher cancer morbidity. We analyzed the data available in the Polish National Cancer Registry (PNCR), Chief Inspectorate for Environmental Protection and Air Quality Guidelines, We checked air pollution by the means of PM2.5and NO2 and thanks to mathematical equation delivered by Saskia C. van der Zee converted them into number of passively smoked cigarettes. Above data we compared to lung cancer morbidity in Lubelskie Region.Based on the latest available data and literature, we can conclude that in 2013-2017 each inhabitant of Lubelskie Region smoked average 8 cigarettes a day +/- 2. The incidence of lung cancer is more or less the same number. After 75 years everyone in the exanimated region had 30 package-years of passive smoking and high risk of lung cancer. Over same period of time cumulative risk of lung cancer according to PNCR were in women almost 2% and in men almost 6%Air quality in Poland is not satisfactory, exceeding the standards presented in the WHO Guidelines 2005, we can assume that this translates into a high risk of the incidence of lung cancer among our inhabitants.

Resumen: Objetivo: Analizar el patrón geográfico de la mortalidad por cáncer de pulmón según sexo en España (nivel provincial) y Andalucía (nivel municipal) durante el periodo 2013-2017. Sujetos y método: Para analizar los patrones espaciales se usaron 3 estimadores de riesgo: la razón de mortalidad estandarizada, el riesgo relativo suavizado (RRs) y la probabilidad posterior (PP) de que el RRs sea mayor que 1. Realizamos un análisis de conglomerados utilizando el índice global de Moran y el índice local de Moran (LISA). Los resultados fueron mapeados. Resultados: En los hombres, 17 provincias tienen un RRs > 1 de las que 15 presentan una PP > 0,95, entre ellas Huelva, Sevilla, Cádiz y algunas provincias del norte peninsular (Asturias y Cantabria). En las mujeres son 10 las que presentan un RRs > 1 y PP > 0,95: 6 situadas en el norte peninsular, Valladolid, Madrid, Valencia y Alicante. En Andalucía, en los hombres, 332 municipios muestran un RRs > 1 de los que 39 muestran una PP > 0,95, la mayoría de los cuales se encuentran en las provincias de Huelva, Cádiz y Sevilla y que incluye a 5 capitales de provincia (Huelva, Sevilla, Cádiz, Málaga y Almería). En las mujeres solo 22 municipios muestran un RRs superior a 1 aunque solo 5 muestran una PP > = 0,80 (uno en Cádiz y 4 en Málaga) y ninguno una PP > 0,95. Conclusiones: Nuestros hallazgos ayudan a identificar áreas de alto riesgo para guiar los esfuerzos de control de la mortalidad por cáncer de pulmón. Abstract: Objective: To analyze the geographical pattern of lung cancer mortality according to sex in Spain (by provinces) and Andalusia (by municipalities) during the period 2013-2017. Subjects and method: Three risk estimators were used to analyze spatial patterns: standardized mortality ratio, relative risk smoothing (RRS), and posterior probability (PP) that RRS is greater than 1. We conducted a cluster analysis using global Moran's index and local Moran's index (LISA). The results were mapped. Results: In men, 17 provinces have an RRS greater than 1, 15 of which have a PP > 0.95, including Huelva, Seville, Cadiz and some provinces in northern Spain (Asturias and Cantabria). In women, 10 provinces have an RRS > 1 and PP > 0.95, 6 located in northern Spain, Valladolid, Madrid, Valencia, and Alicante. In Andalusia, 332 municipalities in an area that includes 5 provincial capitals (Huelva, Seville, Cadiz, Malaga, and Almeria) show an RRS > 1 among men. Thirty nine of these, mostly in the provinces of Huelva, Cadiz and Seville, have a PP > 0.95. In women, only 22 municipalities have an RRS > 1, although only 5 have a PP ≥ 0.80 (one in Cadiz and 4 in Malaga) and none have PP > 0.95. Conclusions: Our findings help identify high-risk areas to guide lung cancer mortality control efforts.

Genomic rearrangement in anaplastic lymphoma kinase (ALK) gene occurs in 3−7% of patients with non-small-cell lung cancer (NSCLC). The detection of this alteration is crucial as ALK positive NSCLC patients benefit from ALK inhibitors, which improve both the patient's quality of life and overall survival (OS) compared to traditional chemotherapy.

Resumen: Se presenta el caso de un paciente con dolor en el hemitórax derecho de larga duración manejado como síndrome de manguito rotador, al que se le toma radiografía de tórax con reporte de imagen mal definida en hemitórax superior derecho; posteriormente, se toma tomografía de tórax con masa de apariencia neoplásica descrita en el lóbulo superior derecho que luego confirma sus características malignas con diagnóstico histológico. Abstract: We present the case of a patient with long-term right hemithorax pain managed as rotator cuff syndrome who underwent a chest X-ray with a report of an ill-defined image in the right upper hemithorax and later a chest CT scan with a mass of neoplastic appearance described in the right upper lobe that was later confirmed as malignant with histological diagnosis.

Introduction Lung cancer has been the main oncological problem in the world for years. It is extremely important to use appropriate diagnostic methods that enable its detection and implementation of appropriate treatment. Aim The presented case shows the advantage of computed tomography over chest X-ray (X-ray) in visualizing neoplastic changes in the lungs. Case Study The paper presents a description of a patient diagnosed with centrally located advanced lung adenocarcinoma with a strong expression of PD-L1 qualified for treatment with pembrolizumab. Results and Discussion Presented case confirms that X-ray is less sensitive, especially in the case of centrally located tumors. Therefore, the emergence of a new cough in a smoker or ex-smoker should raise concerns related to lung cancer despite a normal X-ray image. The central location of the tumor may cause dramatic course of the symptoms. In the presented case, a sudden significant deterioration of the condition was observed due to atelectasis of the entire lung. Haemoptysis observed during hospitalization was another symptom of centraly located tumor mass. Conclusions In conclusion, the history of cigarette smoking, presence of typical symptoms should provide an in-depth diagnosis of lung cancer, despite normal X-ray. Diagnostic procedures include computed tomography in the first place. The course of centrally localized disease may change rapidly during on first cycle of treatment. Due to the possibility of serious complications of the ongoing neoplastic disease, the patient should be under constant medical supervision.

Objective: This article describes a study protocol for evaluating adherence to oral chemotherapy (OCT) in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) in Spain., Methods: This multicenter, observational, prospective study will be conducted by 6 hospital pharmacists from 6 Spanish hospitals. The study will include men and women aged 18 years or older with a diagnosis of locally advanced or metastatic NSCLC who are being treated or have been prescribed OCT. Once included, the patient will be active and prospectively followed up for 3 months, including 4 study visits to record information on sociodemographic variables, antineoplastic treatment and adherence, pharmaceutical care, clinical variables, and patient-reported outcomes (PRO) (the 3-level version of EQ-5D, the EORTC Core Quality of Life Questionnaire, the Brief Illness Perception Questionnaire, the Treatment Satisfaction with Medicines Questionnaire, and the PRO version of Common Terminology Criteria for Adverse Events). Twelve months after patient inclusion, we will record information on the disease progression status and dispensed prescriptions. The primary outcome is the percentage of treatment adherence that will be calculated based on the pill count as follows: the difference between the number of pills dispensed minus the number of unused pills will be divided by the number of days of treatment multiplied by the number of pills/day prescribed by the oncologist; this quotient will be multiplied by 100 to obtain the percentage of adherence. Based on the that pill count reconciliation, those with a percentage adherence >80% will be primarily categorized as adherent. Secondarily, treatment adherence will be also calculated based on the proportion of days covered and the 4-items Morisky Green Levine Medication Adherence Scale. To analyze the impact of patients' and treatment characteristics on adherence, bivariate analyses will be performed using different adherence cut-off points. To evaluate the impact of adherence on treatment efficacy as evaluated by progression-free survival, we will be using the Kaplan-Meier method and compare it with the log-rank test and univariate Cox regression analysis., Conclusions: We expect that our study will provide initial information on key aspects of adherence to OCT (i.e., measurement, facilitators, and barriers) and its relationship with patients' and clinically relevant outcomes in the setting of NSCLC, and that this information will help in designing pharmaceutical interventions to improve adherence., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction and purpose: The purpose of this study is to review literature about alterations to treatment regimens to lung cancer during COVID-19 pandemic accessible on PubMed platform. In pulmonary neoplasms, early diagnosis and treatment is a key to ensure patient safety. Burdening of healthcare systems during pandemic has resulted in many obstacles in oncologic treatment. A brief description of the state of knowledge: The lung cancer is the most frequent and the most deadly cancer in men and women. COVID-19 is a pulmonary infectious disease whose spread around the world has resulted in a pandemic. At the onset of the worldwide pandemic, many institutions, including healthcare facilities were closed, making it more difficult to provide oncological patients the treatment compliant with the standards. The anxiety of patients caused by the pandemic has caused delays in treatment that can cause progression of the disease. In patients with lung cancer mortality of COVID-19 was around 50%, which made their visits at hospital hazardous. Before the accessibility of anti-COVID-19 vaccines telemedical healthcare was one of the ways to provide healthcare to oncological patients. Conclusions: Patients with lung cancer are one of the risk groups of COVID-19. Delays in their treatment caused by the pandemic are potentially dangerous and negatively affect the therapy. Telemedicine is a useful too provide medical care, but has its own limitations.