Colorectal cancer is the second leading cause of cancer-related death globally.

Although some of the molecular changes associated with colorectal cancer are known, how they contribute to cancer development is not yet well defined.

In a study published in Journal of Clinical Investigation, researchers used mouse models and studies of colorectal cancer tissues to show that loss of SOX9 gene promotes tumor progression and the pathway it regulates can be a potential target for future treatments.

New research has identified specific blood-based biomarkers that can predict the failure of prostate cancer treatment in both hormone-sensitive and castration-resistant patients. The study in The Journal of Molecular Diagnostics, published by Elsevier, identifies platelets, C-reactive protein, and chromogranin A as important indicators in hormone-sensitive prostate cancer patients for the combined androgen deprivation and androgen receptor pathway inhibitors therapy failure to guide alternate treatment.

Background: Lung cancer has become the second most common cancer and the leading cause of cancer death in the United States. We aim to determine factors associated with newly diagnosed lung cancer at the Emergency Department (ED) and identify specific patient populations eligible for lung cancer diagnostic screening.

Methods: This is a single-center retrospective observational study. We included all patients aged between 50 and 80 years old, who presented to the ED seeking healthcare between January 1, 2019, and December 31, 2023. Patients’ socio-demographics, clinical information, and whether they were eligible for lung cancer screening determined by the United States Preventive Services Task Force (USPSTF) guideline were analyzed and compared between patients who had newly diagnosed lung cancer at ED and those without. Factors associated with newly diagnosed lung cancer patients were determined by multivariable logistic regressions with inverse probability weighting (IPW) to account for observed selection bias of lung cancer screening eligibility.

Results: Out of 75,516 patients in this study, 18,641 (25%) patients had documented smoking histories. Among these, only 8,051 (10.66%) were eligible for lung cancer screening, while 18,348 patients received lung computer tomography (CT). Among all patients whose CTs were performed, 123 individuals were identified as having been newly diagnosed with lung cancer. Multivariable logistic regressions showed that the adjusted odds ratio (AOR) for eligible lung cancer diagnostic screening was 3.07 [95% confidence interval (CI): 2.08–4.53, P<0.001] without IPW and 3.49 (95% CI: 2.24–5.42, P<0.001) with IPW. Other factors associated with newly diagnosed lung cancer in ED were older age, female, and patients who spoke neither English nor Spanish.

Conclusions: To optimize the identification of suitable patients for lung cancer diagnostic screening in the ED, it may be beneficial to modify the eligibility criteria beyond those currently outlined by the USPSTF guidelines. Integrating additional factors such as advanced age, female sex, and a preference for non-English languages could improve the screening’s effectiveness by capturing at-risk populations that might otherwise be overlooked.

Keywords: Lung cancer; screening eligibility; Emergency Department (ED)

Background: Managing malignant pleural effusion (MPE) with pleurodesis is essential for symptom relief and minimizing the need for repeated thoracentesis. Interstitial lung disease (ILD) is one of the most common complications associated with advanced lung cancer. However, the efficacy and safety of pleurodesis for MPE secondary to lung cancer with ILD remains unclear. This study aimed to evaluate the efficacy and safety of pleurodesis in this population.

Methods: This study was a single-center retrospective analysis. The cases of pleurodesis in patients with MPE secondary to lung cancer complicated with ILD at Nippon Medical School Hospital (Tokyo, Japan) between January 2010 and December 2022 were included.

Results: Of the 26 lung cancer patients with ILD who underwent pleurodesis were analyzed. Fourteen patients received talc and 12 patients received minocycline, respectively. Talc was used in 10 out of 14 patients with drug-induced ILD and radiation-induced lung injury (RILI). In contrast, minocycline was used in 10 out of 12 patients with idiopathic interstitial pneumonias (IIPs). One month after pleurodesis, the efficacy for pleural adhesions was 64.3% and 50.0% in the talc and minocycline groups. The presence of a partially expanded lung before pleurodesis was a predictive factor for failure [odds ratio: 7.00, 95% confidence interval (CI): 1.20–40.83, P=0.04]. When excluding the patients presenting partially expanded lung, the efficacy rate was 77.8% and 71.4% in the talc and minocycline groups. One case of grade 5 acute respiratory distress syndrome (ARDS) was observed in each group. All cases developing ARDS had been treated with systemic prednisolone against ILDs presenting ground glass opacity and consolidation within 6 months before pleurodesis.

Conclusions: Pleurodesis is considered to be one of the treatment options against MPE in patients with ILD. However, two cases of ARDS were observed; thus, clinicians should carefully consider the indication of pleurodesis in the patients who had the recent onset of ILD and were treated with systemic prednisolone.

Keywords: Lung cancer; malignant pleural effusion (MPE); pleurodesis; interstitial lung disease (ILD)

Background: Fluorine 18-labeled fibroblast activation protein inhibitor (¹⁸F-FAPI-04) positron emission tomography/computed tomography (PET/CT) has shown promise for the visualization of advanced stage lung cancer. The accuracy of ¹⁸F-FAPI-04 compared with that of fluorine-18 labeled-fluorodeoxyglucose (¹⁸F-FDG) in detecting early lung adenocarcinoma (LUAD) remains unknown. Taking the surgical pathology of pulmonary nodule as the gold standard, the diagnostic performance of stage IA LUAD were compared between ¹⁸F-FAPI-04 PET/CT and ¹⁸F-FDG PET/CT, and the correlation between ¹⁸F-FAPI-04 uptake and pathological characteristics of stage IA LUAD.

Methods: This prospective study from February 2023 to October 2023 analyzed patients with stage IA LUAD who underwent simultaneous examinations with ¹⁸F-FAPI-04 and ¹⁸F-FDG PET/CT. Semi-quantitative parameters such as maximum standardized uptake value (SUVmax), tumor-to-background ratio (TBR), metabolic tumor volume (MTV), total lesion glycolysis (TLG), FAPI avid tumor volume (FTV), and total lesion FAP expression (TLF) were calculated. The two patterns were compared using either a paired Student’s t-test or a Wilcoxon signed-rank test. Immunohistochemical (IHC) staining for detecting fibroblast activating protein (FAP) expression was performed in all resected tumor specimens. Correlation analysis was performed between ¹⁸F-FAPI-04 uptake and pathological features of stage IA LUAD.

Results: A total of 20 patients diagnosed with stage IA LUAD were included in this study. A total of 24 pulmonary nodules were identified in these 20 patients, all of whom were confirmed to have stage IA LUAD through operation and pathology. Of them, 17 nodules were stained by FAP immunohistochemistry. Compared with ¹⁸F-FDG, ¹⁸F-FAPI-04 PET/CT showed a statistically significant increase in SUVmax and TBR for stage IA LUAD, both in the overall and stratified analyses (adenocarcinoma in situ + minimally invasive adenocarcinoma groups vs. invasive adenocarcinoma groups; moderately vs. well-differentiated lesions; stage IA1 vs. IA2+3; P<0.05). The SUVmax of the intense FAP expression group was significantly higher than that of the mild FAP expression group, demonstrating a statistically significant difference (P=0.005). The FAP-IHC score was positively correlated with the SUVmax of ¹⁸F-FAPI-04 (r=0.64, P=0.005).

Conclusions: ¹⁸F-FAPI-04 PET/CT demonstrates higher SUVmax and TBR than ¹⁸F-FDG PET/CT in the detection of stage IA LUAD. It was re-assured that the ¹⁸F-FAPI-04 uptake of stage IA LUAD was positively correlated with the expression of FAP in vitro.

Keywords: Lung adenocarcinoma (LUAD); fibroblast activation protein; fluorine 18-labeled fibroblast activation protein inhibitor (¹⁸F-FAPI-04); ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG); positron emission tomography/computed tomography (PET/CT)