Invasive non-mucinous lung adenocarcinoma (INMA) is biologically heterogeneous, with histological patterns defining distinct subtypes; however, the significance of non-predominant components is not fully characterized. We investigated the associations of micropapillary/solid (MP/S) and lepidic (Lep) components with clinicopathological features, molecular profiles, and perioperative circulating tumor DNA (ctDNA) dynamics in a Chinese cohort. We retrospectively analyzed 73 INMA patients with definitive histological subtyping and next-generation sequencing data. Tumors were assessed for MP/S and Lep components irrespective of predominance. Histologic patterns were correlated with clinicopathological variables, genomic alterations, and individualized tumor-informed ctDNA detection. The cohort was predominantly early-stage, with 71.2

Objective:This study aimed to identify the effectiveness and safety of anlotinib-related therapeutic regimens in patients with previously immune checkpoint inhibitors (ICIs)-treated advanced non-small cell lung cancer (NSCLC). Methods:A total of 107 patients with previously ICIs-treated advanced NSCLC who received anlotinib-related regimens or single-agent chemotherapy in clinical practice were included in this study retrospectively. The anlotinib group (AG) included 54 patients who received anlotinib-related regimens, and the chemotherapy group (CG) consisted of 53 patients who received single-agent chemotherapy. This study retrospectively collected the efficacy and safety data during the patients' therapeutic process and performed regular follow-up to obtain long-term survival data. Clinical outcomes and safety profiles between AG and CG were analyzed and compared. Results:Best overall response of the 107 patients with previously ICIs-treated advanced NSCLC suggested that objective response rates of AG and CG were 24.1% and 11.3%, respectively; no statistically significant difference was observed (P = 0.084). Disease control rates were 79.6% and 54.7%, respectively (P = 0.006). Furthermore, the median PFS of AG and CG were 6.3 months (95% CI = 0.91-11.69) and 2.8 months (95% CI = 2.32-3.28), respectively, which showed a statistically significant difference (P = 0.002). The median OS in AG and CG were 16.1 months (95% CI = 12.28-19.92) and 10.1 months (95% CI = 3.99-16.21), respectively, which also exhibited a statistically significant difference (P = 0.015). Incidence of adverse reactions with all grades in AG and CG were 85.2% and 83.0%, respectively, grade ≥3 adverse reactions occurred in 40.7% and 45.3%, respectively. Common adverse reactions of patients in AG included fatigue, hypertension, nausea and vomiting, and hematologic toxicity, while patients in CG commonly experienced fatigue, hematologic toxicity, nausea and vomiting, and liver toxicity. Conclusion:Among patients with previously ICIs-treated advanced NSCLC, anlotinib-related therapeutic regimens demonstrated encouraging efficacy and a tolerable safety profile compared with the single-agent chemotherapy regimen. This conclusion still needs further validation in prospective clinical trials.

MET is a notable driver gene in the diversity of aberrations with clinical relevance, including exon 14 skipping, copy number gain, point mutations, and gene fusions. Compared with the former two, MET fusions are severely under‐reported, leaving a series of unanswered questions. In this study, we addressed this gap by characterizing MET fusions in a large, real‐world Chinese cancer population.

Wenhua Liang, Kaican Cai, Qingdong Cao, Chun Chen, Haiquan Chen, Jun Chen, Ke-Neng Chen, Qixun Chen, Tianqing Chu, Yuchao Dong, Jiang Fan, Wentao Fang, Junke Fu, Xiangning Fu, Shugeng Gao, Di Ge, Guojun Geng, Qing Geng, Jie He, Jian Hu, Jie Hu, Wei-Dong Hu, Feng Jiang, Tao Jiang, Wenjie Jiao, He-Cheng Li, Qiang Li, Shanqing Li, Shuben Li, Xiangnan Li, Yong-De Liao, Changhong Liu, Hongxu Liu, Yang Liu, Zhuming Lu, Qingquan Luo, Haitao Ma, Xiaojie Pan, Guibin Qiao, Shengxiang Ren, Weiyu Shen, Yong Song, Daqiang Sun, Guangsuo Wang, Jie Wang, Mengzhao Wang, Qiwen Wang, Wen-Xiang Wang, Li Wei, Ming Wu, Nan Wu, Hui Xia, Shi-Dong Xu, Fan Yang, Kang Yang, Yue Yang, Fenglei Yu, Zhen-Tao Yu, Dong-Sheng Yue, Lanjun Zhang, Weidong Zhang, Zhenfa Zhang, Guofang Zhao, Jian Zhao, Xiaojing Zhao, Chengzhi Zhou, Qinghua Zhou, Kunshou Zhu, Yuming Zhu, Toyoaki Hida, Wolfram C. M. Dempke, Antonio Rossi, Marc de Perrot, Robert A. Ramirez, Mariano Provencio, Jay M. Lee, Antonio Passaro, Lorenzo Spaggiari, Jonathan Spicer, Nicolas Girard, Patrick M. Forde, Tony S. K. Mok, Tina Cascone, Jianxing He; on behalf of CATO consensus group

3064 Background: MET is a driver gene notable in its diversity of clinically relevant aberrations, including exon 14 skipping, copy number gain, point mutations, and gene fusions. Compared with the former two, MET fusions are severely under-reported, leaving unanswered a series of fundamental questions. In this study, we addressed this knowledge gap by screening for and characterizing MET fusions in a real-world, multi-center population of Chinese cancer patients. Methods: We retrospectively included patients with solid tumors and available genome profiles acquired between August 2015 to May 2021. MET fusion-positive ( MET+) patients were subsequently selected for clinical and molecular characterization. Results: A total of 79816 patients across 27 tumor types were screened. We detected 155 putative MET fusions from 122 patients, resulting in an overall prevalence of 0.15%. Lung cancer comprised the majority of MET+ patients (92, 75.4%). Prevalence was markedly higher in liver, biliary tract cancer, and renal cancer (range 0.52%-0.60%) and lower in ovarian cancer (0.06%). A substantial proportion (48/58, 82.8%) of unique partners were reported for the first time. The fusion partners also turned out to be highly heterogeneous, with ST7, HLA-DRB1, and KIF5B as the three most common partners. Mutational landscape analysis of lung adenocarcinoma patients (n = 32) revealed high prevalence of aberrant TP53 in MET+ patients as well as EGFR L858R, L861Q and MET amplification as concurrent alterations. Conclusions: This study is, to our knowledge, currently the largest in characterizing MET fusions. Our findings warrant further clinical validation and mechanistic study that may translate into therapeutic avenues for MET fusion-positive cancer patients.

Objective To explore the expression of vascular endothelial growth factor receptor 3 (VEGFR3) and its significance in lung adenocarcinoma and to examine the effect of VEGFR3 knockdown on the biological behaviors of A549 cells. Methods Immunohistochemistry was used to detect the expression of VEGFR3 in 78 pieces of lung adenocarcinoma tissue and 35 of paracancerous tissue. Relationships between VEGFR3 and clinicopathological indices were also analyzed. Correlations between lung adenocarcinoma patient survival and the expression of vascular endothelial growth factor-C (VEGF-C) or VEGFR3 were analyzed using the TCGA database. VEGFR3 expression was knocked down in A549 cells using RNA interference, and cell proliferation was assessed using a CCK-8 assay. Cell migration and invasion were detected using TranswellTM assays. The effect of siRNA-mediated knockdown of EGFR3 in A549 cells on AKT pathway activity was assessed by Western blot analysis. Results Expression of VEGFR3 was significantly higher in the lung adenocarcinoma tissue than in the adjacent tissue, and positively correlated with TNM stage and lymph node metastasis. The survival rate of patients with high VEGFR3 expression was significantly lower than that of patients with low VEGFR3 expression. Exogenous VEGF-C promoted the expression of VEGFR3, and activated the AKT signaling pathway. Silencing of VEGFR3 inhibited the proliferation, migration, and invasiveness of A549 cells, and reduced the activation of the AKT signaling pathway by VEGF-C. Conclusion High expression of VEGFR3 in the lung adenocarcinoma tissue is positively correlated with poor prognosis. Silencing VEGFR3 can block AKT pathway activity and inhibit the proliferation, migration, and invasion of A549 cells.

Background Capn4 and ZEB1 play important roles in the metastasis of several types of cancer. However, the roles and relationship of Capn4 and ZEB1 in esophageal squamous cell carcinoma (ESCC) remain unclear. Methods ESCC tumor tissues and corresponding normal esophageal epithelial tissues were obtained from 86 patients undergoing resection surgery at the Department of General Surgery, First Affiliated Hospital of Chinese PLA General Hospital from 2012 to 2017. Cell migration and invasion were examined via quantitative real‐time PCR and Western blot assay. Results Our results indicate that both Capn4 and ZEB1 are significantly upregulated in ESCC tissues compared to corresponding adjacent tissues, and a positive correlation between expression and associated malignant characteristics was found. Silencing of Capn4 expression markedly inhibited ESCC invasion and metastasis in vitro and in vivo, and was accompanied by decreased ZEB1 expression. Furthermore, the anti‐metastasis role of Capn4 silencing was reversed by ZEB1 overexpression, whereas knockdown of ZEB1 decreased ESCC metastasis driven by the upregulation of Capn4. Mechanistically, Capn4 regulated ZEB1 expression via activation of the Wnt/β‐catenin signaling pathway in ESCC cells. Conclusion Overall, our results show that enhanced Capn4 expression activates the Wnt/β‐catenin signaling pathway, resulting in increased ZEB1 expression and the promotion of ESCC cell metastasis.

Aim: Although, miR-218 has been implicated in epithelial-to-mesenchymal transition process, the detailed mechanisms of miR-218 involvement in epithelial-to-mesenchymal transition in human lung adenocarcinoma cell are still unclear. Materials & methods: miR-218 function assays and its target gene analysis were performed. Results: miR-218 suppresses human lung adenocarcinoma cell migration and invasion and inhibits its target gene, Ecop and Robo1 expression, which subsequently suppresses NF-κB activity and its downstream targets. Conclusion: miR-218 inhibits human lung adenocarcinoma cell migration and invasion via the suppression of Ecop and Robo1 expression, thus suggesting that miR-218 could serve as a potential therapeutic target.

We investigated the role of microRNA-21 (miR-21) in radiotherapy resistance of non-small cell lung cancers (NSCLC) and the underlying molecular mechanism. A549 cells were transfected with anti-miR-21 or the negative control oligonucleotides and real-time PCR was applied to detect miR-21 expression level. After ionizing radiation (IR), the survival fractions, proliferation, apoptosis, and expression of phosphorylated-Akt of A549 cells were determined by clonogenic survival analysis, MTT assay, flow cytometry, and Western blotting. Downregulation of miR-21 in radioresistant NSCLC A549 cells inhibited the colony-forming ability and proliferation of A549 cells after IR. Moreover, silencing miR-21 enhanced apoptosis of A549 cells induced by IR accompanied by decreased phosphorylated-Akt protein level. However, PI3K activator IGF-1 reversed suppression of phosphorylated-Akt protein level and promotion of apoptosis of A549 cells after IR caused by miR-21 knockdown. Silencing miR-21 in radioresistant NSCLC A549 cells sensitized them to IR by inhibiting cell proliferation and enhancing cell apoptosis through inhibition of PI3K/Akt signaling pathway. This might help in sensitization of NSCLC to radiotherapy.

About 80 % of lung cancers are carcinomas that are classified histologically as non-small-cell lung carcinoma (NSCLC) and targeted chemotherapy of this cancer is currently based on sensitivity of the primary tumor to specific drugs. The purpose of this study was to compare the levels of four serum markers of cancer and the levels of six molecular markers which are possibly associated with drug selection in the primary tumors and metastatic lymph nodes of 39 consecutive NSCLC patients who were admitted to a single institution in China. Serum markers of cancer (neuron-specific enolase, carcinoembryonic antigen (CEA), cancer antigen 125, cytokeratin fragment 21-1) were measured by an automated electrochemiluminescence system and molecular markers (multidrug resistance protein 1, LDL receptor-related protein, ribonucleotide reductase M1, epidermal growth factor receptor, excision repair cross-complementing gene 1, and breast cancer 1) were measured by immunohistochemistry of the primary tumors and metastatic lymph nodes. The results indicate that the serum level of CEA was higher in NSCLC patients with adenocarcinoma relative to those with squamous cell carcinoma, but no significant differences in the other serum markers. Expression of excision repair cross-complementing gene 1 was significantly different in the primary tumors and metastatic sites of NSCLC patients with adenocarcinoma, but there were no other significant differences. This study provides an initial step toward the development of individualized chemotherapy of NSCLC based on measurement of molecular markers in the primary tumors and metastatic lymph nodes.