Intrapatient Molecular and Histologic Heterogeneity After First-generation or Second-generation TKI Therapy of NSCLC Patients: Potential Clinical Impact on Subsequent third-generation TKI Treatment.

Objectives: The discovery of tyrosine kinase inhibitors (TKI) has remarkably improved the clinical course of patients with non-small cell lung cancer driven by Epidermal Growth Factor Receptor (EGFR) mutations. However, virtually in all cases, the disease resurfaces in a TKI-resistant form that is mainly linked to an acquired EGFR-T790M mutation, a MET amplification, or small cell lung cancer (SCLC) transformation. Third-generation TKIs are able to block tumor growth through an irreversible binding to the T790M-mutated receptor.

[On adjuvant therapy after limited resections for NSCLC Stage IA in patients with high risk of recurrence: waiting for the announced 8th Edition 2017 of TNM Staging System].

The adjuvant therapy in NSCLC Stage IA still remains a controversial issue even in the interdisciplinary decision making after limited resections of the neoplasm as an alternative to lobectomy. The Authors accept from literature that this mainly concerns specific sub-group of patients, the istopathological post-resection diagnosis of whom highlights linfovascular o perineural as well as visceral pleura invasion. There is confidence that the presently depersonalizing rigidity in the guidelines implementation is overcome in the presence of clear istological signs of invasion.

[The longsurvivors for non-small cell lung cancer: remarks on the present and in perspective].

The Authors fully share cricitisms voiced in international literature to NSCLC longsurvivors, in particular those remarkes related to advanced disease patients following various anti-tumor treatments ( mostly multimodal). To this point, even the NCCN version 3.2014 guidelines prove inadequate as they mostly focus on longsurvivors post-NSCLC early stage surgical resection.

[Revisiting iatrogenic damage in pneumology past and current implications compared].

Current features of iatrogenic damage by pneumological practice are taken into account and compared with those traced in the past by Daddi and colleagues. The Authors stress the major chances occurred over time and moreover they emphasize the correlated implications that took place with prevention, therapies, informed consent and defensive medicine. Especially in oncological as well as non-oncological field the more relevant iatrogenic damages are represented by the pulmonary interstitial disease and pulmonary thromboembolism.

[A case of quadruple simultaneous second primary metachronous carcinomas subsequently involving colon, prostate, kidney and lung in an octogenarian patient].

The authors describe a case of quadruple second primary metachronous carcinomas subsequently occurred in an octogenarian patient: colon, prostate, kidney and, lastly, lung. No chemotherapy and or radiotherapy were given. Survival resulted three years after diagnosis of the first carcinoma and four years after the last carcinoma.