Publications by authors named "Xu-chao Zhang"

Background: Patients with ALK-rearranged non-small cell lung cancer (ALK+ NSCLC) with symptomatic brain (BM) and leptomeningeal (LM) metastases are underrepresented in clinical trials due to poor performance status. Additionally, the need for improved and validated assessment criteria for evaluating central nervous system (CNS) response remains critical. Lorlatinib has demonstrated systemic activity in patients with ALK+ NSCLC.

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  • * Results showed that a higher PRS was more strongly related to EGFR-positive LUAD cases (OR=8.63) than to EGFR-negative cases (OR=3.50), indicating a significant association based on mutation status.
  • * These findings imply that genetic susceptibility to LUAD differs in never-smoking East Asian women depending on whether the cancer has specific mutations, which could affect public health strategies and clinical practices.*
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  • The study discusses challenges in classifying salivary gland malignancies due to their similar features, highlighting the usefulness of molecular phenotyping, particularly through next-generation sequencing (NGS).
  • A case of a young female with a salivary gland tumor at the tongue base was presented, revealing an EWSR1::BEND2 gene fusion through RNA-based NGS, which is a rare finding in this type of cancer.
  • The findings suggest that the EWSR1::BEND2 fusion may play a significant role in the development of salivary gland tumors, indicating that RNA-based NGS is crucial for accurate diagnosis and understanding of this rare malignancy.
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  • Transformation to small cell lung cancer (SCLC) is a resistance mechanism seen in lung adenocarcinoma (LUAD) patients treated with tyrosine kinase inhibitors, particularly in those with leptomeningeal metastases (LM).
  • In a study of 237 non-small cell lung cancer (NSCLC) patients who had lumbar punctures, SCLC cells were identified in the cerebrospinal fluid (CSF) of 8 patients, all of whom showed resistance to targeted therapies.
  • The results suggest that SCLC transformation in CSF can be detected using cytological evaluation and ctDNA analysis, providing valuable insights into treatment resistance mechanisms, with this transformation correlating with reduced survival rates.
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Objectives: Non-small cell lung cancer (NSCLC) patients with exon 20 insertion mutations (ex20ins) of the epidermal growth factor receptor (EGFR) were resistant to monotherapy of immune checkpoint inhibitor (ICI). However, recent reports have shown that the combination of ICI and chemotherapy (ICI-combined regimen) exhibited certain efficacy for NSCLC with EGFR ex20ins. The mechanisms behind this phenomenon have not been thoroughly clarified.

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  • * Single-cell RNA sequencing revealed that LMs contain diverse macrophage populations with stronger immunosuppressive characteristics, particularly a subset linked to osimertinib resistance influenced by Midkine (MDK).
  • * Elevated MDK levels in cerebrospinal fluid and plasma correlate with worse patient outcomes, suggesting MDK and the RNASE1_M macrophage subtype could be potential targets for treating LMs in NSCLC patients.
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  • * The newly developed multi-ancestry PRS showed a strong correlation with LUAD risk, indicating that individuals in the highest PRS percentile had significantly increased risk compared to those in the lowest.
  • * Findings suggest that those in the highest risk category have a lifetime risk of about 6.69%, and they reach the average population's 10-year risk for LUAD by age 41, highlighting the importance of multi-ancestry PRS for better risk assessment in this group.
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Hemoglobinopathies are one of the most common single-gene genetic disorders globally, with approximately 1% to 5% of the global population carrying the mutated gene for thalassemia. Thalassemia are classified into transfusion-dependent thalassemia and non-transfusion-dependent thalassemia based on the need for blood transfusion. Traditional treatment modalities include blood transfusion, splenectomy, hydroxyurea therapy, and iron chelation therapy, which are now widely used for clinical treatment and constitute the main methods recommended in the β-thalassemia treatment guidelines.

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Objectives: Primary pulmonary lymphoepithelioma-like carcinoma (PLELC) is a subtype of lung carcinoma associated with the Epstein-Barr virus (EBV). The clinical predictive biomarkers of immune checkpoint blockade (ICB) in PLELC require further investigation.

Methods: We prospectively analysed EBV levels in the blood and immune tumor biomarkers of 31 patients with ICB-treated PLELC.

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  • * LUAD can be categorized into two metabolic phenotypes: redox and non-redox, with significant differences in mutation prevalence and immune cell response; redox LUAD primarily features mutations in KEAP1, STK11, NRF2, and SMARCA4.
  • * Patients with the redox phenotype show poorer response rates, progression-free survival, and overall survival when treated with ICIs, largely due to a reduction in tissue-resident memory CD8+ T cells.
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Background: Mesenchymal-epithelial transition () amplification is a crucial oncogenic driver and a resistance mechanism to epidermal growth factor receptor tyrosine kinase inhibitors (TKIs) of non-small-cell lung cancer (NSCLC). Fluorescence hybridization (FISH) is the gold standard for amplification detection. However, it is inapplicable when tissue samples are unavailable.

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No direct comparison has been performed between different programmed cell death-1 (PD-1) inhibitors for first-line treatment in patients with advanced non-small cell lung cancer (NSCLC). The feasibility of using PD-L1-expression-guided immunotherapy remains unknown. In this open-label, phase 2 study (NCT04252365), patients with advanced NSCLC without EGFR or ALK alterations were randomized (1:1) to receive sintilimab or pembrolizumab monotherapy (PD-L1 expression ≥ 50%), or sintilimab or pembrolizumab plus platinum-based chemotherapy (PD-L1 expression < 50%).

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Introduction: EGFR C797X (C797S or C797G) mutation is the most frequent on-target mechanism of resistance to osimertinib. The hypothesis that the allelic context of C797X/T790M has implications for treatment is on the basis of sporadic reports and needs validation with larger cohorts.

Methods: We identified patients with EGFR C797X-mutant NSCLC from nine centers who progressed on osimertinib, all analyzed in a single laboratory through next-generation sequencing.

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Background: The transformation of epidermal growth factor receptor ()-mutant lung adenocarcinoma (LUAD) into small cell lung cancer (SCLC) accounts for 3-14% of the resistance mechanism to EGFR tyrosine kinase inhibitors (TKIs). At present, there is no relevant research to explore the dynamic expression of -mutant proteins and genomic evolution in -mutant transformed SCLC/neuroendocrine carcinoma (NEC).

Methods: Genetic analysis and protein level analysis by next-generation sequencing (NGS), Whole-exome sequencing (WES) and immunohistochemistry were performed to explore expression of -mutant proteins and genomic evolution in -mutant transformed SCLC.

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Pulmonary nodules with part-solid imaging features manifest during the progression from preinvasive to invasive lung adenocarcinoma. To define the spatial composition and evolutionary trajectories of early-stage lung adenocarcinoma, we combined spatial transcriptomics (ST) and pathological annotations from 20 part-solid nodules (PSNs), four of which were matched with single-cell RNA sequencing. Two malignant cell populations (MC1 and MC2) were identified, and a linear evolutionary relationship was observed.

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  • CAR T cell therapy, used to fight cancer, sometimes doesn't work well and can cause harm to healthy tissues.
  • A new type of therapy called CFR64 is made to improve how these T cells attack cancer cells while minimizing side effects.
  • CFR64 T cells are better at fighting cancer long-term and show more stability and strength compared to traditional CAR T cells.
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  • Lung adenocarcinoma is the most prevalent form of lung cancer, and existing known genetic risk factors account for only a small portion of its heritability.
  • A comprehensive genome-wide association study involving nearly 22,000 cases and over 150,000 controls identified 12 new genetic variants linked to the disease, raising the count to 28 variants across 25 distinct locations in the genome.
  • The study emphasized that these genetic markers are particularly significant in East Asian populations, especially among never-smokers, and indicates that further research could inform better prevention and treatment strategies tailored to these populations.
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Genomic MET amplification and exon 14 skipping are currently clinically recognized biomarkers for stratifying subsets of non-small cell lung cancer (NSCLC) patients according to the predicted response to c-Met inhibitors (c-Metis), yet the overall clinical benefit of this strategy is quite limited. Notably, c-Met protein overexpression, which occurs in approximately 20-25% of NSCLC patients, has not yet been clearly defined as a clinically useful biomarker. An optimized strategy for accurately classifying patients with c-Met overexpression for decision-making regarding c-Meti treatment is lacking.

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Background: Circulating tumor cells (CTCs) are prognostic biomarker in non-small-cell lung cancer (NSCLC). CTCs could also be used as predictor of efficacy of systemic treatments in advanced NSCLC.

Objectives: We described the dynamic changes of CTCs during first-line platinum-based chemotherapy in advanced NSCLC and clarified the correlation between CTC counts and efficacy of chemotherapy.

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The efficacy of immunotherapy in advanced HER2-mutated non-small-cell lung cancer (NSCLC) remains incomprehensively studied. A total of 107 NSCLC patients with de novo HER2 mutations were retrospectively studied at Guangdong Lung Cancer Institute [GLCI cohort, exon 20 insertions (ex20ins): 71.0%] to compare clinical/molecular features and immune checkpoint inhibitor (ICI)-based therapy efficacy between patients with ex20ins and non-ex20ins.

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Mutations in epidermal growth factor receptor and anaplastic lymphoma kinase are common driver events in non-small cell lung cancer (NSCLC), which are associated with a high frequency of bone metastases (BMs). While the bone marrow represents a specialized immune microenvironment, the immune repertoire of BMs remains unknown. Considering the higher incidence of BMs in driver gene-positive NSCLCs, and the unique biology of the bone, herein, we assessed the infiltrating immune cells and T cell receptor (TCR) profile of BMs in driver-positive NSCLCs.

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EMERGING-CTONG 1103 showed improved progression-free survival (PFS) with neoadjuvant erlotinib vs. chemotherapy for patients harbouring EGFR sensibility mutations and R0 resected stage IIIA-N2 non-small cell lung cancer (NSCLC) (NCT01407822). Herein, we report the final results.

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Introduction: Recently, several clinical trials of immunotherapy for extensive-stage small-cell lung cancer (ES-SCLC) have shown limited benefits because of unselected patients. Thus, we aimed to explore whether YES-associated protein 1 (YAP-1) and POU domain class 2 transcription factor 3 (POU2F3) could identify SCLC patients with durable benefits from immunotherapy as potential biomarkers.

Methods: We performed IHC of YAP-1 and POU2F3, and RNA-seq on tissues of ES- SCLC patients.

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Predicting the clinical response to chemotherapeutic or targeted treatment in patients with locally advanced or metastatic lung cancer requires an accurate and affordable tool. Tumor organoids are a potential approach in precision medicine for predicting the clinical response to treatment. However, their clinical application in lung cancer has rarely been reported because of the difficulty in generating pure tumor organoids.

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MET inhibitors have shown promising efficacy for MET-dysregulated non-small cell lung cancer (NSCLC). However, quite a few patients cannot benefit from it due to the lack of powerful biomarkers. This study aims to explore the potential role of plasma proteomics-derived biomarkers for patients treated with MET inhibitors using mass spectrometry.

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