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Rare lung tumors, mapping to better guide patients

A team of 70 researchers conducted a thorough molecular description of neuroendocrine lung tumors, thus identifying patients with a severe form of these rare cancers. The generated data open up perspectives for better support.

In our body, neuroendocrine cells have the mission to secrete a hormone when they receive a nerve signal. These cells are present in many organs, especially in the lungs, where their abnormal proliferation leads to the formation of lung neuroendocrine tumor (NPT). Of the four forms of NPT, typical or atypical carcinoid tumors (depending on the appearance of cancer cells, more or less close to that of healthy cells) are cancers that often occur in non-smokers. They represent only 1 to 2% of invasive lung cancers and have a generally better prognosis than most lung cancers. But the distinction between these so-called "indolent" forms and other, more aggressive NPTs is sometimes tricky. To improve their diagnosis and better understand their biology, an in-depth analysis of the molecular characteristics of 257 TNP has been performed by an international team of researchers. Their results, published in the journal Nature Communications, provide a panorama that should help clinicians to optimize patient care.

During this exploration, the researchers were particularly interested in the description of so-called atypical carcinoid tumors, the least known, in order to understand the molecular springs that underlie their clinical characteristics. Genetic mutations, levels of expression of all the genes ... all these data allowed researchers, accompanied by an artificial intelligence system, to establish the existence of a group of tumors that stood out within those considered as "atypical carcinoids". In a very interesting way, these tumors, which the researchers named "supra-carcinoids", had a distinct clinical profile, with a poorer prognosis than other carcinoid tumors: the 10-year survival observed in the two groups created was 27% for patients with supra-carcinoid tumors versus 88% for those who were affected by another atypical carcinoid tumor.

In addition to defining molecular profiles specific to different NPTs, the authors of this study confirmed the diagnostic and prognostic value of certain markers. They also revealed the relevance of certain therapeutic strategies, such as the targeting of the DLL3 protein or the stimulation of the immune system, adapted to different tumors.

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