The lung is home to a dynamic microbial population crucial to modulating immune balance. Interest in the role of the lung microbiota in disease pathogenesis and treatment has exponentially increased. In lung cancer, early studies suggested an important role of dysbiosis in tumor initiation and progression. These results have helped accelerate research into the lung microbiota as a potential diagnostic marker and therapeutic target. Microbiota signatures could represent diagnostic biomarkers of early-stage disease. Lung microbiota research is in its infancy with a limited number of studies and only single-center studies with a significant methodological variation. Large, multicenter longitudinal studies are needed to establish the clinical potential of this exciting field.

Tyrosine kinase inhibitors (TKIs) have emerged as first-line treatment for the management of epidermal growth factor receptor (EGFR)-mutated advanced non-small cell lung cancer (NSCLC). Erlotinib and gefitinib were the initial TKIs to be approved for lung cancer and showed improved response rates compared with chemotherapy. Afatinib is an irreversible ErbB family blocker that has also been shown to be active in EGFR-mutated NSCLC. Afatinib has been tested as first-line treatment of advanced NSCLC in the LUX-Lung trial program, as well as in the second- and third-line settings. In this article, we will review the data from the 8 reported LUX-Lung trials.

Lung cancer is the leading cause of cancer-related mortality for both men and women in the United States. In 2008, it is estimated that there will be 215,000 new cases and 162,000 deaths from lung cancer.¹ x 1 Jemal, A, Siegel, R, Ward, E et al. Cancer statistics 2008. CA Cancer J Clin. 2008; 58: 71–96 Crossref | PubMed | Scopus (9446) | Google Scholar See all References The World Health Organization estimates 1.2 million new cases annually, making it the most common cancer worldwide.² x 2 WHO. Global cancer rates could increase 50% to 15 million by 2020 [WHO Web site]. Available at: http://www.who.int/mediacentre/news/releases/2003/pr27/en; April 3, 2003. (Accessed January 18, 2010.) Google Scholar See all References Non-small cell lung cancer (NSCLC) makes up approximately 85% of all newly diagnosed cases of lung cancer.

Introduction Paclitaxel is an active agent in extensive-stage (ES) small cell lung cancer (SCLC). Nevertheless, the optimal schedule is uncertain. A dose-dense schedule was previously evaluated in a Cancer and Leukemia Group B study of patients with non-SCLC, resulting in a 42% response rate and median survival of 12.3 months. Because of these promising results, this dose and schedule of paclitaxel was evaluated in patients with ES-SCLC. Methods Patients were eligible for this phase II trial (Cancer and Leukemia Group B 39901) if they had documented ES-SCLC, no prior chemotherapy, and performance status of 0 to 2. Paclitaxel was administered as an intravenous infusion at 150 mg/m² over 3 hours weekly for 6 consecutive weeks every 8 weeks. Results Thirty-six patients with median age of 65 were enrolled. Of them 25 were men and 33 with a performance status 0 to 1. A median of two 8-week cycles were delivered. The percent of patients with grade 3/4 toxicity included neutropenia 22%, anemia 9%, febrile neutropenia 6%, fatigue 20%, sensory neuropathy 26%, motor neuropathy 11%, and dyspnea 17%. There were two treatment-related deaths, both from pneumonitis. The overall response rate was 33% (3% complete response and 30% partial response). Median progression-free and overall survivals were 3.7 and 9.2 months, respectively. One-year progression-free and overall survivals were 17% and 36%, respectively. Conclusions For patients with ES-SCLC, dose-dense weekly paclitaxel was associated with fairly mild hematologic toxicity. Nevertheless, nonhematologic toxicities, including neuropathy, fatigue, and dyspnea required frequent dose delays and reductions. The overall response rate is disappointing and much lower than that seen with standard platinum-based combinations. Paclitaxel in this dose and schedule should not be used as front-line therapy for patients with ES-SCLC.

Pancreatic ductal adenocarcinoma is a malignancy with a high mortality rate. It exhibits significant heterogeneity in metabolic pathways which are associated with its progression. In this review, we discuss the role of single cell RNA sequencing in unraveling the metabolic and clinical features of these highly malignant tumors.