Advances in Experimental Medicine and Biology 890 Aamir Ahmad Shirish M. Gadgeel Editors Lung Cancer and Personalized Medicine: Novel Therapies and Clinical Management A dvances in Experimental Medicine and Biology Volume 890 Editorial Board: IRUN R. COHEN, The Weizmann Institute of Science, Rehovot, Israel ABEL LAJTHA, N.S. Kline Institute for Psychiatric Research, Orangeburg, NY, USA JOHN D. LAMBRIS, University of Pennsylvania, Philadelphia, PA, USA RODOLFO PAOLETTI, University of Milan, Milan, Italy M ore information about this series at h ttp://www.springer.com/series/5584 A amir A hmad • S hirish M . Gadgeel E ditors L ung Cancer and Personalized Medicine: Novel Therapies and Clinical Management E ditors A amir A hmad S hirish M . Gadgeel K armanos Cancer Institute K armanos Cancer Institute W ayne State University W ayne State University D etroit, M I, U SA D etroit, M I, U SA I SSN 0065-2598 ISSN 2214-8019 (electronic) Advances in Experimental Medicine and Biology ISBN 978-3-319-24931-5 ISBN 978-3-319-24932-2 (eBook) D OI 10.1007/978-3-319-24932-2 L ibrary of Congress Control Number: 2015960242 S pringer Cham Heidelberg New York Dordrecht London © Springer International Publishing Switzerland 2 016 T his work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. 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Part I of this volume, available as a separate book, discussed lung cancer as a disease, the available therapies and the associated challenges. In this edition, we focus on the upcoming and novel strategies to better understand and target lung cancer. As dis- cussed in the chapters presented here, our understanding of lung cancer and the vari- ous factors associated with its onset and progression has vastly improved in last several years. All this information is critical to developing personalized therapies tailored for the benefi t of individual patients. A major component of personalized therapy is the ability to profi le an individual lung cancer patient. The molecular and genomic profi ling of lung cancers are steps in this direction. C hapter 1 focuses on the advancements in these areas of lung can- cer research. C hapter 2 summarizes all of the emerging biomarkers, relevant to personalized care of lung cancer patients. This chapter discusses the many potential biomarkers, such as ROS1, RET, MET, HER2 and BRAF that are under investiga- tion. This is in addition to EGFR and ALK, the more established biomarkers cov- ered in more detailed chapters in part I of this volume. For a successful personalized profi ling of lung cancer patients, a comprehensive signature, with relative status of multiple biomarkers, is very critical. C hapter 3 focuses on the process of epithelial to mesenchymal transition (EMT), a phenomenon that is particularly relevant to metastasis of lung cancers. The important role that EMT plays in acquisition of stem cell-like properties and resistance to targeted therapies is now well accepted, and all these topics are covered in this chapter. C hapter 4 continues on the topic of cancer stem cells (CSCs) and provides a more detailed overview of our knowledge on the topic. The existence of CSCs has been a hotly debated topic for last several years. In addition to the various markers and a role of CSCs in the recurrence and drug resistance mechanisms of lung can- cers, this chapter also describes the emerging evidence of natural agents and their synthetic derivatives as compounds that can effectively target CSCs. C hapter 5 details the current knowledge of lung cancer cells’ niche—the microenvironment— which feeds and sustains lung cancer cells, providing them the perfect environment to acquire an aggressive phenotype. A better understanding of tumor microenvironment v vi Preface is critical to the development of future personalized therapies for lung cancer patients. The next chapter, C hapter 6 , examines the epigenetic changes associated with lung cancer progression and their possible validation as therapeutic targets. This chapter discusses the epigenetic changes that are now known to infl uence the expression of oncogenes as well as the tumor suppressors, and the various epigen- etic events that can potentially be targeted as part of personalized management of lung cancer patients. C hapter 7 provides a detailed overview of next-generation sequencing and the associated promise of early detection and molecular profi ling of lung cancers. The importance of early detection and complete profi ling cannot be over-stated, and, moving forward, such methodologies will be very handy at the time of making deci- sions for personalized treatment plans. C hapter 8 discusses the promising fi eld of ‘cancer nanomedicine’. The nanoparticle-based systems, discussed in this chapter, can be an invaluable tool in the delivery of novel therapeutic agents in an attempt to enhance their effectiveness. According to the American Cancer Society, lung cancers are three distinct types: non-small cell lung cancers; small cell lung cancers; and lung carcinoid tumors. While non-small cell lung cancers represent a major subtype with up to 85% of all lung cancers, small cell lung cancers are known to be particularly aggressive. C hapter 9 describes the recent updates towards personalized therapy of small cell lung cancers. The foregoing chapters address the various characteristics of lung cancers and the putative targets of therapy, knowledge of which is essential to the development of personalized clinical management. The manner in which the personalized approach is actually applied in clinical management of lung cancers is discussed in the last two chapters of this section. Radiation therapy is a major treatment option for lung cancers, and Chapter 1 0 discusses the concept of personalized radiation therapy that promises to improve treatment outcomes with substantially reduced toxicity. Finally, Chapter 1 1 details the approaches to making a decision for person- alized treatment of lung cancer patients, based on the individual clinical character- istics, biomarkers and other parameters that an individual lung cancer patient presents. B etween the two parts, this volume comprehensively covers many aspects of modern day lung cancer research, with special focus on personalized therapy. We are so excited to have a panel of experts and leading lung cancer scientists contrib- ute to this volume, and it is our distinct pleasure to present this volume to the scien- tifi c community. D etroit, USA Aamir A hmad, P hD Shirish M . Gadgeel, M D C ontents L ung Cancer Genomics in the Era of Accelerated Targeted Drug Development .......................................................................................... 1 P riyanga W ijesinghe and A liccia B ollig-Fischer E merging Biomarkers in Personalized Therapy of Lung Cancer .............. 2 5 P hilip T . C agle, K irtee R aparia, and B ryce P . P ortier E pithelial Mesenchymal Transition in Aggressive Lung Cancers .............. 3 7 V ivek M ittal T he Role of Cancer Stem Cells in Recurrent and Drug-Resistant Lung Cancer .................................................................................................... 5 7 R aagini S uresh, S hadan A li, A amir A hmad, P hilip A . P hilip, and F azlul H . S arkar T he Microenvironment of Lung Cancer and Therapeutic Implications ........................................................................ 7 5 V ivek M ittal, T ina El R ayes, N avneet N arula, T imothy E . M cGraw, N asser K. A ltorki, and M ary H elen Barcellos-Hoff E pigenetics in Personalized Management of Lung Cancer ......................... 1 11 A amir A hmad N ext-Generation Sequencing and Applications to the Diagnosis and Treatment of Lung Cancer ..................................................................... 1 23 K ristina M . K ruglyak, E rick L in, and F rank S . O ng N anomedicine for Treatment of Lung Cancer ............................................. 1 37 S ajid H ussain P ersonalized Therapy of Small Cell Lung Cancer ....................................... 1 49 B ryan J . S chneider and G regory P . K alemkerian vii viii Contents P ersonalized Radiation Therapy (PRT) for Lung Cancer .......................... 1 75 J ian-Yue J in and F eng-Ming (Spring) K ong P ersonalized Therapy of Non-Small Cell Lung Cancer (NSCLC) ............. 2 03 S hirish M . Gadgeel I ndex ................................................................................................................. 2 23 C ontributors A amir A hmad K armanos Cancer Institute, Wayne State University, Detroit, MI, USA S hadan A li D epartment of Oncology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA N asser K. A ltorki D epartment of Cardiothoracic Surgery, Weill Medical College of Cornell University, New York, NY, USA Neuberger Berman Lung Cancer Research Center, Weill Medical College of Cornell University, New York, NY, USA A liccia B ollig-Fischer D epartment of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University, D etroit, M I, U SA P hilip T . C agle H ouston Methodist Hospital, Weill Medical College of Cornell University, H ouston, T X, U SA S hirish M . G adgeel K armanos Cancer Institute, Wayne State University, D etroit, M I, U SA M ary H elen Barcellos-Hoff D epartment of Radiation Oncology, New York University School of Medicine, N ew York, N Y, U SA S ajid H ussain N CI-designated Cancer Center, Sanford Burnham Prebys Medical Discovery Institute, L a Jolla, C A, U SA J ian-Yue J in C ancer Center, Georgia Regents University, A ugusta, G A, U SA G regory P . K alemkerian Division of Hematology/Oncology, University of Michigan, A nn Arbor, M I, U SA F eng-Ming ( Spring) K ong C ancer Center, Georgia Regents University, Augusta, GA, USA K ristina M . K ruglyak O ncology, I llumina, Inc., S an Diego, C A, U SA ix