High tumor burden in non-small-cell lung cancer: A review of the literature

⁴ Medical Oncology. Hospital Universitario Fundación de Alcorcón. Alcorcón. Spain, Medical Oncology. Hospital Universitario Fundación de Alcorcón. Alcorcón. Spain

⁵ Medical Oncology, Hospital Universitario La Paz. Madrid, Spain

JCTR 2022, 8(5), 403–413; https://doi.org/10.18053/jctres.08.202205.008

Submitted: 2 May 2022 | Revised: 17 July 2022 | Accepted: 27 July 2022 | Published: 13 September 2022

© 2022 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )

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Abstract

Background and aim: Lung cancer is the leading cause of cancer death worldwide and the majority of the patients have advanced/metastatic disease on presentation. In clinical practice, several biomarkers and clinical factors are taken into account when choosing the best treatment option in advanced Non–small cell lung cancer (NSCLC). One potential marker may be tumor burden (TB). However, this concept is not specifically defined in NSCLC and usually, it is used as a synonymous for aggressive disease.

Methods: A non-systematic literature review was conducted. We searched for eligible randomized controlled trials (RCTs) from PubMed, Embase, and the Cochrane Central Register of Controlled Trials with a cutoff at February 2021. The keywords included non-small cell lung cancer, tumor burden, aggressive disease, prognosis biomarker, predictive biomarker and immunotherapy.

Results and Conclusion: This review addresses the definition of TB in advanced NSCLC, the pathophysiology of high-TB lesions, and the role of TB as a prognosis biomarker.

Relevance for Patients: The concept of aggressive disease, as high tumor burden definition, remains poorly defined and rarely considered in clinical research or clinical practice in oncology. The identification of this subgroup of patients could be interesting for defining and optimizing a more aggressive treatment strategy

Keywords

non-small-cell lung cancer

tumor burden

aggressive disease

Conflict of interest

Luis Cabezón Gutiérrez declares the following conflicts of interest: Advisory role; Boehringer-Ingelheim, AstraZeneca, Roche and Brystol Myers Squibb. Speakers’ bureau; Roche, AstraZeneca, Brystol Myers Squibb, Merck Serono, Ipsen Pharma, Lilly and Amgen, Angelini, Grunenthal, Kyowa Kirin, Mudipharma, Pfizer, Roche, Rovi, Leo Pharma and Boehringer Ingelheim. Xabier Mielgo-Rubio declares the following conflicts of interest: Advisory role; Boehringer-Ingelheim, AstraZeneca, Brystol Myers Squibb. Speakers’ bureau; Roche, AstraZeneca, Brystol Myers Squibb, MSD, Abbott. Research funding; Brystol Myers Squibb. Maria Serono, Raquel Cervera-Calero, and Oliver Higuera declare no conflicts of interests.

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