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EXPERT CONSENSUS

Expert consensus and current landscape of NUT carcinoma: A comprehensive strategy from diagnosis to treatment

Zhuomiao Ye1,2 ,  Xin Li1,2 ,  Fei Xie3 ,  Chao Deng3 ,  Dan Yang1 ,  Hongle Li4 ,  Yuanzhi Lu5 ,  Zhenbin Mao6 ,  Qingwei Meng7 ,  Lidong Wang8 ,  Zhe Wang9 ,  Jinliang Xing10 ,  Chong Bai11 ,  Zhimin Bian12 ,  Paolo Boffano13 ,  Steven Brower14 ,  Rui Chen15 ,  Wantao Chen16 ,  Jinhai Deng17 ,  Xinpei Deng18 ,  Chunming Ding19 ,  Jianchun Duan20 ,  Song Duan21 ,  Nejat Duzgunes22 ,  Pierfrancesco Franco23 ,  Guobin Fu24 ,  Longmei Guo25 ,  Ye Guo26 ,  Ruiqin Han27 ,  Ling Hao28 ,  Lang He29 ,  Yayi He30 ,  Xiaotong Hu31 ,  Junmei Jia32 ,  Yanfang Jiang33 ,  Weilin Jin34 ,  Kalevi Kairemo35 ,  Mohamed Kamal36,37 ,  Evan T. Keller38 ,  Rensheng Lai1 ,  Chao Li39 ,  Jun Li40 ,  Lifeng Li41 ,  Qingxia Li42 ,  Wenbin Li43 ,  Xuening Li44 ,  Yang Li45 ,  Yongsheng Li46 ,  Yu Li47 ,  Mikael S. Lindström48 ,  Xiaodong Liu49 ,  Yan Liu50 ,  Yanqing Liu51 ,  Zengjun Liu52 ,  Jose Manuel Lopes53 ,  Hongyang Lu54 ,  Xiangwen Luo1,2 ,  Wenping Ma55 ,  Hongxue Meng56 ,  Anjie Min57 ,  Amancio Carnero Moya58 ,  Athanasios G. Papavassiliou59 ,  Xi Pan60 ,  Min Peng61 ,  Helmut H. Popper62 ,  Lixin Qiu63 ,  Di Qu64 ,  Axel H. Schönthal65 ,  Vishal Shelat66 ,  Yi Shi67 ,  Alexander Shtil68 ,  Hifzur R Siddique69 ,  Yang Song70 ,  Haichuan Su70 ,  Min Tang71 ,  Mengyuan Wang3 ,  Qiming Wang72 ,  Shubin Wang73 ,  Bing Wei74 ,  Dawei Wu75 ,  Longxiang Wu76 ,  Liangbi Xu77 ,  Yubo Yan78 ,  Nong Yang79 ,  Zihuan Yang80 ,  Zongbi Yi81 ,  Songtao Yu82 ,  Heng Zhang83 ,  Hongmei Zhang84 ,  Lijuan Zhang85 ,  Jianfu Zhao86 ,  Zheng Zhao87 ,  Shaoquan Zheng88 ,  Chengzhi Zhou89 ,  Pu Zhou90 ,  Qin Zhou91 ,  Guodong Zhu92 ,  Qin Yan93 ,  Minghui Zhang1,2* ,  Mingzhu Yin1,2*
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1 Clinical Research Center, Medical Pathology Center, Cancer Early Detection and Treatment Center and Translational Medicine Research Center, Chongqing University Three Gorges Hospital, Chongqing University, Wanzhou, Chongqing, China
2 School of Medicine Chongqing University, Chongqing University, Shapingba, Chongqing, China
3 Department of Breast Surgery, Chongqing University Three Gorges Hospital, Chongqing University, Wanzhou, Chongqing, China
4 The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China
5 Department of Clinical Pathology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
6 The China Food and Drug Corporation Quality and Safety Promotion Association, China
7 Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
8 State Key Laboratory of Esophageal Cancer Prevention & Treatment and Henan Key Laboratory for Esophageal Cancer Research of the First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China
9 Department of Thyroid, Breast, and Vascular Surgery, Xijing Hospital, The Air Force Medical University, Xi’an, Shaanxi, China
10 State Key Laboratory of Cancer Biology and Department of Physiology and Pathophysiology, Air Force Medical University, Xi’an, Shaanxi, China
11 Department of Respiratory and Critical Care Medicine, Shanghai Changhai Hospital, the First Affiliated Hospital of Second Military Medical University, Shanghai, China
12 Department of Comprehensive, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
13 Division of Dentistry, Vercelli Hospital, Vercelli, Piemonte, Italy
14 The Lefcourt Family Cancer Treatment and Wellness Center, Englewood Health, Englewood, New Jersey; Icahn School of Medicine at Mount Sinai, New York City, New York; Hackensack Meridian School of Medicine, Nutley, New Jersey, United States of America
15 Department of Pathology, Chongqing University Cancer Hospital, Shapingba, Chongqing, China
16 Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
17 Richard Dimbleby Laboratory of Cancer Research, School of Cancer & Pharmaceutical Sciences, King’s College London, London, Greater London, United Kingdom
18 Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, China
19 Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
20 State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
21 Department of Pathology, Chongqing University Three Gorges Hospital, Wanzhou, Chongqing, China
22 Department of Biomedical Sciences, Arthur A Dugoni School of Dentistry, University of the Pacific, San Francisco, California, United States of America
23 Department of Translational Medicine (DIMET), University of Eastern Piedmont, Department of Radiation Oncology, ‘Maggiore della Carità’ University Hospital, Novara, Piedmont, Italy
24 The Second Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong; Department of Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong; The Third Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, China
25 Department of Otolaryngology, The Fourth Hospital of Harbin Medical University, Nangang, Harbin, Heilongjiang, China
26 Department of Oncology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
27 State Key Laboratory of Medical Molecular Biology, Department of Biochemistry and Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
28 Department of Oncology, The Fourth Hospital of Harbin Medical University, Harbin, Heilongjiang, China
29 Department of Oncology, Cancer Prevention and Treatment Institute of Chengdu, Chengdu Fifth People’s Hospital (The Second Clinical Medical College Affiliated Fifth People’s Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, Sichuan, China
30 Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University Medical School Cancer Institute, Tongji University School of Medicine, Shanghai, 200433, China
31 Department of Pathology, Sir Run Run Shaw Hospital of Zhejiang University College of Medicine & Sir Run Run Shaw Institute of Clinical Medicine of Zhejiang University, Hangzhou, Zhejiang, China
32 Department of Oncology, The First Hospital of Shanxi Medical University, Yingze, Taiyuan, Shanxi, China
33 Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, Genetic Diagnosis Center, the First Hospital of Jilin University, Changchun, Jilin, China
34 Institute of Cancer Neuroscience, Medical Frontier Innovation Research Center, The First Hospital of Lanzhou University, The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China
35 Department of Nuclear Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
36 USC Michelson Center Convergent Science Institute in Cancer, Los Angeles, California, United States of America
37 Department of Zoology, University of Benha, Benha, Egypt
38 Departments of Urology and Pathology and the Biointerfaces Institute, University of Michigan, Ann Arbor, Michigan, United States of America
39 Department of Pathology, College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou, Fujian, China
40 Department of Molecular Pathology, Clinical Pathology Center, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China
41 Henan International Joint Laboratory of Children’s Infectious Diseases, Children’s Hospital Affiliated to Zhengzhou University, Henan Children’s Hospital, Zhengzhou Children’s Hospital, Zhengzhou, Henan, China
42 Departments of Oncology & Immunotherapy, Hebei General Hospital, Shijiazhuang, Hebei, China
43 Department of Pathology, National Cancer Center, National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
44 Department of Clinical Pharmacology, Zhongshan Hospital, Fudan University, Shanghai, China
45 Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
46 Department of Medical Oncology, Chongqing University Cancer Hospital, Shapingba, Chongqing, China
47 Department of Pathology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Shapingba, Chongqing, China
48 Division of Genome Biology, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Box 1031, 171 21, Stockholm, Sweden
49 Department of Trauma and Emergency Surgeon, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
50 Department of Medical Oncology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
51 Herbert Irving Comprehensive Cancer Center, Columbia University, New York City, New York, United States of America
52 Department of Rare Tumors, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, Shandong, China
53 Department of Pathology, São João Local Health Unit, Faculty of Medicine, Institute for Research and Innovation in Health, Institute of Molecular Pathology and Immunology of University of Porto, Portugal
54 Zhejiang Key Laboratory of Diagnosis & Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer, Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer, Chinese Academy of Sciences, Hangzhou, Zhejiang, China
55 Department of Neurosurgery, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
56 Department of Pathology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
57 Department of Oral and Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
58 Institute of Biomedicine of Seville (Instituto de Biomedicina de Sevilla), Spanish National Research Council (Consejo Superior de Investigaciones Científicas), Seville, Spain
59 Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
60 Department of Oncology, the third Xiangya Hospital, Central South University, Changsha, Hunan, China
61 Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
62 Department of Pathology, Medical University of Graz, Graz, Styria, Austria
63 Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
64 Department of Oncology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
65 Department of Molecular Microbiology & Immunology, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA 90089, USA
66 Surgical Science Training Center, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng 308433, Singapore
67 Department of Pathology, Fujian Cancer Hospital Affiliated to Fujian Medical University, Fuzhou, Fujian, China
68 Blokhin National Medical Research Center of Oncology, Ministry of Health, Moscow, Russia
69 Molecular Cancer Genetics and Translational Research Lab, Section of Genetics, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
70 Department of Oncology, Tangdu Hospital, Air Force Medical University, Xi’an, Shaanxi, China
71 Department of Oncology, Chongqing General Hospital, Chongqing University, Shapingba, Chongqing, China
72 Department of Internal Medicine, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan, China
73 Department of Medical Oncology, Peking University Shenzhen Hospital, Beijing University, Shenzhen, Guangdong, China
74 Department of Molecular Pathology, Henan Key Laboratory of Molecular Pathology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
75 National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
76 Department of Gastrointestinal Surgery, Affiliated Tumor Hospital of Nantong University, Nantong Tumor Hospital, Nantong, Jiangsu, China
77 Endoscopy Center of the Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, China
78 epartment of Thoracic Surgery, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
79 Department of Pulmonary Gastroenterology, Hunan Cancer Hospital, Changsha, Hunan, China
80 Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangdong Institute of Gastroenterology; Department of Clinical Laboratory, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
81 Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors Hubei Cancer Clinical Study Center, Wuhan, Hubei, China
82 Department of Oncology, Southwest Hospital, Third Military Medical University (Army Medical University), Shapingba, Chongqing, China
83 Department of General Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
84 Department of Oncology, Xijing Hospital, Air Force Medical University, Xincheng, Xi’an, Shaanxi, China
85 Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
86 Research Center of Cancer Diagnosis and Therapy, Department of Oncology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
87 Department of Oncology, Shaanxi Cancer Hospital, Xi’an, Shaanxi, China
88 Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
89 State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
90 Department of Oncology, People’s Hospital of Shapingba, Shapingba, Chongqing, China
91 Department of Oncology, Xiangya Hospital, Central South University, No. 87, Changsha, Hunan, China
92 Guangdong-Hong Kong-Macau Great Bay Area Geroscience Joint Laboratory, School of Medicine, Jinan University, Guangzhou, China
93 Department of Pathology, Yale Center for Immuno-Oncology, Yale Cancer Center, Yale University, New Haven, Connecticut, United States of America
Tumor Discovery 2024, 3(4), 4904 https://doi.org/10.36922/td.4904
Submitted: 22 September 2024 | Accepted: 14 November 2024 | Published: 24 December 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Nuclear protein of the testis (NUT) carcinoma is a rare and highly aggressive malignancy characterized by the rearrangement of the NUT midline carcinoma family member 1 (NUTM1) gene. Nevertheless, standardized strategies for its diagnosis and treatment remain unavailable, underscoring the need for expert consensus. To address this gap, we conducted a systematic review to gather comprehensive information on NUT carcinoma from five databases: PubMed, Web of Science, Embase, Cochrane Library, and Ovid Medline. This expert consensus was collaboratively developed by a team of international multidisciplinary experts, in partnership with the NUT Carcinoma Diagnosis Working Group of the Chinese Anti-Cancer Association’s Oncogene Diagnosis Professional Committee. This working group comprises medical oncologists, radiation oncologists, surgical oncologists, pathologists, nurses, molecular biologists, statisticians, and bioinformatics specialists. A systematic review, based on data from 526 patients across 199 articles, was conducted to comprehensively explore various characteristics, including demographic features (e.g., patient gender, distribution regions, and age), tumor-node-metastasis (TNM) classification stage, clinical symptoms, tumor size, metastatic patterns, immunohistochemical (IHC) findings, treatment modalities, prognosis-related information, and NUTM1 fusion partners. We have developed an expert consensus on diagnosing and treating NUT carcinoma using a multidisciplinary approach. The guideline provides eight recommendations, addressing epidemiological characteristics, clinical and imaging manifestations, pathological findings, IHC features, molecular mechanisms and subtypes, prognosis, diagnosis, and treatment strategies for NUT carcinoma. Furthermore, an international platform has been established to disseminate NUT carcinoma knowledge and patient recruitment, providing patients and healthcare providers access to NUT carcinoma-related information and updates on clinical trial recruitment.

Keywords
Nuclear protein of the testis carcinoma
Expert consensus
Diagnosis
Treatment
Funding
This work was supported in part by the Chongqing Wanzhou Municipal Science and Health Joint Medical Research Project Key Program (grant no. wzstc-kw2023001), the Chongqing Wanzhou PhD “Through Train” Research Project (grant no. Wzstc20230402), and the Chongqing Natural Science Foundation (grant no. CSTB2023NSCQ-MSX0658).
Conflict of interest
Mingzhu Yin and Helmut H. Popper are the Editors-in- Chief and Xin Li, Paolo Boffano, Steven Brower, Xinpei Deng, Nejat Duzgunes, Pierfrancesco Franco, Weilin Jin, Kalevi Kairemo, Mohamed Kamal, Evan T. Keller, Mikael S. Lindström, Yanqing Liu, Jose Manuel Lopes, Wenping Ma, Amancio Carnero Moya, Athanasios G. Papavassiliou, Axel Schonthal, Vishal Shelat, Alexander Shtil, Hifzur R Siddique, Shaoquan Zheng, and Qin Yan are Editorial Board Member of this journal. However, none of these individuals were involved in this paper’s editorial or peer-review process, either directly or indirectly. In addition, the other authors declare that they have no known competing financial interests or personal relationships that could have influenced the work reported in this paper.
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Tumor Discovery, Electronic ISSN: 2810-9775 Print ISSN: 3060-8597, Published by AccScience Publishing
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