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Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Jul 24, 2020; 11(7): 412-427
Published online Jul 24, 2020. doi: 10.5306/wjco.v11.i7.412
Role of imaging biomarkers in mutation-driven non-small cell lung cancer
Dexter P Mendoza, Zofia Piotrowska, Jochen K Lennerz, Subba R Digumarthy
Dexter P Mendoza, Subba R Digumarthy, Division of Thoracic Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, United States
Zofia Piotrowska, Massachusetts General Hospital Cancer Center and Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, United States
Jochen K Lennerz, Center for Integrated Diagnostics, Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, United States
Author contributions: Mendoza DP wrote the first draft; all authors contributed to the content of the manuscript and reviewed and revised the manuscript.
Conflict-of-interest statement: Mendoza DP and Lennerz JK declare no conflict of interests for this article; Piotrowska Z has served as a compensated consultant or received honoraria from AstraZeneca, Spectrum, Ariad/Takeda, Novartis, ImmunoGen, AbbVie, GuardantHealth, Genentech, Eli Lilly, InCyte and Medtronic and receives institutional research funding from Novartis, Takeda, Spectrum, AstraZeneca and Tesaro; Digumarthy SR provides independent image analysis for hospital contracted clinical research trials programs for Merck, Pfizer, Bristol Mayer Squibb, Novartis, Roche, Polaris, Cascadian, Abbvie, Gradalis, Clinical Bay, Zai laboratories. Digumarthy SR reeceived honorarium from: Siemens, not related to this work.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Subba R Digumarthy, MD, Associate Professor, Division of Thoracic Imaging and Intervention, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, United States. sdigumarthy@mgh.harvard.edu
Received: December 31, 2019
Peer-review started: December 31, 2019
First decision: April 29, 2020
Revised: May 31, 2020
Accepted: June 14, 2020
Article in press: June 14, 2020
Published online: July 24, 2020
Processing time: 201 Days and 2.8 Hours
Abstract

Lung cancer remains the leading cause of cancer-related deaths worldwide. The treatment of non-small cell lung cancer (NSCLC), which accounts for a vast majority of lung cancers, has shifted to personalized, targeted therapy following discoveries of several targetable oncogenic mutations. Targeting of specific mutations has improved outcomes in many patients. This success has led to several target-specific agents replacing chemotherapy as first-line treatment in certain mutated NSCLC. Several researchers have reported that there may be imaging biomarkers that may be predictive of the presence of these mutations. These features, when present, have the potential in triaging patients into the most appropriate diagnostic and treatment algorithms. Distinct imaging features and patterns of metastases that have been associated with NSCLC with various targetable oncogenic mutations are presented in this review.

Keywords: Non-small cell lung cancer; Imaging biomarker; Targeted therapy; Oncogenic mutations; Radiomics; Metastatic pattern

Core tip: Non-small cell lung cancer (NSCLC) is a leading cause of cancer-related deaths worldwide. Targeted therapy has improved outcomes in subsets of patients with certain targetable mutations. Several researchers have reported imaging biomarkers, which may predict the presence of these mutations. In this review, we present the primary tumor imaging features and patterns of metastases in NSCLC with oncogenic mutations.