Preface

Lung cancer management has undergone revolutionary changes in recent years. This book introduces the reader to some of the most relevant and exciting advances in the field. The book begins with a discussion of minimally invasive surgical techniques followed by a review of the progress in nonoperative therapies like radiotherapy and ablation. Next, the book examines systemic therapy that has moved well beyond standard cytotoxic chemotherapy and that can often be combined with local therapies even for metastatic disease. Finally, the book presents several newer diagnostic and therapeutic tools that have not yet become mainstream.

This book is dedicated to patients with lung cancer who have contributed to the acquisition and consolidation of knowledge by consenting to data collection through clinical trials or registries. By comprehensively reviewing the most impactful innovations of the modern era, we hope to inspire you to imagine what might be possible in the near future.

**II**

**Section 4**

*by Martina Vrankar*

*by Ana C. Belzarena*

*by Peter Ping Lin*

**Section 5**

Bone Metastases in Lung Cancer

and Nanoparticle Technologies

Systemic Therapy Personalization **105**

**Chapter 7 107**

**Chapter 8 131**

**Chapter 9 151**

Potential Future Directions **163**

**Chapter 10 165**

**Chapter 11 185**

Liquid Biopsy Analysis of Circulating Tumor Biomarkers in Lung Cancer

Lung Cancer Oncotherapy through Novel Modalities: Gas Plasma

*by Milad Rasouli, Nadia Fallah and Kostya (Ken) Ostrikov*

*by Beatrice Aramini, Valentina Masciale, Federico Banchelli, Roberto D'Amico,* 

Challenges in the Treatment of Oligometastatic Non-small Cell Lung Cancer

Precision Medicine in Lung Cancer: Challenges and Opportunities

in Diagnostic and Therapeutic Purposes

*Massimo Dominici and Khawaja Husnain Haider*

**Henry S. Park, MD, MPH** Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT, USA

**1**

Section 1

Introduction

Section 1 Introduction

**3**

**Chapter 1**

Perspectives

*Henry Soo-Min Park*

**1. Introduction**

**2. Surgery**

Introductory Chapter: Recent

Treatment - The Value of Multiple

The remarkable advances in lung cancer management that we have witnessed in the past two decades did not arise in a vacuum. Surgeons, radiation oncologists, medical oncologists, pulmonologists, palliative care specialists, radiologists, pathologists, laboratory scientists, and patients have long collaborated to make the vision

Minimally invasive surgery (MIS) has altered the landscape of thoracic surgery.

With both approaches, there were initial concerns that there would be higher rates of complications as well as margin-positive resections that could translate into more intensive adjuvant regimens or poorer survival outcomes. Both techniques have substantial learning curves, but surgeons and centers gradually accumulated experience and increased the proportion of patients who underwent surgeries with a minimally invasive approach. Over a relatively short period of time, adoption of MIS has led to improved perioperative outcomes like pain, complications, length of hospital stay, and in-hospital costs without compromising oncologic outcomes [2, 3]. Not only has MIS allowed surgical patients to regain independence sooner than they would have otherwise, but also patients who may have not previously considered surgery due to the risk of morbidity might now be candidates for this potentially curative modality.

Nonsurgical local approaches have also expanded in scope due to developments in technology. Radiotherapy can now be administered with exceptional accuracy

Thoracotomies had been standard-of-care for lung cancer resections until the advent of video-assisted thoracoscopic surgery in the mid-1990s. While initially utilized primarily for patients with favorable anatomy and good pulmonary function, this has been increasingly adopted for use in more frail patients with more technically challenging anatomy [1]. Robotic-assisted thoracoscopic surgery was approved in the early-2000s with the help of even more sophisticated technology

Progress in Lung Cancer

of improved cure rates, survival, and quality-of-life a reality.

that imitated the manual dexterity of an open procedure.

**3. Radiotherapy and other ablative therapies**

## **Chapter 1**
