Circulating cell-free and extracellular vesicles-derived microRNA as prognostic biomarkers in patients with early-stage NSCLC: results from RESTING study.


Journal

Journal of experimental & clinical cancer research : CR
ISSN: 1756-9966
Titre abrégé: J Exp Clin Cancer Res
Pays: England
ID NLM: 8308647

Informations de publication

Date de publication:
22 Aug 2024
Historique:
received: 12 04 2024
accepted: 08 08 2024
medline: 22 8 2024
pubmed: 22 8 2024
entrez: 21 8 2024
Statut: epublish

Résumé

Factors to accurately stratify patients with early-stage non-small cell lung cancer (NSCLC) in different prognostic groups are still needed. This study aims to investigate 1) the prognostic potential of circulating cell-free (CF) and extracellular vesicles (EVs)-derived microRNA (miRNAs), and 2) their added value with respect to known prognostic factors (PFs). The RESTING study is a multicentre prospective observational cohort study on resected stage IA-IIIA patients with NSCLC. The primary end-point was disease-free survival (DFS), and the main analyses were carried out separately for CF- and EV-miRNAs. CF- and EV-miRNAs were isolated from plasma, and miRNA-specific libraries were prepared and sequenced. To reach the study aims, three statistical models were specified: one using the miRNA data only (Model 1); one using both miRNAs and known PFs (age, gender, and pathological stage) (Model 2), and one using the PFs alone (Model 3). Five-fold cross-validation (CV) was used to assess the predictive performance of each. Standard Cox regression and elastic net regularized Cox regression were used. A total of 222 patients were enrolled. The median follow-up time was 26.3 (95% CI 25.4-27.6) months. From Model 1, three CF-miRNAs and 21 EV-miRNAs were associated with DFS. In Model 2, two CF-miRNAs (miR-29c-3p and miR-877-3p) and five EV-miRNAs (miR-181a-2-3p, miR-182-5p, miR-192-5p, miR-532-3p and miR-589-5p) remained associated with DFS. From pathway enrichment analysis, TGF-beta and NOTCH were the most involved pathways. This study identified promising prognostic CF- and EV-miRNAs that could be used as a non-invasive, cost-effective tool to aid clinical decision-making. However, further evaluation of the obtained miRNAs in an external cohort of patients is warranted.

Sections du résumé

BACKGROUND BACKGROUND
Factors to accurately stratify patients with early-stage non-small cell lung cancer (NSCLC) in different prognostic groups are still needed. This study aims to investigate 1) the prognostic potential of circulating cell-free (CF) and extracellular vesicles (EVs)-derived microRNA (miRNAs), and 2) their added value with respect to known prognostic factors (PFs).
METHODS METHODS
The RESTING study is a multicentre prospective observational cohort study on resected stage IA-IIIA patients with NSCLC. The primary end-point was disease-free survival (DFS), and the main analyses were carried out separately for CF- and EV-miRNAs. CF- and EV-miRNAs were isolated from plasma, and miRNA-specific libraries were prepared and sequenced. To reach the study aims, three statistical models were specified: one using the miRNA data only (Model 1); one using both miRNAs and known PFs (age, gender, and pathological stage) (Model 2), and one using the PFs alone (Model 3). Five-fold cross-validation (CV) was used to assess the predictive performance of each. Standard Cox regression and elastic net regularized Cox regression were used.
RESULTS RESULTS
A total of 222 patients were enrolled. The median follow-up time was 26.3 (95% CI 25.4-27.6) months. From Model 1, three CF-miRNAs and 21 EV-miRNAs were associated with DFS. In Model 2, two CF-miRNAs (miR-29c-3p and miR-877-3p) and five EV-miRNAs (miR-181a-2-3p, miR-182-5p, miR-192-5p, miR-532-3p and miR-589-5p) remained associated with DFS. From pathway enrichment analysis, TGF-beta and NOTCH were the most involved pathways.
CONCLUSION CONCLUSIONS
This study identified promising prognostic CF- and EV-miRNAs that could be used as a non-invasive, cost-effective tool to aid clinical decision-making. However, further evaluation of the obtained miRNAs in an external cohort of patients is warranted.

Identifiants

pubmed: 39169404
doi: 10.1186/s13046-024-03156-y
pii: 10.1186/s13046-024-03156-y
doi:

Substances chimiques

Biomarkers, Tumor 0
MicroRNAs 0
Circulating MicroRNA 0

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

241

Informations de copyright

© 2024. The Author(s).

Références

Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49.
doi: 10.3322/caac.21660 pubmed: 33538338
Uramoto H, Tanaka F. Recurrence after surgery in patients with NSCLC. Transl Lung Cancer Res. 2013;3(4):242–9. https://doi.org/10.3978/j.issn.2218-6751.2013.12.05 .
doi: 10.3978/j.issn.2218-6751.2013.12.05
Cho WCS, Tan KT, Ma VWS, et al. Targeted next-generation sequencing reveals recurrence-associated genomic alterations in early-stage non-small cell lung cancer. Oncotarget. 2018;9(91):36344–57. https://doi.org/10.18632/oncotarget.26349 .
doi: 10.18632/oncotarget.26349 pubmed: 30555633 pmcid: 6284742
Wistuba II, Behrens C, Lombardi F, et al. Validation of a proliferation-based expression signature as prognostic marker in early stage lung adenocarcinoma. Clin Cancer Res. 2013;19(22):6261–71. https://doi.org/10.1158/1078-0432.ccr-13-0596 .
doi: 10.1158/1078-0432.ccr-13-0596 pubmed: 24048333
Ulivi P, Petracci E, Marisi G, et al. Prognostic role of circulating miRNAs in early-stage non-small cell lung cancer. J Clin Med. 2019;8(2):131. https://doi.org/10.3390/jcm8020131 .
doi: 10.3390/jcm8020131 pubmed: 30678026 pmcid: 6407000
Kratz JR, Li JZ, Tsui J, et al. Genetic and immunologic features of recurrent stage I lung adenocarcinoma. Sci Rep. 2021;11(1):23690. https://doi.org/10.1038/s41598-021-02946-0 .
doi: 10.1038/s41598-021-02946-0 pubmed: 34880292 pmcid: 8654957
Qiu B, Guo W, Zhang F, et al. Dynamic recurrence risk and adjuvant chemotherapy benefit prediction by ctDNA in resected NSCLC. Nat Commun. 2021;12(1):6770. https://doi.org/10.1038/s41467-021-27022-z .
doi: 10.1038/s41467-021-27022-z pubmed: 34799585 pmcid: 8605017
Baverel PG, Dubois VFS, Jin CY, et al. Population pharmacokinetics of durvalumab in cancer patients and association with longitudinal biomarkers of disease status. Clin Pharmacol Ther. 2018;103(4):631–42. https://doi.org/10.1002/cpt.982 .
doi: 10.1002/cpt.982 pubmed: 29243223 pmcid: 5887840
Goldstraw P, Chansky K, Crowley J, et al. The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (Eighth) Edition of the TNM classification for lung cancer. J Thorac Oncol. 2016;11(1):39–51. https://doi.org/10.1016/j.jtho.2015.09.009 .
doi: 10.1016/j.jtho.2015.09.009 pubmed: 26762738
Pasini L, Vannini I, Ulivi P, et al. Comparative analysis of free-circulating and vesicle-associated plasma microRNAs of healthy controls and early-stage lung cancer patients. Pharmaceutics. 2022;14(10):2029. https://doi.org/10.3390/pharmaceutics14102029 .
doi: 10.3390/pharmaceutics14102029 pubmed: 36297464 pmcid: 9610033
Welsh JA, Goberdhan DCI, O’Driscoll L, et al. Minimal information for studies of extracellular vesicles (MISEV2023): from basic to advanced approaches. J Extracell Vesicles. 2024;13(2):e12404. https://doi.org/10.1002/jev2.12404 .
doi: 10.1002/jev2.12404 pubmed: 38326288 pmcid: 10850029
Simon RM, Subramanian J, Li MC, Menezes S. Using cross-validation to evaluate predictive accuracy of survival risk classifiers based on high-dimensional data. Brief Bioinform. 2011;12(3):203–14. https://doi.org/10.1093/bib/bbr001 .
doi: 10.1093/bib/bbr001 pubmed: 21324971 pmcid: 3105299
Chang L, Zhou G, Soufan O, Xia J. miRNet 2.0: network-based visual analytics for miRNA functional analysis and systems biology. Nucleic Acids Res. 2020;48(W1):gkaa467. https://doi.org/10.1093/nar/gkaa467 .
doi: 10.1093/nar/gkaa467
Shukuya T, Ghai V, Amann JM, et al. Circulating MicroRNAs and extracellular vesicle-containing MicroRNAs as response biomarkers of anti–programmed cell death protein 1 or programmed death-ligand 1 therapy in NSCLC. J Thorac Oncol. 2020;15(11):1773–81. https://doi.org/10.1016/j.jtho.2020.05.022 .
doi: 10.1016/j.jtho.2020.05.022 pubmed: 32565389 pmcid: 7641981
Kinoshita T, Yip KW, Spence T, Liu FF. MicroRNAs in extracellular vesicles: potential cancer biomarkers. J Hum Genet. 2017;62(1):67–74. https://doi.org/10.1038/jhg.2016.87 .
doi: 10.1038/jhg.2016.87 pubmed: 27383658
Bai X, He C, Fu B, et al. microRNA-877 contributes to decreased non-small cell lung cancer cell growth via the PI3K/AKT pathway by targeting tartrate resistant acid phosphatase 5 activity. Cell Cycle. 2020;19(23):3260–76. https://doi.org/10.1080/15384101.2020.1839697 .
doi: 10.1080/15384101.2020.1839697 pubmed: 33222607 pmcid: 7751652
Luo W, Sun C, Zhou J, et al. miR-135a-5p functions as a glioma proliferation suppressor by targeting tumor necrosis factor receptor-associated factor 5 and predicts patients’ prognosis. Am J Pathol. 2019;189(1):162–76. https://doi.org/10.1016/j.ajpath.2018.08.019 .
doi: 10.1016/j.ajpath.2018.08.019 pubmed: 30312580
Diao H, Xu X, Zhao B, Yang G. miR-135a-5p inhibits tumor invasion by targeting ANGPT2 in gallbladder cancer. Mol Med Rep. 2021;24(1):528. https://doi.org/10.3892/mmr.2021.12167 .
doi: 10.3892/mmr.2021.12167 pubmed: 34036386 pmcid: 8170269
Wang J, Yang J, Zhang H, Liao Y, Xu D, Ma S. Effects of miR-135a-5p and miR-141 on proliferation, invasion and apoptosis of colorectal cancer SW620 cells. Oncol Lett. 2020;20(1):914–20. https://doi.org/10.3892/ol.2020.11598 .
doi: 10.3892/ol.2020.11598 pubmed: 32566020 pmcid: 7286134
Jin X, Guan Y, Zhang Z, Wang H. Microarray data analysis on gene and miRNA expression to identify biomarkers in non-small cell lung cancer. BMC Cancer. 2020;20(1):329. https://doi.org/10.1186/s12885-020-06829-x .
doi: 10.1186/s12885-020-06829-x pubmed: 32299382 pmcid: 7164187
Zhao H, Feng L, Cheng R, et al. miR-29c-3p acts as a tumor promoter by regulating β-catenin signaling through suppressing DNMT3A, TET1 and HBP1 in ovarian carcinoma. Cell Signal. 2024;113:110936. https://doi.org/10.1016/j.cellsig.2023.110936 .
doi: 10.1016/j.cellsig.2023.110936 pubmed: 37925048
Simiene J, Dabkeviciene D, Stanciute D, et al. Potential of miR-181a-5p and miR-630 as clinical biomarkers in NSCLC. BMC Cancer. 2023;23(1):857. https://doi.org/10.1186/s12885-023-11365-5 .
doi: 10.1186/s12885-023-11365-5 pubmed: 37697308 pmcid: 10496384
Gao S, Guo W, Liu T, et al. Plasma extracellular vesicle microRNA profiling and the identification of a diagnostic signature for stage I lung adenocarcinoma. Cancer Sci. 2022;113(2):648–59. https://doi.org/10.1111/cas.15222 .
doi: 10.1111/cas.15222 pubmed: 34837453
Jiang W, Zheng L, Yan Q, Chen L, Wang X. MiR-532-3p inhibits metastasis and proliferation of non-small cell lung cancer by targeting FOXP3. J BU : Off J Balk Union Oncol. 2019;24(6):2287–93.
Liu C, Lv D, Li M, et al. Hypermethylation of miRNA-589 promoter leads to upregulation of HDAC5 which promotes malignancy in non-small cell lung cancer. Int J Oncol. 2017;50(6):2079–90. https://doi.org/10.3892/ijo.2017.3967 .
doi: 10.3892/ijo.2017.3967 pubmed: 28440397
Kolenda T, Guglas K, Kopczyńska M, et al. Good or not good: role of miR-18a in cancer biology. Rep Pr Oncol Radiother. 2020;25(5):808–19. https://doi.org/10.1016/j.rpor.2020.07.006 .
doi: 10.1016/j.rpor.2020.07.006
Yang W, Yin Y, Bi L, et al. MiR-182-5p promotes the metastasis and epithelial-mesenchymal transition in non-small cell lung cancer by targeting EPAS1. J Cancer. 2021;12(23):7120–9. https://doi.org/10.7150/jca.60419 .
doi: 10.7150/jca.60419 pubmed: 34729113 pmcid: 8558643
Ghafouri-Fard S, Safarzadeh A, Katiraei SHF, Hussen BM, Hajiesmaeili M. Diverse functions of miR-328 in the carcinogenesis. Pathol - Res Pr. 2023;251:154896. https://doi.org/10.1016/j.prp.2023.154896 .
doi: 10.1016/j.prp.2023.154896
Trakunram K, Chaniad P, Geater SL, et al. Serum miR-339-3p as a potential diagnostic marker for non-small cell lung cancer. Cancer Biol Med. 2020;17(3):652–63. https://doi.org/10.20892/j.issn.2095-3941.2020.0063 .
doi: 10.20892/j.issn.2095-3941.2020.0063 pubmed: 32944397 pmcid: 7476089
Zhou D, Ji G, Wei G, et al. MiR-361-3p promotes tumorigenesis of osteosarcoma cells via targeting ARID3A. Tissue Cell. 2022;76:101759. https://doi.org/10.1016/j.tice.2022.101759 .
doi: 10.1016/j.tice.2022.101759 pubmed: 35219069
Zhu K, Lin J, Chen S, Xu Q. miR-9-5p promotes lung adenocarcinoma cell proliferation, migration and invasion by targeting ID4. Technol Cancer Res Treat. 2021;20:15330338211048592. https://doi.org/10.1177/15330338211048592 .
doi: 10.1177/15330338211048592 pubmed: 34723712 pmcid: 8564129
Zou P, Zhu M, Lian C, et al. miR-192-5p suppresses the progression of lung cancer bone metastasis by targeting TRIM44. Sci Rep. 2019;9(1):19619. https://doi.org/10.1038/s41598-019-56018-5 .
doi: 10.1038/s41598-019-56018-5 pubmed: 31873114 pmcid: 6928221
Tang Z, Jiang Y, Ding S, Jiang S, Tang R, Luo P. miR-370 impacts the biological behavior of lung cancer cells by targeting the SMAD1 signaling pathway. Am J Transl Res. 2022;14(11):8117–28.
pubmed: 36505312 pmcid: 9730076
Zhang JX, Yang W, Wu JZ, et al. MicroRNA-32-5p inhibits epithelial-mesenchymal transition and metastasis in lung adenocarcinoma by targeting SMAD family 3. J Cancer. 2021;12(8):2258–67. https://doi.org/10.7150/jca.48387 .
doi: 10.7150/jca.48387 pubmed: 33758603 pmcid: 7974882
Ortiz-Quintero B. Cell-free microRNAs in blood and other body fluids, as cancer biomarkers. Cell Prolif. 2016;49(3):281–303. https://doi.org/10.1111/cpr.12262 .
doi: 10.1111/cpr.12262 pubmed: 27218664 pmcid: 6496612
Gayosso-Gómez LV, Ortiz-Quintero B. Circulating MicroRNAs in blood and other body fluids as biomarkers for diagnosis, prognosis, and therapy response in lung cancer. Diagnostics. 2021;11(3):421. https://doi.org/10.3390/diagnostics11030421 .
doi: 10.3390/diagnostics11030421 pubmed: 33801442 pmcid: 7999833
Wang D, Hao C, Zhang L, et al. Exosomal miR-125a-5p derived from silica-exposed macrophages induces fibroblast transdifferentiation. Ecotoxicol Environ Saf. 2020;192:110253. https://doi.org/10.1016/j.ecoenv.2020.110253 .
doi: 10.1016/j.ecoenv.2020.110253 pubmed: 32059163
Nicoloso MS, Sun H, Spizzo R, et al. Single-nucleotide polymorphisms inside microRNA target sites influence tumor susceptibility. Cancer Res. 2010;70(7):2789–98. https://doi.org/10.1158/0008-5472.CAN-09-3541 .
doi: 10.1158/0008-5472.CAN-09-3541 pubmed: 20332227 pmcid: 2853025
Li B, Chen J, Wu Y, Luo H, Ke Y. Decrease of circARID1A retards glioblastoma invasion by modulating miR-370-3p/ TGFBR2 pathway. Int J Biol Sci. 2022;18(13):5123–35. https://doi.org/10.7150/ijbs.66673 .
doi: 10.7150/ijbs.66673 pubmed: 35982888 pmcid: 9379412
Wang S, Chen Y, Lei G, et al. Serum exosome-derived microRNA-193a-5p and miR-381-3p regulate adenosine 5’-Monophosphate-Activated Protein Kinase/Transforming Growth Factor Beta/Smad2/3 signaling pathway and promote fibrogenesis. Clin Transl Gastroenterol. 2024;15(2):e00662. https://doi.org/10.14309/ctg.000000000000066 .
doi: 10.14309/ctg.000000000000066 pubmed: 38099588
Ge L, Habiel DM, Hansbro PM, et al. miR-323a-3p regulates lung fibrosis by targeting multiple profibrotic pathways. JCI Insight. 2016;1(20):e90301. https://doi.org/10.1172/jci.insight.90301 .
doi: 10.1172/jci.insight.90301 pubmed: 27942594 pmcid: 5135276
Wang Y, Xue Q, Zheng Q, et al. SMAD4 mutation correlates with poor prognosis in non-small cell lung cancer. Lab Investig. 2021;101(4):463–76. https://doi.org/10.1038/s41374-020-00517-x .
doi: 10.1038/s41374-020-00517-x pubmed: 33303972
Wei J, Yu H, Liu T, Wang Z, Lang C, Pan Y. FOXA1-induced LINC00621 promotes lung adenocarcinoma progression via activating the TGF-β signaling pathway. Thorac Cancer. 2023;14(21):2026–37. https://doi.org/10.1111/1759-7714.14986 .
doi: 10.1111/1759-7714.14986 pubmed: 37277890 pmcid: 10363846
Sato R, Imamura K, Semba T, et al. TGF-β signaling activated by cancer-associated fibroblasts determines the histological signature of lung adenocarcinoma. Cancer Res. 2021;81(18):canres.3941.2020. https://doi.org/10.1158/0008-5472.can-20-3941 .
doi: 10.1158/0008-5472.can-20-3941
Qian C, Jiang Z, Zhou T, et al. Vesicle-mediated transport-related genes are prognostic predictors and are associated with tumor immunity in lung adenocarcinoma. Front Immunol. 2022;13:1034992. https://doi.org/10.3389/fimmu.2022.1034992 .
doi: 10.3389/fimmu.2022.1034992 pubmed: 36524130 pmcid: 9745133
Cárdenas-Quesada N, Díaz-Beltrán L, Rosa-Garrido C, et al. TFG-β nuclear staining as a potential relapse risk factor in early-stage non-small-cell lung cancer. Int J Mol Sci. 2022;23(22):13780. https://doi.org/10.3390/ijms232213780 .
doi: 10.3390/ijms232213780 pubmed: 36430262 pmcid: 9694009
Lee JH, Shin KM, Lee SY, et al. Genetic variant of notch regulator DTX1 predicts survival after lung cancer surgery. Ann Surg Oncol. 2019;26(11):3756–64. https://doi.org/10.1245/s10434-019-07614-2 .
doi: 10.1245/s10434-019-07614-2 pubmed: 31313037
Vasileva MV, Khromova NV, Kopnin BP, Dugina VB, Kopnin PB. Significance of NOTCH1 expression in the progression of human lung and colorectal cancers. Biochem (Mosc). 2022;87(10):1199–205. https://doi.org/10.1134/s0006297922100133 .
doi: 10.1134/s0006297922100133
Sebastian NT, Webb A, Shilo K, et al. A PI3K gene expression signature predicts for recurrence in early-stage non–small cell lung cancer treated with stereotactic body radiation therapy. Cancer. 2023;129(24):3971–7. https://doi.org/10.1002/cncr.34983 .
doi: 10.1002/cncr.34983 pubmed: 37560930
Ye Q, Falatovich B, Singh S, Ivanov AV, Eubank TD, Guo NL. A multi-omics network of a seven-gene prognostic signature for non-small cell lung cancer. Int J Mol Sci. 2021;23(1):219. https://doi.org/10.3390/ijms23010219 .
doi: 10.3390/ijms23010219 pubmed: 35008645 pmcid: 8745553
Zhao J, Li X, Liu L, Zhu Z, He C. Exosomes in lung cancer metastasis, diagnosis, and immunologically relevant advances. Front Immunol. 2023;14:1326667. https://doi.org/10.3389/fimmu.2023.1326667 .
doi: 10.3389/fimmu.2023.1326667 pubmed: 38155975 pmcid: 10752943
Yu F, Liang M, Huang Y, Wu W, Zheng B, Chen C. Hypoxic tumor-derived exosomal miR-31-5p promotes lung adenocarcinoma metastasis by negatively regulating SATB2-reversed EMT and activating MEK/ERK signaling. J Exp Clin Cancer Res. 2021;40(1):179. https://doi.org/10.1186/s13046-021-01979-7 .
doi: 10.1186/s13046-021-01979-7 pubmed: 34074322 pmcid: 8167983
Zhang X, Sai B, Wang F, et al. Hypoxic BMSC-derived exosomal miRNAs promote metastasis of lung cancer cells via STAT3-induced EMT. Mol Cancer. 2019;18(1):40. https://doi.org/10.1186/s12943-019-0959-5 .
doi: 10.1186/s12943-019-0959-5 pubmed: 30866952 pmcid: 6417285
Chang RM, Fu Y, Zeng J, Zhu XY, Gao Y. Cancer-derived exosomal miR-197-3p confers angiogenesis via targeting TIMP2/3 in lung adenocarcinoma metastasis. Cell Death Dis. 2022;13(12):1032. https://doi.org/10.1038/s41419-022-05420-5 .
doi: 10.1038/s41419-022-05420-5 pubmed: 36494333 pmcid: 9734149
Hsu YL, Hung JY, Chang WA, et al. Hypoxic lung cancer-secreted exosomal miR-23a increased angiogenesis and vascular permeability by targeting prolyl hydroxylase and tight junction protein ZO-1. Oncogene. 2017;36(34):4929–42. https://doi.org/10.1038/onc.2017.105 .
doi: 10.1038/onc.2017.105 pubmed: 28436951
Luo C, Xin H, Zhou Z, et al. Tumor-derived exosomes induce immunosuppressive macrophages to foster intrahepatic cholangiocarcinoma progression. Hepatology. 2022;76(4):982–99. https://doi.org/10.1002/hep.32387 .
doi: 10.1002/hep.32387 pubmed: 35106794
Poggio M, Hu T, Pai CC, et al. Suppression of exosomal PD-L1 induces systemic anti-tumor immunity and memory. Cell. 2019;177(2):414-427.e13. https://doi.org/10.1016/j.cell.2019.02.016 .
doi: 10.1016/j.cell.2019.02.016 pubmed: 30951669 pmcid: 6499401
Konoshenko MY, Lekchnov EA, Vlassov AV, Laktionov PP. Isolation of extracellular vesicles. Biomed Res Int. 2018;2018:8545347. https://doi.org/10.1155/2018/8545347 .
doi: 10.1155/2018/8545347 pubmed: 29662902 pmcid: 5831698

Auteurs

Elisabetta Petracci (E)

Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.

Luigi Pasini (L)

Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.

Milena Urbini (M)

Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy. milena.urbini@irst.emr.it.

Enriqueta Felip (E)

Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.

Franco Stella (F)

Thoracic Surgery Department AUSL Romagna, Forlì, Italy.

Fabio Davoli (F)

Thoracic Surgery Department AUSL Romagna, Ravenna, Italy.

Maurizio Salvi (M)

Thoracic Surgery Department AUSL Romagna, Riccione, Italy.

Michele Beau-Faller (M)

Molecular Laboratory, University Hospital, Strasbourg University, Strasburg, France.

Michela Tebaldi (M)

Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.

Irene Azzali (I)

Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.

Matteo Canale (M)

Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.

Piergiorgio Solli (P)

Unit of Thoracic Surgery and Lung Transplantation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

Giulia Lai (G)

Unit of Thoracic Surgery and Lung Transplantation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

Ramon Amat (R)

Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.

Caterina Carbonell (C)

Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.

Pierre-Emmanuel Falcoz (PE)

Thoracic Surgery Department, Nouvel Hôpital Civil', University Hospital, Strasburg, France.

Alex Martinez-Marti (A)

Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain.

Erwan Pencreach (E)

Molecular Laboratory, University Hospital, Strasbourg University, Strasburg, France.

Angelo Delmonte (A)

Oncology Department, Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" (IRST) IRCCS, Meldola, Italy.

Lucio Crinò (L)

Oncology Department, Istituto Romagnolo per lo Studio dei Tumori "Dino Amadori" (IRST) IRCCS, Meldola, Italy.

Paola Ulivi (P)

Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy. paola.ulivi@irst.emr.it.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH