Soft, half-loud, strong: the first description of the mutations that trigger lung cancer in those who have never smoked is inspired by music. They are different from those identified so far in smokers, they depend on natural processes inside the cells and their discovery, the result of an international research published in the journal Nature Genetics, marks an important step forward towards future personalized therapies and more precise diagnoses.
Like investigators, the researchers began to lift the veil on a hitherto mysterious phenomenon led by the Italian Maria Teresa Landi who, after her doctorate in Molecular Epidemiology at the University of Milan, has been living in the United States for many years. where he works in the Division of Epidemiology and Genetics of the National Cancer Institute of the National Institutes of Health (NIH), in Bethesda. The Italian participation in the research is important, with the foundations Irccs Casa Sollievo della Sofevole in San Giovanni Rotondo, Ca 'Granda Ospedale Maggiore in Milan and Regina Elena in Rome, University of Bari.
Of the more than two million people diagnosed with lung cancer each year, most are smokers and it is estimated that only a small fraction, between 10% and 15%, have never smoked. It is possible that some people get sick from exposure to secondhand smoke or other environmental factors, from radon to pollutants, but the mechanism that makes non-smokers sick was not known until now. The first data now come from research coordinated by Landi and based on the DNA sequence of tumors taken from 232 patients who had never smoked and with lung cancer, 75% of whom are women and with an average age of about 65 years. . "What we are seeing is that there are different subtypes of lung cancer in non-smokers that have distinct molecular characteristics and evolutionary processes," notes Landi."In the future - he added - we may be able to have different treatments based on these subtypes".
To the three subtypes the researchers assigned names inspired by music, in reference to the noise level, that is the quantity of mutations that trigger them. Thus 'plan' corresponds to the largest group, which has so many mutations that it is difficult to treat and in which tumor formation occurs very slowly, over a period of years. The 'half-strong' subtype has mutations in the Egfr gene, usually altered in many forms of lung cancer, and leads to a more rapid development of the disease. Finally, the 'strong' subtype originates from a genetic mechanism more similar to that seen in smokers' tumors and develops rapidly. Based on these differences, it is now possible to calibrate diagnoses and therapies.
