Pancoast tumors represent a unique and challenging subtype of non-small cell lung cancer, distinguished by their position at the apex of the thoracic cavity. Protheragen offers a comprehensive suite of preclinical development services for both diagnostics and therapeutics targeting Pancoast tumors. Our capabilities encompass the entire drug discovery and development continuum, from pinpointing and validating potential targets to conducting rigorous preclinical efficacy assessments.
Overview of Pancoast Tumors
Pancoast tumors, also known as superior sulcus tumors, are a rare and intricate subset of non-small-cell lung cancers (NSCLCs). They originate in the upper lobe of the lung and often invade adjacent critical structures like the chest wall, brachial plexus, and subclavian vessels. Their unique anatomical location and tendency for extensive local invasion led to symptoms such as severe shoulder pain, Horner's syndrome, and atrophy of the intrinsic hand muscles. Despite their rarity, these tumors pose significant challenges due to their proximity to vital structures and the complexity of therapeutic options.
Fig.1 Anatomical evaluation of Pancoast tumors. (Chen Z.,
et al., 2023)
Pathogenesis of Pancoast Tumors
The etiology of Pancoast tumors is multifactorial. Smoking is a major risk factor for the development of these tumors. Genetic mutations and exposure to carcinogens also contribute to their formation. Molecular alterations, such as mutations in the epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) genes, have been identified in some cases. Additionally, the anatomical location of Pancoast tumors contributes to their aggressive nature and the difficulty in achieving complete surgical resection.
Diagnostics Development for Pancoast Tumors
Histopathological Examination
Confirming the diagnosis of Pancoast tumors relies heavily on biopsy and histopathological examination. Techniques such as fine-needle aspiration or core needle biopsy can obtain tissue samples for histological analysis. Additionally, immunohistochemical staining can identify specific markers and mutations, which is crucial for guiding personalized therapeutic strategies.
Imaging Techniques
Computed tomography (CT) scans offer detailed visualizations of the thoracic inlet, facilitating the assessment of how extensively the tumor has invaded surrounding structures. Positron emission tomography (PET) scans, on the other hand, can detect metabolic activity within the tumor, which aids in identifying metastatic disease.
Molecular Diagnostics
Molecular diagnostic techniques, particularly next-generation sequencing (NGS), are becoming more prevalent in identifying genetic mutations and other molecular alterations in Pancoast tumors. These tests can pinpoint actionable targets for targeted therapies and immunotherapies, thereby enhancing outcomes.
Therapeutics Development for Pancoast Tumors
- Multimodal Therapy: The standard of care for Pancoast tumors is trimodality therapy, which includes induction chemoradiotherapy followed by surgical resection. This therapeutic strategy has been shown to enhance the rates of complete resection and local disease control. Chemotherapy usually involves platinum-based agents, and radiotherapy is administered at doses ranging from 45 to 60 Gy.
- Immunotherapy: Immunotherapy, especially with inhibitors targeting programmed death 1 (PD-1) or its ligand (PD-L1), has transformed the therapeutic landscape for advanced non-small-cell lung cancer (NSCLC), including Pancoast tumors. Drugs like nivolumab, pembrolizumab, and durvalumab have emerged as key players in this field.
Table 1. Therapeutics of Pancoast Tumors.
| Therapeutics |
Drug Name |
Target |
Description |
Stage |
| Chemotherapy |
Cisplatin/Etoposide |
Tumor cells |
The standard induction chemotherapy regimen is used in trimodality therapy. |
Approved |
| Chemotherapy |
Carboplatin/Etoposide |
Tumor cells |
Alternative induction chemotherapy regimen used in trimodality therapy. |
Approved |
| Radiation Therapy |
N/A |
Tumor cells |
Used in combination with chemotherapy as part of trimodality therapy. |
Approved |
| Immunotherapy |
Tislelizumab |
PD-1 |
Investigated as a neoadjuvant therapeutic in combination with chemotherapy. |
Phase II |
Disclaimer: Protheragen focuses on providing preclinical research services. This table is for information exchange purposes only. This table is not a treatment plan recommendation. For guidance on treatment options, please visit a regular hospital.
Our Services
Protheragen offers a full suite of development services for diagnostics and therapeutics targeting superior sulcus tumors. Our expertise encompasses advanced histopathology and molecular diagnostics to ensure precise identification of these tumors. Additionally, we provide immunotherapy and targeted therapy services tailored to meet the unique requirements of our clients.
Disease Models
- Human Cancer Cell Lines
- Chemically Induced Models
- Patient-Derived Xenograft (PDX) Models
- Genetically Engineered Mouse Models (GEMMs)
Protheragen's preclinical research services are tailored to facilitate the development of innovative diagnostics and therapeutics for Pancoast tumors. We offer a comprehensive range of services, including in vitro and in vivo studies, pharmacokinetics and pharmacodynamics analysis, as well as efficacy and safety evaluations. If you are interested in our services, please feel free to contact us.
References
- Chen, Zhenchian, et al. "Anatomic evaluation of Pancoast tumors using three-dimensional models for surgical strategy development." The Journal of Thoracic and Cardiovascular Surgery 165.3 (2023): 842-852.
- Tohme, Scarlett, Kavita Parikh, and Paul C. Lee. "Pancoast tumors: current management and outcomes—a narrative review." Current Challenges in Thoracic Surgery 6 (2024).
All of our services and products are intended for preclinical research use only and cannot be used to diagnose, treat or manage patients.
