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The clinical development of locally and advanced non-small cell lung cancer (NSCLC) suffers from a lack of biomarkers as a guide in the selection of optimal prognostic prediction. Circulating Tumour Cells (CTCs) are correlated to prognosis and show efficacy in cancer monitoring in patients. However, their enumeration alone might be inadequate; it might also be critical to understand the viability, the apoptotic state and the kinetics of these cells. Here, we report what we believe to be a new and selective approach to visually detect tumour specific CTCs. Firstly, using labelled human lung cancer cells, we detected a specific density interval in which NSCL-CTCs were concentrated. Secondly, to better characterize CTCs in respect to their heterogeneous composition and tumour reference, blood and tumour biopsy were performed on specimens taken from the same patient. The approach consisted in comparing phenotype profile of CTCs, and their progenitor Tumour Stem Cells, (TSCs). Moreover, NSCL-CTCs were cultivated in short-time human cultures to provide response to drug sensitivity. Our bimodal approach allowed to reveal two items. Firstly, that one part of a tumour, proximal to the bronchial structure, displays a predominance of CD133+. Secondly, specific NSCL-CTCs Epithelial Cell Adhesion Molecule (EpCAM)+CD29+ can be used as a negative prognostic factor as well the high expression of CTCs EpCAM+. These data were confirmed by drug-sensitivity tests, in vitro, and by the survival curves, in vivo.

The high incidence of resectable lung metastases from colorectal cancer and the very poor prognosis of untreated patients (less than 24-month survival) has promoted the surgical approach to treatment. Since the main aims of this kind of surgery are the complete resection of the tumor, the preservation of tumor-free parenchyma, and a minimal surgical trauma, innovative surgical techniques have been developed. We report on our experience in the radioimmunoassisted pulmonary metastasectomy by the use of a hand-held gamma-detecting probe (GDP) and describe the application of the intraoperative radioimmunolocalization of tumor to video-assisted minimally invasive surgery.

Objective: The ultimate goal of the therapy of lung metastases is to destroy all malignant cells while sparing normal ones. Liposomes represent a novel approach for the selective transport of tracers and therapeutic agents to cancer cells because of their flexibility, low toxicity, wide range of possible variants, simplicity to make, and because agents can be entrapped in them in their native states in large amounts. We have studied the biodistribution of "Stealth" liposomes in the experimental model of lung metastases in the rat., Methods: The secondaries were induced by i.v. injection 20. 10(6) cancer cells (DHD/K12/TRb line) in BD-IX rats. The study of the liposome biodistribution in the rat was carried out by the use of unilamellar liposomes with homogeneous size distribution (0.1 microns), the liposomes were labeled with Cholesteryl-Bodipy. The rats were sacrificed at scheduled times after the injection; blood, urine, metastatic and healthy lung, colon, liver and spleen were analysed by a microcytofluorimetric examination., Results: Liposomes prolonged the circulation time of Cholesteryl-Bodipy. Only spleen and lung metastases exhibited an accretion of fluorescent liposomes., Conclusions: The biodistribution of such formulation of liposomes in rats with lung metastases, may be of considerable importance in diagnosis and therapy of the secondaries, for increasing the concentration of tracers and therapeutic agents in tumor tissue while minimizing the likelihood of aspecific distribution and toxicity to non target tissue.