COVID-19 and lung cancer.

COVID-19 pandemic had affected health services around the world, also reducing the diagnosis of lung cancer. On the other hand, examination of surgical specimens in patients with lung cancer and SARS-CoV-2 gave the opportunity to evidence early histologic features related to this emerging pandemic.Different prioritization of health organizations during COVID-19 pandemic resulted in a significant decline of lung cancer screening (up to 56%), delayed diagnosis (up to 30-40%) and higher advanced stage, with some exceptions (i.e., Canada). Increased use of stereotactic radiation treatments in stage I-IIA have been noticed in better-organized health systems. Surgical specimens performed for lung cancer in patients with incipient SARS-CoV-2 permitted to appreciate early histologic findings of COVID-19 with hyperplastic pneumocytes with/without fibrin exudate, alveolar macrophages/myeloid cells, perivascular T-lymphocytic infiltrate and lack of hyaline membrane.While the COVID-19 pandemic has declined the rate of lung cancer diagnosis worldwide, some institutions have significantly limited detrimental effects. Histology related to early SARS-CoV-2 infection in surgical samples for lung cancer revealed specific histologic changes.

[ALK determination: liquid and tissue biopsy. Comparing techniques and effectiveness of alectinib in a controversial clinical case.] / Determinazione di ALK: tra biopsia liquida e tissutale. Tecniche a confronto ed efficacia di alectinib in un caso clinico controverso.

The next generation sequencing (NGS) applied to liquid biopsy is useful to determine the biomolecular identity of the prevalent neoplastic cell population. The sensitivity of ALK detection in liquid biopsy is comparable to that showed by the gold standard tissue biopsy and its usefulness is demonstrated in clinical practice by the similar efficacy of ALK TKIs to obtain prolonged disease control. ALK ve+ lung cancer today presents a large number of therapeutic opportunities leading to a long/term survival. Correct evaluation of ALK translocation is a paramount in order to guide the correct therapeutic strategy as illustrated in the present clinical case.