Radiogenomics in lung cancer: Where are we?

• Published in: Lung cancer (Amsterdam, Netherlands) Netherlands), 2023-02, Vol.176, p.56-74
• Main Authors: Aguado-Barrera, Miguel E., Sosa-Fajardo, Paloma, Gómez-Caamaño, Antonio, Taboada-Valladares, Begoña, Couñago, Felipe, López-Guerra, José Luis, Vega, Ana
• Format: Article
• Language: English
• Subjects: Adverse effects; Genomics; Humans; Lung; Lung Neoplasms; Lung Neoplasms - genetics; Lung Neoplasms - radiotherapy; Polymorphism, Single Nucleotide; Precision Medicine; Quality of Life; Radiation Genomics; Radiation Injuries - genetics; Radiation Oncology; Radiation Tolerance; Radiation Tolerance - genetics; Radiotherapy; Single Nucleotide Polymorphism; Toxicity
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/j.lungcan.2023.01.001

•Forty-six publications on radiogenomic analyses of lung cancer were included in this review.•All these studies used candidate gene approach; time has come to advance to GWAS.•Most SNPs from inflammation and DNA repair pathways, 12 good biomarker candidates.•Bigger sample size cohorts and uniformity in the reporting of data are required.•Clinical application of genomic biomarkers of radiation induced toxicity is needed. Huge technological and biomedical advances have improved the survival and quality of life of lung cancer patients treated with radiotherapy. However, during treatment planning, a probability that the patient will experience adverse effects is assumed. Radiotoxicity is a complex entity that is largely dose-dependent but also has important intrinsic factors. One of the most studied is the genetic variants that may be associated with susceptibility to the development of adverse effects of radiotherapy. This review aims to present the current status of radiogenomics in lung cancer, integrating results obtained in association studies of SNPs (single nucleotide polymorphisms) related to radiotherapy toxicities. We conclude that despite numerous publications in this field, methodologies and endpoints vary greatly, making comparisons between studies difficult. Analyzing SNPs from the candidate gene approach, together with the study in cohorts limited by the sample size, has complicated the possibility of having validated results. All this delays the incorporation of genetic biomarkers in predictive models for clinical application. Thus, from all analysed SNPs, only 12 have great potential as esophagitis genetic risk factors and deserve further exploration. This review highlights the efforts that have been made to date in the radiogenomic study of radiotoxicity in lung cancer.