Evidence mapPaperPMID 42122160Full record

ReviewCancers2026

The Occupational and Environmental Respiratory Exposome as a Potential Modulator of Adaptive Resistance to EGFR and ALK Inhibitors in Non-Small Cell Lung Cancer.

Irina Luciana Gurzu, Claudia Mariana Handra, Cristina Mandanach, Nina Ionovici, Bogdan Gurzu

Abstract readReview
In one paragraph

Review in Cancers, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Irina Luciana GurzuDepartment of Preventive Medicine and Interdisciplinarity, Discipline of Occupational Health, Grigore. T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.ORCID 0000-0003-3095-3497
Claudia Mariana HandraClinical Department V, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.ORCID 0000-0003-4870-6355
Cristina MandanachClinical Department V, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania.ORCID 0000-0003-3440-9309
Nina IonoviciOccupational Medicine Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Bogdan GurzuDepartment of Morfofunctional Sciences II, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania.ORCID 0000-0002-1834-9142

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTargeted therapies directed against oncogenic drivers have substantially improved outcomes for patients with epidermal growth factor receptor (EGFR)-mutant and anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC). Despite high initial response rates, most patients ultimately develop acquired resistance to tyrosine kinase inhibitors (TKIs), reflecting complex biological adaptations under therapeutic pressure.

methodsThis narrative review synthesizes experimental, translational, and clinical studies examining how environmental and occupational respiratory exposures may influence resistance mechanisms in EGFR- and ALK-driven NSCLC. The review emphasizes exposure-associated signaling plasticity, inflammatory microenvironmental modulation, metabolic reprogramming, and pharmacokinetic alterations.

resultsRecent evidence suggests that respiratory exposures, including cigarette smoke, air pollution, diesel exhaust, and occupational inhalational toxicants, can modulate oncogenic signaling networks relevant to resistance to targeted therapies. These mechanisms include aberrant EGFR activation, bypass signaling through the mesenchymal-epithelial transition receptor (MET) and SRC pathways, epithelial-mesenchymal transition (EMT), adaptive kinome remodeling, and exposure-associated inflammatory signaling, all of which may influence tumor evolution and therapeutic response.

conclusionsThis review introduces a novel exposome-driven conceptual framework integrating environmental exposures with signaling plasticity and resistance evolution in oncogene-driven NSCLC. These findings support the concept that the respiratory exposome may represent an underrecognized modifier of targeted therapy response. Incorporating structured exposure assessment into precision oncology approaches may refine risk stratification and inform exposure-aware therapeutic strategies.

Indexed as

ALKEGFRexposomenon-small cell lung canceroccupational exposureprecision oncologytargeted therapy resistancetyrosine kinase inhibitors

Identifiers

PMID42122160
PMCPMC13162710

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.