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Current practice trends toward more individualized therapy, including non-operative options such as ablation and stereotactic ablative radiotherapy. 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\nHospital Physiotherapy Institutes (IRCCS), Italy  \nREVIEWED BY Huiyu Li,  \nUniversity of Texas Southwestern Medical  \nCenter, United States Qiongwen Zhang, Sichuan University, China Sabahattin Cömertpay,  \nKahramanmaras Sütü Imam University, Türkiye  \n*CORRESPONDENCE Chunxiang Li  \n [lichunxiang@cicams.ac.cn](lichunxiang@cicams.ac.cn)[ ](lichunxiang@cicams.ac.cn)Shugeng Gao  \n [gaoshugeng@cicams.ac.cn](gaoshugeng@cicams.ac.cn)[ ](gaoshugeng@cicams.ac.cn)Jie He  \n [hejie@cicams.ac.cn](hejie@cicams.ac.cn)  \n†These authors have contributed equally to this work  \nSPECIALTY SECTION  \nThis article was submitted to Thoracic Oncology, a section of the journal Frontiers in Oncology  \nRECEIVED 02 September 2022  \nACCEPTED 13 February 2023  \nPUBLISHED 22 February 2023  \nCITATION  \nTian H, Bai G, Yang Z, Chen P, Xu J, Liu T, Fan T, Wang B, Xiao C, Li C, Gao S and He J (2023) Multiple primary lung cancer:  \nUpdates of clinical management and genomic features.  \nFront. Oncol. 13:1034752 .  \ndoi: 10.3389/fonc.2023.1034752  \nCOPYRIGHT  \n© 2023 Tian, Bai, Yang, Chen, Xu, Liu, Fan, Wang, Xiao, Li, Gao and He. This is an openaccess article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.  \nMultiple primary lung cancer: Updates of clinical management and genomic features  \nHe Tian 1†, Guangyu Bai 1†, Zhenlin Yang 1†, Ping Chen 2, Jiachen Xu 3, Tiejun Liu 1, Tao Fan 1, Bingning Wang 4, Chu Xiao 1, Chunxiang Li 1*, Shugeng Gao 1* and Jie He 1*  \n1 Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China, 2 Department of Medical Oncology, Yancheng No. 1 People’s Hospital, Yancheng, Jiangsu, China, 3 Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China, 4 Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China  \nIn recent decades, multiple primary lung cancer (MPLC) has been increasingly prevalent in clinical practice. However, many details about MPLC have not been completely settled, such as understanding the driving force, clinical management, pathological mechanisms, and genomic architectures of this disease. From the perspective of diagnosis and treatment, distinguishing MPLC from lung cancer intrapulmonary metastasis (IPM) has been a clinical hotpot for years. Besides, compared to patients with single lung lesion, the treatment for MPLC patients is more individualized, and non-operative therapies, such asablation and stereotactic ablative radiotherapy (SABR), are prevailing. The emergence of next-generation sequencing has fueled a wave of research about the molecular features of MPLC and advanced the NCCN guidelines. In this review, we generalized the latest updates on MPLC from definition, etiology and epidemiology, clinical management, and genomic updates. We summarized the different perspectives and aimed to offer novel insights into the management of MPLC.  \nKEYWORDS  \nmultiple primary lung cancer (MPLC), clinical management, genomic, heterogeneity, intrapulmonary metastasis (IPM)  \nIntroduction  \nLung cancer is the most fatal malignancy globally, significantly burdening the public health system (1) . In recent decades, lung cancer risk h","cbCairMzyve19JoD","https://ap.wps.com/l/cbCairMzyve19JoD","pdf",572513,11,"English","# Introduction\n## Clinical importance of MPLC\n## Distinguishing MPLC from IPM\n# Etiology and epidemiology\n## Smoking, field cancerization, and familial heredity\n# Diagnosis and clinical management overview\n## Imaging limitations and genomic approaches\n## Surgery and non-operative therapies","[{\"question\":\"Why is distinguishing MPLC from IPM important in clinical management?\",\"answer\":\"Distinguishing MPLC from intrapulmonary metastasis (IPM) is vital because it can significantly affect treatment strategy, and imaging evidence alone may no longer accurately separate the two diseases.\"},{\"question\":\"What therapeutic approaches are commonly considered for MPLC patients?\",\"answer\":\"Surgical resection remains a mainstream choice, while patients who are not suitable for surgery may receive non-operative therapies such as image-guided thermal ablation (IGAB) and stereotactic ablative radiotherapy (SABR), and treatment is increasingly individualized.\"},{\"question\":\"What factors have been reported as associated with MPLC initiation and development?\",\"answer\":\"Previous studies link MPLC with smoking, field cancerization, and familial heredity, while ongoing research also targets genomic mutations, tumor architectures, and the tumor microenvironment.\"}]","Multiple primary lung cancer - Updates of clinical management and genomic features | PDF",1790242795,28]