• VINAY S Department of Biotechnology and Bioinformatics, School of Life Sciences, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.
  • CHANDAN DHARMASHEKARA Department of Biotechnology and Bioinformatics, School of Life Sciences, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.
  • ASHWINI PRASAD Department of Microbiology, School of Life Sciences, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.
  • KOLLUR SHIVA PRASAD Department of Sciences, Amrita School of Arts and Sciences, Amrita Vishwa Vidyapeetham, Mysuru Campus, Mysuru, Karnataka, India.
  • CHANDRASHEKAR SRINIVASA Department of Biotechnology, Davangere University, Shivagangotri, Davangere, Karnataka, India
  • KAVITHA GC Department of Biotechnology, Davangere University, Shivagangotri, Davangere, Karnataka, India
  • POOJITHA B. SRIDHARA SETTY Department of Biotechnology, Davangere University, Shivagangotri, Davangere, Karnataka, India
  • CHANDAN SHIVAMALLU Department of Biotechnology and Bioinformatics, School of Life Sciences, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India.



4(methylnitrosomine)-1-(3-pyridyl)-1-butano nitrosonornicotine, Carcinogen, Cigarette, Mutant, Nitrosamine ketone, P53, Tumor


Smoking ambiguity contributes to a certain revelation regarding the process by which cancer is induced. In the laboratory, carcinogens induce clear lung tumor to lung cancer induction. For instance, carcinogenic chemicals, namely, 4(methyl nitrosomine)-1-(3-pyridyl)-1-butanol, and nitrosonornicotine (NNN) cause tumor malignancy. It is evident from the mechanistic studies that the carcinogens have a stronger tendency to mutate the genes like suppresser gene, a gene that encodes the receptor of the cell surface to the nucleus, thus, giving way to the proliferation of mutation leading to neoplastic cells. In this analysis article, we have discussed molecular mechanics that can cause cancer by nitrosamines such as nicotine-derived nitrosamine ketone and NNN regarding a variety of significant cigarette combustion carcinogens and the effort to introduce a different dimensional approach to the prevention of cancer, by understanding the perspective of various treatments.


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Hamilton M, Wolf JL, Rusk J, Beard SE, Clark GM, Witt K, et al. Effects of smoking on the pharmacokinetics of erlotinib. Clin Cancer Res 2006;12:2166-71.

Cagle PT, Chirieac LR. Advances in treatment of lung cancer with targeted therapy. Arch Pathol Lab Med 2012;136:504-9.

Bearz A, Berretta M, Lleshi A, Tirelli U. Target therapies in lung cancer. J Biomed Biotechnol 2011;2011:921231.

Van Zandwijk N, Fong KM. Update in lung cancer: Prologue to a modern review series. Respirology 2015;20:183-4.

Alama A, Truini A, Coco S, Genova C, Grossi F. Prognostic and predictive relevance of circulating tumor cells in patients with non-small-cell lung cancer. Drug Discov Today 2014;19:1671-6.

These Guidelines Have Been Replaced by 2010 Guideline on Radical Management. BTS recommendations to respiratory physicians for organising the care of patients with lung cancer. Thorax 2011; :8-9.

Thomas L, Kwok Y, Edelman MJ. Management of paraneoplastic syndromes in lung cancer. Curr Treat Option Oncol 2004;5:51-62.

Salgia R. Diagnostic challenges in non-small-cell lung cancer: An integrated medicine approach. Future Oncol 2015;11:489-500.

Kerr KM. Classification of lung cancer: Proposals for change? Arch Pathol Lab Med 2012;136:1190-3.

Romaszko AM, Doboszynska A. Multiple primary lung cancer: A literature review. Adv Clin Exp Med 2018;27:725-30.

Gibbons DL, Byers LA, Kurie JM. Smoking, p53 mutation, and lung cancer. Mol Cancer Res 2014;12:3-13.

Park BJ, Louie O, Altorki N. Staging and the surgical management of lung cancer. Radiol Clin North Am 2000;38:545-61.

Garelli E, Rittmeyer A, Putora PM, Glatzer M, Dressel R, Andreas S. Abscopal effect in lung cancer: Three case reports and a concise review. Immunotherapy 2019;11:1445-61.

Amann A, Corradi M, Mazzone P, Mutti A. Lung cancer biomarkers in exhaled breath. Exp Rev Mol Diagn 2011;11:207-17.

Marks LB, Saynak M, Christodouleas JP. Stage III vs. stage IV lung cancer: Crossing a great divide. Lung Cancer 2010;67:1-3.

Divisi D, De Vico A, Ferrari V, Crisci R. Management of lung cancer in a situs viscerum inversus patient. Eur J Cardiothorac Surg 2014;45:197-8.

Adjei AA. Lung cancer-celebrating progress and acknowledging challenges. J Thorac Oncol 2013;8:1350-1.

Brunelli A. Ventilatory efficiency slope: An additional prognosticator after lung cancer surgery. Eur J Cardiothorac Surg 2016;50:780-1.

Laskin JJ. Bronchoalveolar carcinoma: Current treatment and future trends. Clin Lung Cancer 2004;6:S75-9.

Thomas M, Hoffknecht P, Droege C, Baisch A, Reinmuth N, Kreuter M, et al. Non-small-cell lung cancer: Multimodality approach in stage-III resectable disease. Lung Cancer 2004;45:S99-105.

Laptenko O, Shiff I, Freed-Pastor W, Zupnick A, Mattia M, Freulich E, et al. The p53 C terminus controls site-specific DNA binding and promotes structural changes within the central DNA binding domain. Mol Cell 2015;57:1034-46.

Wang C, Liu L, Liu X, Chen W, He G. Mechanisms of lung cancer caused by cooking fumes exposure: A minor review. Chin Med Sci J 2017;32:193-7.

Lee DK. Suspected lung cancer: Its initial management and staging. Prim Care Respir J 2007;16:106-11.

Tsujino K, Kuwatsuka Y, Harada A, Fujii O, Soejima T. Radiotherapy for non-small cell lung cancer. Jpn J Clin Radiol 2009; ???:115-22.

Green JA, Bates V, Greenhalgh J, Boland A, Jain P, Dickson RC, et al. First-line treatment of advanced epidermal growth factor receptor (EGFR) mutation positive non-squamous non-small cell lung cancer. Cochrane Database Syst Rev 2013;5:CD010383.

Singer GA, Hickey DA. Thermophilic prokaryotes have characteristic patterns of codon usage, amino acid composition and nucleotide content. Gene 2003;317:39-47.

Chang CF, Gould MK. The five commandments of efficient and effective care in the initial evaluation of lung cancer. Curr Opin Pulm Med 2016;22:319-26.

Carrozzi L, Viegi G. Lung cancer and chronic obstructive pulmonary disease: The story goes on. Radiology 2011;261:688-91.

Khandelwal A, Bacolla A, Vasquez KM, Jain A. Long non-coding RNA: A new paradigm for lung cancer. Mol Carcinog 2015;54:1235-51.

Abirami N, Arulmozhi R. In-silico approach towards protein targets related to diabetes mellitus-an overview. Orient J Chem 2017;33:1614-22.

Dayhoff H, Calderone H. Composition of proteins. In: Atlas of Protein Sequence and Structure. Washington, DC: National Biomedical Research; 1979. p. 363-73.

Maemondo M, Inoue A, Kobayashi K, Sugawara S, Oizumi S, Isobe H, et al. Gefitinib or chemotherapy for non-small-cell lung cancer with mutated EGFR. N Engl J Med 2010;362:2380-8.

Hecht SS. Cigarette smoking and lung cancer: Chemical mechanisms and approaches to prevention. Lancet Oncol 2002;3:461-9.

Imielinski M, Berger AH, Hammerman PS, Hernandez B, Pugh TJ, Hodis E, et al. Mapping the hallmarks of lung adenocarcinoma with massively parallel sequencing. Cell 2012;150:1107-20.

Thongprasert S, Srinivasan S, Tsai CM, Khoa MT, Heeroma K, Itoh Y, et al. A prospective, molecular epidemiology study of EGFR mutations in Asian patients with advanced non-small-cell lung cancer of adenocarcinoma histology (PIONEER). J Thorac Oncol 2014;154-62.

Detterbeck FC, Gibson CJ. Turning gray: The natural history of lung cancer over time. J Thorac Oncol 2008;3:781-92.

Galbiatti AL, Caldas HC, Padovani JA, Pavarino EC, Goloni- Bertollo EM. Sensitivity of human laryngeal squamous cell carcinoma HEP-2 to metrotexate chemoterapy. Exp Oncol 2012;34:367-9.

Qi W, Li X, Kang J. Advances in the study of serum tumor markers of lung cancer. J Cancer Res Ther 2014;10:C95-101.

Warren GW, Cummings KM. Tobacco and lung cancer: Risks, trends, and outcomes in patients with cancer. Am Soc Clin OncolEduc 2013; :359-64.

Hubers AJ, Prinsen CF, Sozzi G, Witte BI, Thunnissen E. Molecular sputum analysis for the diagnosis of lung cancer. Br J Cancer Nat 2013;109:530-7.

Rami-Porta R, Asamura H, Brierley J, Goldstraw P. Staging, tumor profile, and prognostic groups in lung cancer or the new tower of babel. J Thoracic Oncol 2016;11:1201-3.

Parsons A, Daley A, Begh R, Aveyard P. Influence of smoking cessation after diagnosis of early stage lung cancer on prognosis: Systematic review of observational studies with meta-analysis. BMJ 2010;340:b5569.

Lee JK, Hahn S, Kim DW, Suh KJ, Keam B, Kim TM, et al. Epidermal growth factor receptor tyrosine kinase inhibitors vs conventional chemotherapy in non-small cell lung cancer harboring wild-type epidermal growth factor receptor: A meta-analysis. JAMA J Am Med Assoc 2014;311:1430-7.

Zhang Y, Kang S, Fang W, Hong S, Liang W, Yan Y, et al. Impact of smoking status on EGFR-TKI efficacy for advanced non-small-cell lung cancer in EGFR mutants: A meta-analysis. Clin Lung Cancer 2015;16:144-51.

El-Aarag SA, Mahmoud A, Hashem MH, Abd Elkader H, Hemeida AE, ElHefnawi M. In silico identification of potential key regulatory factors in smoking-induced lung cancer. BMC Med Genomics 2017;10:40.

Noboa EM, Narváez PL. Lung cancer screening. Medicine (Spain) 2018;19:3835-8.

Hasegawa Y, Ando M, Maemondo M, Yamamoto S, Isa S, Saka H, et al. The role of smoking status on the progression-free survival of non-small cell lung cancer patients harboring activating epidermal growth factor receptor (EGFR) mutations receiving first-line EGFR tyrosine kinase inhibitor versus platinum doublet chemotherapy: A meta-analysis of prospective randomized trials. Oncologist 2015;20:307-15.

Akira C, Sakurada E, Kondo T. Early central airways lung cancer. General Thorac Cardiovasc Surg 2012;60:557-60.

Veronesi G, Bottoni E, Finocchiaro G, Alloisio M. When is surgery indicated for small-cell lung cancer? Lung Cancer 2015;90:582-9.

Buonato JM, Lazzara MJ. ERK1/2 blockade prevents epithelial-mesenchymal transition in lung cancer cells and promotes their sensitivity to EGFR inhibition. Cancer Res 2014;74:309-19.

Sim EH, Yang IA, Wood-Baker R, Bowman RV, Fong KM. Gefitinib for advanced non-small cell lung cancer. Cochrane Database Syst Rev 2018;1:CD006847.

Sheng Z, Zhang Y. The efficacy of epidermal growth factor receptor tyrosine kinase inhibitors in non-small cell lung cancer harboring wild-type epidermal growth factor receptor: A meta-analysis of 25 RCTs. Am J Clin Oncol 2017;40:362-9.

Malyankar UM, MacDougall JR. Genome-scale analysis of lung cancer progression. Am J Pharmacogenomics 2004;4:169-76.

International Agency for Research on Cancer. Monographs on the evaluation of carcinogenic risks to humans. In: Smokeless Tobacco and Some Tobacco-specific N-Nitrosamines. Vol. 89. Lyon, France: International Agency for Research on Cancer; 2007.

Quinn S. Lung cancer: The role of the nurse in treatment and prevention. NursingStandard 1999;13:49-54.

Hjertman M, Wejde J, Larsson O. Characterization of hydrophobic prenyl groups of isoprenylated proteins in human cancer cells. Biochem Biophys Res Commun 2001;288:736-41.

Braithwaite KL, Rabbitts PH. Multi-step evolution of lung cancer. Semin Cancer Biol 1999;9:255-65.

Chou KC, Cai YD. Predicting protein-protein interactions from sequences in a hybridization space. J Proteome Res 2006;5:316-22.

Bragg DG. Current applications of imaging procedures in the patient with lung cancer. Int J Radiat Oncol Biol Phys 1991;21:847-51.

Muhm J, Miller W, Fontana RS, Sanderson DR, Uhlenhopp MA. Lung cancer detected during a screening program using four-month chest radiographs. Radiology 1983;148:609-15.

Doll R. Cancers weakly related to smoking. Br Med Bull 1996;52:35-49.

Bennett A, White J. Improving care and quality of life for patients with lung cancer. NursingStandard 2013;28:50-8.

Miller AB. Epidemiology, prevention, and prognostic factors in lung cancer. Curr Opin Oncol 1991;3:282-7.

Jablons DM, Cheng SJ, Clary-Macy RN, Hirsch FR. 1st international lung cancer conference in Beijing October 27-30, 2002. Lung Cancer 2003;41:237-44.

Devesa SS, Blot V, Fraumeni JF. Declining lung cancer rates among young men and women in the United States: A cohort analysis. J Natl Cancer Inst 1989;81:1568-71.

Petty TL. The predictive value of spirometry: Identifying patients at risk for lung cancer in the primary care setting. Postgrad Med 1997;101:128-30.

Holmes EC. Adjuvant treatment in resected lung cancer. Semin Surg Oncol 1990;6:263-7.

Lubin JH, Qlao YL, Taylor PR, Yao SX, Schatzkin A, Mao BL, et al. Quantitative evaluation of the radon and lung cancer association in a case-control study of Chinese tin miners. Cancer Res 1990;50:174-80.

Denholm R, Crellin E, Arvind A, Quint J. Asthma and lung cancer, after accounting for co-occurring respiratory diseases and allergic conditions: A systematic review protocol. BMJ Open 2017;7:e013637.

Cancer Research UK. Lung Cancer Cancer Research U.K. Website; 2011. Available from: cancerstats. [Last accessed on 2011 May 23].

Moore S, Corner J, Haviland J, Wells M, Salmon E, Normand C, et al. Nurse led follow up and conventional medical follow up in management of patients with lung cancer: Randomised trial. BMJ 2002;325:1145.

Nakamura R, Kurishima K, Kobayashi N, Ishikawa S, Goto Y, Sakai M, et al. Postoperative follow-up for patients with non-small cell lung cancer. Onkologie 2010;33:14-8.

Virgo KS, McKirgan LW, Caputo MC, Chao LC, Caputo NA, Naunheim KS, et al. Post-treatment management options for patients with lung cancer. Ann Surg 1995;222:700-10.

Liam CK, Wahid MI, Rajadurai P, Cheah YK, Ng TS. Epidermal growth factor receptor mutations in lung adenocarcinoma in Malaysian patients. J Thorac Oncol 2013;8:766-72.

Haggar AM, Pearlberg J, Froelich JW, Hearshen DO, Beute GH, Lewis JW Jr., et al. Chest-wall invasion by carcinoma of the lung: Detection by MR imaging. AJR Am J Roentgenol 1989;148:1075-8.

Fontana RS, Sanderson DR, Woolner LB, Taylor WF, Miller WE, Muhm JR, et al. Screening for lung cancer: A critique of the Mayo lung project. Cancer 1991;67:1155-64.

Ataman ÖU, Arrett A, Illeron T, Kramar A, ESTRO-REACT Group. Optimization of follow-up timing from study of patterns of first failure after primary treatment. An example from patients with NSCLC: A study of the REACT working group of ESTRo. Radiother Oncol 2006;78:95-100.

Reinig JW, Doppman JL, Dwyer AL. Adrenal the pulmonary nodule by MR. Radiology 1986;158:81-4.

British Thoracic Society Standards of Care Committee. BTS statement on criteria for specialist referral, admission, discharge and follow-up for adults with respiratory disease. Thorax 2008;63:i1-16.

Rubins J, Unger M, Colice GL, American College of Chest Physicians. Follow-up and surveillance of the lung cancer patient following curative intent therapy: ACCP evidence-based clinical practice guideline (2nd edition). Chest 2007;132:355S-67.

Chanda R, Nallaguntla L. Formulation and evaluation of medicated lozenges for sore throat. Asian J Pharm Clin Res 2020;13:62-7.

Farooqui M, Pardeshi R, Jadhav S. Antioxidant-Vitamin C: Lung function; lung cancer. Asian J Pharm Clin Res 2016;9:43-51.



How to Cite

S, V., C. DHARMASHEKARA, A. PRASAD, K. S. PRASAD, C. SRINIVASA, K. GC, P. B. S. SETTY, and C. SHIVAMALLU. “SMOKING CARCINOGENS AND LUNG CANCER – A REVIEW”. Asian Journal of Pharmaceutical and Clinical Research, vol. 14, no. 1, Jan. 2021, pp. 5-12, doi:10.22159/ajpcr.2021.v14i1.39811.



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