Precision Cancer Medicine in Lung Cancer - Preclinical, Translational & Clinical Research – Simon Ekman's research group

Molecular characterization of non-small cell lung cancer.
Molecular characterization of non-small cell lung cancer.


Our research focuses on thoracic oncology, mainly lung cancer, and includes both clinical, translational and preclinical studies. We aim to find new treatment targets and biomarkers that are important for prognosis and treatment response, especially in the areas of lung cancer. For this purpose, we have established patient cohorts where we have collected detailed clinical data and associated tumor material for molecular analyses. Resistance to therapy is a common clinical issue in the treatment of lung cancer and is an important reason for poor prognosis. A major focus of our translational and clinical lung cancer research is the identification of mechanisms of resistance to and biomarkers for tyrosine kinase inhibitors, mainly of EGFR and ALK, and immunotherapy. An important aim is to improve diagnostics and treatment using precision cancer medicine. This involves research programs in diagnostics, imaging, treatments and cancer registers as well as preclinical and translational projects. In these projects we are involving patients treated in clinical routine at Karolinska University Hospital as well as in different clinical studies.

Another focus of research is the important clinical issue of brain metastasis in lung cancer, which is a patient group with a poor prognosis. This involves investigation of molecular mechanisms of brain metastasis in lung cancer and development of novel therapeutics. These studies involve analyses of brain metastasis tissue and cerebrospinal fluid (CSF) with a focus on treatment with targeted therapies. We perform exosome analysis in the collected specimens, where exosomes have been shown to be released from tumor cells and to carry DNA and RNA reflecting the molecular profiles of the solid tumor tissues. In another brain metastasis study in lung cancer, we have performed an imaging study of uptake of an EGFR tyrosine kinase inhibitor in the brain using PET imaging and radiolabeled drug with the aim to identify and understand response and resistance in treatment of brain metastasis.

Selected collaborations: Swedish Lung Cancer Study Group, National Lung Cancer Register, Oslo University (PIs Prof Odd Terje Brustugun, Prof Åslaug Helland), University of Copenhagen/Rigshospitalet (PI Prof Jens Benn SØrensen), Uppsala University (PIs Prof Johan Botling, Prof Patrick Micke, Dr Georg Holgersson), Umeå University (PI Prof Michael Bergqvist), University of Manchester/Christie Hospital (PI Dr Raffaele Califano), University of Colorado Denver (PI Prof Fred Hirsch), University of Crete/University General Hospital Heraklion (PI Prof Dimitris Mavroudis).

Funding bodies

CF-Cancerfonden, KIS/KIF, EP-Erling Persson, Sjöbergstiftelsen, VR- Vetenskapsrådet, SLS-Svenska Läkaresällskapet, Cancer Research KI, Oasmia, FoUU, Takeda, Radiumhemmets Forskningsfonder.


Selected publications

Staff and contact

Group leader

All members of the group

Research teams

Decorative picture of lung
Source: Ekman S, Cselényi Z, Varrone A, et al. A PET and MRI study exploring osimertinib brain exposure and efficacy in EGFRm NSCLC CNS metastases. Presented at: 2020 World Lung Conference on Lung Cancer Singapore; January 28-31, 2021; Virtual. Poster P76.72.

Group leader: Simon Ekman, MD/PhD, Associate Professor

Team leaders: Rolf Lewensohn MD/PhD, Professor, Kristina Viktorsson PhD, Karin Lindberg MD/PhD, Per Hydbring PhD, Luigi De Petris MD/PhD, Simon Ekman MD/PhD, Associate Professor




De Petris

Research focus

Lung cancer is the leading cause of cancer-related mortality. Possibilities to increase survival of lung cancer patients have rapidly emerged with precision cancer medicine treatments e.g. tyrosine kinase inhibitors (TKIs) towards Epidermal Growth Factor Receptor (EGFR), Anaplastic Lymphoma Kinase (ALK) and other oncogenic drivers as well as immune checkpoint inhibitors (ICIs) blocking the PD-1/PD-L1 axis. 

However, treatment resistance is a major clinical issue leading to shortened survival of patients. In our translational research we investigate mechanisms of resistance to therapy as well as treatment toxicity on preclinical, translational and clinical levels in lung cancer in relation to treatment with TKIs, ICIs and Stereotactic Body Radiotherapy (SBRT).

In our preclinical and translational projects we focus on EGFR/ALK TKI/Immunotherapy/Radiotherapy resistance to discover novel targets for therapeutic intervention. We work on Ephrin/Eph ligand and DNA repair signaling cascades and on coding and non-coding RNAs including miRNA-driven mechanisms.

In the translational parts we search for prognostic and treatment predictive biomarkers in tumors and liquid biopsies (plasma, cerebrospinal fluid, pleural effusion fluid) with focus on tumor imaging with PET-labeled TKIs, fine needle aspiration of tumors and on tumor-derived exosomes, in part within a multidisciplinary project with KTH and Uppsala University (

In addition, we have uncovered miRNA candidates that confer resistance to targeted therapies in non-small cell lung cancer (NSCLC), including the TKI osimertinib, targeting EGFR, and TKIs against ALK.


In the clinical parts we run programs at Theme Cancer: Stereotactic Body Radiotherapy treatment and toxicity, non-small cell and small cell lung cancer patient responses and outcome as well as and on brain metastasis. 

We run clinical trials in these areas as principal investigators or in collaborative efforts within Sweden and the Nordics. We are responsible for the Nordic SBRT study group, the Sjöberg Node at Karolinska within the Partnership for Precision Medicine in Cancer (PPMC) and are active in the Personalized Cancer Medicine (PCM) Program at KI, including Cancer Core Europe Basket of Basket trials.

You can find more detailed description of our research by clicking on the different teams and their research.  You are also welcome to contact our group leader:


Preclinical/translational projects

  • Analyses of Ephrin/Eph ligand and DNA repair signaling cascades in context of EGFR TKIs and Radiotherapy in lung cancer (PIs: Kristina Viktorsson & Rolf Lewensohn)​
  • MiRNA-driven signaling networks in EGFR- and ALK TKI refractoriness (PIs: Per Hydbring & Simon Ekman)
  • Fine Needle Aspiration Analytics of Lung Cancer tumors for diagnostics and treatment monitoring (PIs: Rolf Lewensohn, Bosse Franzén, Kristina Viktorsson, Simon Ekman & Luigi De Petris)​
  • Protein, mRNA and miRNA analyses of Tumor Derived Exosomes in plasma and malignant pleural effusion liquid biopsies to reveal treatment predictive biomarkers (PI:s: Kristina Viktorsson, Per Hydbring, Rolf Lewensohn & Simon Ekman)
  • Tumor Imaging with PET-labelled TKIs to understand EGFR-TKI response in NSCLC patients (PI:s Simon Ekman & Rolf Lewensohn)


Clinical projects

  • Curative attempts for lung cancer patients with high dose precision radiotherapy /stereotactic body radiotherapy (SBRT) combined with pharmaceutical agents- evaluation of effect and toxicity (PI:s: Rolf Lewensohn & Karin Lindberg)
  • Brain metastasis in lung Cancer patients- clinical and molecular analyses (PI: Simon Ekman)
  • Non-small cell and small cell lung cancer patient response and outcomes (PI:s Simon Ekman, Rolf Lewensohn, Luigi De Petris & Gunnar Wagenius)
  • The Sjöberg Node at Karolinska (PI:s Simon Ekman & Rolf Lewensohn)
  • Cancer Core Europe Basket of Basket trials (PI Karolinska: Luigi De Petris)