Introduction: Non-small cell lung cancer (NSCLC) is the second most common cancer globally. The mesenchymal-epithelial transition (MET) proto-oncogene can be targeted in NSCLC patients. Methods: We performed a literature search on PubMed in December 2019 for studies on MET inhibitors and NSCLC. Phase II and III clinical trials published in English between 2014 and 2019 were selected. Results: Data on MET inhibitors (tivantinib, cabozantinib, and crizotinib) and anti-MET antibodies (emibetuzumab and onartuzumab) are reported in the text. Conclusion: Emibetuzumab could be used for NSCLC cases with high MET expression. Further, studies on onartuzumab failed to prove its efficacy, while the results of tivantinib trials were clinically but not statistically significant. Additionally, cabozantinib was effective, but adverse reactions were common, and crizotinib was generally well-tolerated.
Ductal carcinoma in situ (DCIS) is a precursor mammary lesion whose malignant
cells do not extend beyond the basement membrane and presents a risk of
progression to malignant disease. Its early detection increased with screening
mammography. The objective of this study was to review the literature on the
main presentations of DCIS on magnetic resonance imaging (MRI), through searches
of the Medline/PubMed, Latin-American and Caribbean Center on Health Sciences
Information (Lilacs), and Scientific Electronic Library Online (SciELO)
databases. DCIS can occur in its pure form or in conjunction with invasive
disease, in the same lesion, in different foci, or in the contralateral breast.
MRI has a high sensitivity for the detection of pure DCIS, being able to
identify the non-calcified component, and its accuracy increases with the
nuclear grade of the lesion. The most common pattern of presentation is
non-nodular enhancement; heterogeneous internal structures; a kinetic curve
showing washout or plateau enhancement; segmental distribution; and restricted
diffusion. MRI plays an important role in the detection of DCIS, especially in
the evaluation of its extent, contributing to more reliable surgical excision
and reducing local recurrence.
Background and Objective
The therapeutic landscape for non-small cell lung cancer (NSCLC) has evolved considerably in the last few years. The targeted drugs and molecular diagnostics have been developed together at a fast pace. This narrative review explores the evolution of anaplastic lymphoma kinase (ALK) targeting therapies from discovering the ALK protein, molecular tests, present clinical trial data and future perspectives. Since the body of evidence on lung cancer is growing daily, most oncologists need time to implement data in their daily practice.
Methods
We developed a narrative review to provide up-to-date help in the clinical decision-making of ALK-altered NSCLC patients. In 2022, the authors reviewed PubMed’s published pivotal randomized Phase 3 trial results.
Key Content and Findings
The development of ALK inhibitors was a revolution that is still ongoing; second and third-generation ALK inhibitors provided more than 30 months of progression-free survival (PFS) and impressive “brain-control”. Brigatinib provided a survival benefit for patients with baseline brain metastases (HR 0.43, 95% CI: 0.21–0.89), and Lorlatinib demonstrated intracranial response rates of 82%, with 71% of complete intracranial responses. Personalized medicine is the new paradigm, from performing broad genetic panels for diagnosis to individual targeted therapy or combinations of different targeted agents.
Conclusions
In the future, performing broad molecular panels should be the standard of care in the front line and after each progression to detect arising resistance mechanisms. Longer PFS will substantially convert a deadly condition into an almost chronic disease in the following decades. Treatment sequencing will be the cornerstone for patient survival, and liquid biopsies may replace tissue biopsies.
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