Differences Between the East and the West in Managing Advanced-Stage Non-small Cell Lung Cancer

Abstract

Lung cancer is a common cancer associated with high mortality rates worldwide. Unfortunately, it usually presents at a late stage, precluding the chance of curative therapy. The discovery of oncogenic driver mutations in patients with non-small cell lung cancer over the past 20 years has led to new molecular targeted therapies that have dramatically improved treatment efficacy and quality of life. New generations of therapy that target the drug-resistant mutations have also quickly evolved, benefiting patients who are refractory or intolerant to first-line targeted therapy. Eastern patients, from Southeast Asia, Japan and China, are known to have a higher incidence of epidermal growth factor receptor mutation. Therefore, compared with the West, more patients would benefit from these recent advances. In contrast, survival of patients without driver mutations has benefited from advances in novel therapeutics, including the immune checkpoint inhibitors. The current review aims to highlight the recent developments in the management of advanced-stage non-small cell lung cancer and to compare the differences in clinical practice between Eastern and Western countries.

Real-World Treatment and Outcomes of ALK-Positive Metastatic Non–Small Cell Lung Cancer in a Southeast Asian Country

“…Of the 1581 NSCLC patients included in the lung registry during the period of our study, 4.1% had ALK translocations. This figure is in keeping with international studies (4%–5%), 1–8 but lower than another Asian study that had a prevalence of ALK translocation in NSCLC patients of 6.7%. 1 , 2 The lower prevalence can probably be attributed to the low rate of ALK -translocation testing in patients with adenocarcinoma in Malaysia.…”

“… 1–7 In one Asian study, the prevalence of ALK translocations in NSCLC patients was up to 6.7% of NSCLC patients. 1 , 2 Patients who harbor ALK translocations are likely to be young (<50 years old), female, nonsmokers, or have adenocarcinoma. 8 …”

“…ALK gene translocation is a common genetic aberration in patients with lung cancer. 1 Studies in both Western and Asian populations have revealed that about 4%–5% of non–small cell lung cancer (NSCLC) patients harbor ALK translocations. 1–7 In one Asian study, the prevalence of ALK translocations in NSCLC patients was up to 6.7% of NSCLC patients.…”

“… 1 Studies in both Western and Asian populations have revealed that about 4%–5% of non–small cell lung cancer (NSCLC) patients harbor ALK translocations. 1–7 In one Asian study, the prevalence of ALK translocations in NSCLC patients was up to 6.7% of NSCLC patients. 1 , 2 Patients who harbor ALK translocations are likely to be young (<50 years old), female, nonsmokers, or have adenocarcinoma.…”

Identification of Antitumor Constituents in Toad Venom by Spectrum-Effect Relationship Analysis and Investigation on Its Pharmacologic Mechanism

“…Lung cancer is one of the most common cancers in humans with high incidence and mortality rate. Non-Small Cell Lung Carcinoma (NSCLC), the most common form of lung cancer, comprises of approximately 85% of all cases of lung cancer [ 1 , 2 ]. Natural medicines have shown attractive potential for preventing and treating diseases for centuries and have contributed to the development of modern medicine [ 3 ].…”