Targeted therapies for lung cancer: how did the game begin?

Abstract

Lung cancer is the leading cause of cancer death worldwide, causing 1.4 million deaths annually [1]. Patients with advanced stage nonsmall cell lung cancer (NSCLC) are usually managed with combinations of platinum-based chemotherapy and they have poor prognosis with a median survival of 8 months [2]. Chromosomal rearrangements and gene mutations that contribute to the constant activation of kinases play a crucial role in the process of carcinogenesis. During the past decade, knowledge gained from next-generation sequencing has radically affected lung cancer management and led to targeted therapies. To this end, the discovery of missing lung cancer driving mutations together with comprehensive understanding of the molecular basis of the disease have driven the introduction of novel therapeutic agents that specifically target cancer cells. In this article, we will present the landmark studies of epidermal growth factor receptor (EGFR), Kirsten rat sarcoma viral oncogene homolog (KRAS) and echinoderm microtubule-associated protein-like 4–anaplastic lymphoma kinase (EML4–ALK) pathways, which are the targets of the most common inhibitors that are used on everyday clinical practice.

Real-World Treatment Patterns and Survival in Stage IV Non-Small-Cell Lung Cancer in Canada

“…benefits 9 , but better therapies are needed because tumour resistance typically emerges after a few months on-therapy. Second-generation tkis have been associated with modest improvements in progression-free or overall survival (os) in patients positive for an EGFR mutation (EGFRm+).…”

Management of incidental nodules in lung cancer screening: ready for prime-time?

“…A score that could reliably predict pulmonary nodule aetiology would improve patient management by minimising the number of invasive procedures and reducing healthcare costs and patients' discomfort [12]. To this end, patients with a probably benign nodule could be managed by serial surveillance avoiding invasive tests, whereas those patients with a probably malignant nodule could be stratified to the most appropriate treatment more quickly [13]. These authors previously developed a biomarkerdriven lung nodule classifier based upon 222 subjects [14].…”