Abstract
Targeted molecular treatments have changed the way non-small cell lung cancer (NSCLC) is managed. Epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), v-raf murine sarcoma viral oncogene homolog B1 (BRAF), and c-ros oncogene 1 (ROS1) mutations are now used to guide specific anti-cancer therapies to improve patient outcomes. New targeted molecular treatments are constantly being developed and evaluated as a means to improve efficacy, overcome resistance, or minimise toxicity. This review article summarises the current evidence for the efficacy, resistance mechanisms, and safety of targeted molecular treatments against specific mutations in NSCLC.
Highlights
Worldwide, lung cancer is the most commonly diagnosed cancer and the leading cause of cancer mortality
Platinum doublet chemotherapy, which was the standard of care for all patients with incurable locally advanced or metastatic Non-small cell lung cancer (NSCLC) [3], achieved a response rate of 19%, and a median overall survival of 7.9 months [4]
Epidermal growth factor receptor (EGFR) mutations were first described in lung adenocarcinomas in 2004 [11] and were rapidly recognised as a predictor for response to EGFR tyrosine kinase inhibitors (TKIs)
Summary
Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer mortality. It accounted for 1.8 million new cases in 2012 (12.9% of all cancers) and caused 1.6 million deaths (19.4% of all cancers) [1]. Prior to the use of targeted therapy and immunotherapy, patients with advanced lung cancer had a poor prognosis. Platinum doublet chemotherapy, which was the standard of care for all patients with incurable locally advanced or metastatic NSCLC [3], achieved a response rate of 19%, and a median overall survival of 7.9 months [4]. Specific mutations have been found to be prevalent in lung adenocarcinomas, some of which are predictors for response to targeted treatment. We will explore the current evidence for targeted therapy for different mutations in NSCLC, with the aim of providing clinical guidance for oncologists treating NSCLC
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