Abstract
The landscape of advanced non-small lung cancer (NSCLC) therapies has rapidly been evolving beyond chemotherapy over the last few years. The discovery of oncogenic driver mutations has led to new ways in classifying NSCLC as well as offered novel therapeutic targets for anticancer therapy. Targets such as epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) gene rearrangements have successfully been targeted with appropriate tyrosine kinase inhibitors (TKIs). Other driver mutations such as ROS, MET, RET, BRAF have also been investigated with targeted agents with some success in the early phase clinical setting. Novel strategies in the field of immune-oncology have also led to the development of inhibitors of cytotoxic T lymphocyte antigen-4 (CTLA-4) and programmed death-1 receptor (PD-1), which are important pathways in allowing cancer cells to escape detection by the immune system. These inhibitors have been successfully tried in NSCLC and also now bring the exciting possibility of long term responses in advanced NSCLC. In this review recent data on novel targets and therapeutic strategies and their future prospects are discussed.
Highlights
LungLung cancer cancer isis the the most most common common cancer cancer worldwide worldwideas as well well as as the the leading leading cause cause of of cancer cancer related related deaths [1].Non-small cell lung cancer (NSCLC)accounts for up to of all lung cancers and of deaths [1]
A driver mutation cannot be identified and for those patients, chemotherapy remains the standard of care
This study showed a modest survival benefit in patients with high epidermal growth factor receptor (EGFR) expression and as this was shown in about 7% of squamous cell carcinoma (SCC), this was further studied in another trial involving another agent blocking the EGFR pathway
Summary
Lung cancer cancer isis the the most most common common cancer cancer worldwide worldwideas as well well as as the the leading leading cause cause of of cancer cancer related related deaths [1]. Of all lung cancers and of deaths [1]. Non-small cell lung cancer (NSCLC) accounts for up to 85% of all lung cancers and of these, these, adenocarcinoma and squamous cell carcinoma account for and. Respectively [2,3].[2,3] Most of these patients present with locally advanced inoperable or metastatic disease, which makes their of these patients present with locally advanced inoperable or metastatic disease, which makes their cancer cancerincurable, incurable,and andunfortunately unfortunatelyalmost almostall allofofthese thesepatients patientswill willdie diefrom fromtheir theirillness illness[4]. Arrows represent the downstream activation with inhibitors are shown in blue. Dashed arrows represent the proposed auto-activatory representing the inhibitory action. The discovery discovery of of these these mutations mutations targeted and others still inway development [7,8]
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