The many facets of lung adenocarcinoma – a disease comprising distinct molecular subgroups.

Abstract

Abstract: Lung cancer is one of the most prevalent types of cancer throughout the world and a leading cause of cancer-related deaths. Lung cancer comprises small cell and non-small cell lung cancer. The most prevalent type of non-small cell lung cancer is adenocarcinoma (AdC). 5-year survival rates of lung AdC range between 50 and 2% for stage Ia and IV, respectively. Novel strategies to treat lung cancer focus on personalized medicine. Personalized medicine is based on a thorough molecular characterization of tumors to tailor therapy specifically to each individual patient. This principle was developed following recent advances in molecular tumor biology that lead to the detection of oncogenic driver mutations. Oncogenic driver mutations confer cancer-properties to the cell and the cancer cell depends on the oncogenic driver mutation to sustain its phenotype (oncogene addiction).Oncogenic driver mutations can be exploited in the treatment of cancer by targeted therapies. Targeted therapies specifically attack cancer cells while causing less side effects than conventional chemotherapy.In lung AdC, oncogenic driver mutations define distinct molecular subgroups. This review aims at presenting the 9 best characterized molecular subgroups of lung AdC. We want to illustrate 1) the respective oncogenic mechanism, 2) patient characteristics, 3) prognostic significance and 4) targeted therapy options for each subgroup.