Abstract

Lung cancer is a leading cause of cancer related deaths globally. Nearly 90% of patients with lung cancer in the western hemisphere report tobacco use. Activating mutations in the epidermal growth factor receptor tyrosine kinase (EGFR TK) and re-arrangements involving anaplastic lymphoma kinase (ALK) are present in 15% of patients with non-small cell lung cancer (NSCLC). EGFR TK and ALK inhibitors are associated with dramatic responses in these specific molecular subsets of NSCLC. Whole genome, exome and transcriptome sequencing studies of small cell and NSCLC tumour samples have revealed a complex landscape with numerous single nucleotide variations, insertions, deletions, gene amplifications and structural rearrangements. A number of novel targets for therapies have now been identified. Ongoing studies will continue to explore the genomic landscape of lung cancer to identify unique alterations amenable for therapeutic intervention. In addition a better understanding the role of intra-tumoral heterogeneity and clonal evolution in disease progression is needed to improve the outcomes of patients with lung cancer.