Personalised therapy for lung cancer


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Scott Gettinger
Yale University, Connecticut, USA

Abstract

Although lung cancer continues to represent the leading cause of cancer-related mortality worldwide, clear progress has been made in the last decade. Subgroups of patients defined by driving molecular abnormalities have been identified, with well tolerated oral agents targeting these abnormalities. In particular, small molecular inhibitors of both the epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) are associated with high response rates in EGFR mutant and ALK rearranged lung cancer respectively. In addition, lung cancer histology has emerged as predictive of sensitivity to chemotherapy, and promising biomarkers such as excision repair cross-complementation group 1 (ERCC1), ribonucleotide reductase M1 (RRM1) and breast cancer 1 (BRCA1) are being evaluated prospectively to assist in further refining chemotherapy. Multiple other molecularly targeted agents are being evaluated in lung cancer, and novel immunotherapies are beginning to show promise. As our understanding of the heterogeneous nature of lung cancers grows, individualised therapy will continue to evolve with great hope.