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Published on: September 20, 2016
The distinctive nature of adenocarcinoma of the lung
1Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
Abstract:
In recent years, many personalized treatments have been developed for NSCLC (non-small-cell lung cancer) patients. Among these, gefitinib, erlotinib, and afatinib are selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors for patients with EGFR gene mutations, while crizotinib and ceritinib are two new tyrosine kinase inhibitors directed against the echinoderm microtubule-like protein 4-anaplastic lymphoma kinase translocation. The possibility of these new molecules being used to treat patients without adenocarcinoma histology is notably small. For example, EGFR mutations and anaplastic lymphoma kinase fusion gene rearrangement are rare in patients with squamous cell carcinoma (generally <1%). Additionally, the benefit of targeted treatment approaches in patients with small-cell lung cancer histology is limited. All of these findings highlight the distinctive nature of adenocarcinoma of the lung among all lung cancer subtypes. Unfortunately, to date, less than 15% of patients with adenocarcinoma of the lung are ideal candidates for these targeted therapies.
Insights
Personalized lung cancer treatments targeting EGFR or ALK mutations are effective for non-small cell lung cancer (NSCLC) patients with adenocarcinoma histology. However, less than 15% of these patients are ideal candidates for such targeted therapies.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Personalized medicine has advanced non-small cell lung cancer (NSCLC) treatment.
- Targeted therapies like EGFR and ALK inhibitors show promise for specific NSCLC subtypes.
Purpose of the Study:
- To evaluate the applicability of current targeted therapies in NSCLC patients.
- To identify the proportion of NSCLC patients suitable for targeted treatment.
Main Methods:
- Review of targeted therapies for NSCLC.
- Analysis of genetic mutations (EGFR, ALK) in different NSCLC histologies.
- Assessment of treatment eligibility criteria.
Main Results:
- EGFR mutations and ALK rearrangements are rare in squamous cell carcinoma (<1%).
- Targeted therapy benefits are limited in small-cell lung cancer.
- Less than 15% of adenocarcinoma patients are ideal candidates for current targeted therapies.
Conclusions:
- Lung adenocarcinoma is a distinct subtype with unique treatment considerations.
- Current targeted therapies are not broadly applicable across all NSCLC histologies.
- The majority of NSCLC patients do not meet the criteria for existing targeted treatments.
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