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FGFR1 inhibition in lung squamous cell carcinoma: questions and controversies
C E Weeden1, B Solomon2, M-L Asselin-Labat1
1ACRF Stem Cells and Cancer Division, The Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia; Department of Medical Biology, The University of Melbourne, Parkville, VIC, Australia.
Abstract:
Although the incidence of lung cancer has decreased due to the reduction of tobacco use, lung cancer remains the leading cause of cancer-related death. Lung squamous cell carcinoma represents 30% of lung cancers and only recently have possible drug-targetable mutations been identified in this disease, including fibroblast growth factor receptor 1 (FGFR1) gene amplification and genetic alterations in the phosphoinositide-3 kinase pathway. These discoveries have generated a great interest in the clinic and the initiation of clinical trials using FGFR tyrosine kinase inhibitors to treat FGFR-altered lung cancers. However, preliminary results from these studies have shown that not all patients respond to therapy. Here we review current unresolved questions on the selection of patients for their recruitment in FGFR tyrosine kinase inhibitor trials, how FGFR inhibitors could be combined with other targeted therapies or immunotherapies to improve patient outcome, and how the current preclinical models can help address these questions.
Insights
Lung squamous cell carcinoma (LSCC) shows promise for targeted therapy with fibroblast growth factor receptor (FGFR) inhibitors. Research is ongoing to identify optimal patient selection and combination strategies for improved treatment outcomes.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Lung cancer remains a leading cause of cancer death despite reduced tobacco use.
- Lung squamous cell carcinoma (LSCC) accounts for 30% of lung cancers and has recently identified targetable mutations.
- Fibroblast growth factor receptor 1 (FGFR1) gene amplification and phosphoinositide-3 kinase pathway alterations are key findings in LSCC.
Purpose of the Study:
- To review unresolved questions in FGFR tyrosine kinase inhibitor (TKI) clinical trials for LSCC.
- To explore strategies for improving patient selection and combination therapies.
- To assess the role of preclinical models in addressing these challenges.
Main Methods:
- Literature review of current research on FGFR inhibitors in LSCC.
- Analysis of clinical trial data and preclinical model utility.
- Synthesis of information on patient selection, combination therapies, and therapeutic resistance.
Main Results:
- Not all patients respond to current FGFR TKI therapies, indicating a need for better patient stratification.
- Combination therapies (e.g., with other targeted agents or immunotherapies) may enhance treatment efficacy.
- Preclinical models are crucial for investigating mechanisms of response and resistance.
Conclusions:
- Further research is needed to refine patient selection criteria for FGFR TKI therapy in LSCC.
- Optimizing combination strategies is essential for improving clinical outcomes.
- Advanced preclinical models will be instrumental in guiding future therapeutic development.
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