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Treatment of oncogene-driven non-small cell lung cancer

Elisabeth A Kastelijn1, Adrianus J de Langen2, Bas J M Peters3

  • 1Department of Pulmonology, St. Antonius Hospital Utrecht/Nieuwegein, Utrecht.

Current Opinion in Pulmonary Medicine
|March 14, 2019
PubMed
Abstract

Insights

Targeted therapies improve outcomes for oncogene-driven non-small cell lung cancer (NSCLC). While tyrosine kinase inhibitors (TKIs) are effective, resistance develops. Blood tests help identify drivers and monitor treatment resistance.

Area of Science:

  • Oncology
  • Molecular Biology
  • Genetics

Background:

  • Advanced or metastatic non-small cell lung cancer (NSCLC) treatment has been revolutionized by targeted therapies.
  • Understanding oncogene-driven NSCLC is crucial for optimizing patient care.

Purpose of the Study:

  • To review the treatment strategies for oncogene-driven non-small cell lung cancer (NSCLC).
  • To discuss the efficacy of targeted therapies and the role of immunotherapy in this patient population.

Main Methods:

  • Review of current literature on targeted therapies and immunotherapy for NSCLC.
  • Analysis of clinical outcomes in patients with specific genetic alterations (EGFR, ALK, ROS1, BRAF V600E).

Main Results:

  • Tyrosine kinase inhibitors (TKIs) demonstrate superior clinical outcomes compared to chemotherapy for EGFR, ALK, ROS1, and BRAF V600E-altered NSCLC.
  • Acquired resistance to TKIs leads to disease progression.
  • Immunotherapy has not shown improved overall survival over chemotherapy in EGFR and ALK-positive NSCLC.
  • Blood-based genetic analysis offers a noninvasive method for driver screening and resistance monitoring.

Conclusions:

  • Targeted molecular therapies are the standard of care for oncogene-driven NSCLC, offering significant clinical benefit with low toxicity.
  • The efficacy of immunotherapy in NSCLC patients with molecular alterations requires further investigation.
  • Liquid biopsy (blood-based genotyping) is increasingly valuable for NSCLC diagnosis and monitoring treatment resistance.

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