Lung Cancer: Targeted Therapy in 2025

Area of Science:

• Oncology
• Genomics
• Molecular Biology

Background:

• The landscape of lung cancer treatment has been revolutionized by the identification of actionable genomic alterations (AGAs).
• Non-small cell lung cancer (NSCLC), particularly lung adenocarcinoma, frequently harbors these AGAs.
• Understanding these alterations is crucial for personalized treatment strategies.

Purpose of the Study:

• To provide a comprehensive review of the current state-of-the-art treatments for specific AGAs in NSCLC.
• To discuss the clinical implications and toxicities of targeted therapies for these alterations.
• To explore treatment options beyond the metastatic setting, including adjuvant and stage III therapies.

Main Methods:

• Literature review of current research and clinical guidelines on actionable genomic alterations in NSCLC.
• Focus on targeted therapies for EGFR, ALK, ROS1, BRAF V600E, METex14, RET, KRAS G12C, ERBB2 (HER2), and NTRK alterations.
• Inclusion of data on treatment efficacy, toxicity profiles, and application in different disease stages.

Main Results:

• Targeted therapies have demonstrated significant efficacy in NSCLC patients with specific AGAs.
• Established treatments exist for EGFR mutations, ALK and ROS1 fusions, BRAF V600E, METex14, RET, KRAS G12C, ERBB2, and NTRK fusions.
• Adjuvant and stage III treatment strategies are emerging for certain AGAs, notably EGFR mutations and ALK fusions.

Conclusions:

• Actionable genomic alterations are key drivers in NSCLC, necessitating molecular profiling for optimal treatment selection.
• Targeted therapies offer improved outcomes for patients with specific AGAs across various disease stages.
• Ongoing research continues to expand therapeutic options and refine treatment approaches for NSCLC.