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Author Spotlight: Dissection and Isolation of Region-Specific Decellularized Lung Tissue
Published on: September 29, 2023
FGFR-driven lung cancer: Dissecting resistance and exploring therapeutic avenues
Pengfei Zhang1, Wuxuan Mei2, Yueru Yao3
1Department of Medical Laboratory, Shenzhen Longhua District Central Hospital, the Affiliated Longhua Hospital of Shenzhen University, Shenzhen 518110, China.
Abstract:
Fibroblast growth factor receptors (FGFRs) are significant oncogenic contributors in lung cancer. The clinical development of FGFR-directed agents represents a promising advancement in precision oncology. However, their efficacy is substantially limited by the emergence of diverse resistance mechanisms. This review summarizes FGFR biology, genomic alterations, and signaling pathways in tumorigenesis. Nonselective tyrosine kinase inhibitors and selective FGFR inhibitors (including pan-FGFR and isoform-specific agents) have shown clinical activity in patients with FGFR-altered lung cancer. Moreover, resistance mechanisms, such as secondary FGFR mutations, bypass signaling, tumor microenvironment (TME) remodeling, and phenotypic switching, are discussed. Innovative approaches, including the second-generation FGFR TKIs, monoclonal antibodies (mAbs), FGF traps, antibody-drug conjugates, and synergistic combinations with immunotherapy or other receptor tyrosine kinase (RTK) inhibitors, are discussed to overcome resistance. Overall, this review offers theoretical insights and proposes strategies to tackle resistance to FGFR-directed treatments in lung cancer.
Insights
Fibroblast growth factor receptor (FGFR) inhibitors show promise in lung cancer, but resistance limits their effectiveness. This review explores FGFR biology, resistance mechanisms, and strategies to overcome treatment challenges in precision oncology.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Fibroblast growth factor receptors (FGFRs) are key drivers in lung cancer development.
- Targeting FGFRs represents a significant advance in precision oncology for lung cancer treatment.
Purpose of the Study:
- To review FGFR biology, genomic alterations, and signaling in lung cancer.
- To discuss current FGFR inhibitors and their clinical activity.
- To summarize resistance mechanisms and novel strategies to overcome them.
Main Methods:
- Literature review of FGFR biology, tumorigenesis, and therapeutic strategies.
- Analysis of resistance mechanisms including secondary mutations and pathway alterations.
- Exploration of emerging therapeutic approaches and combination strategies.
Main Results:
- FGFR alterations are common in lung cancer, with inhibitors showing clinical activity.
- Diverse resistance mechanisms, including secondary mutations and TME remodeling, limit efficacy.
- Second-generation inhibitors, mAbs, FGF traps, ADCs, and combination therapies are emerging strategies.
Conclusions:
- Understanding FGFR biology and resistance is crucial for effective lung cancer treatment.
- Novel therapeutic strategies are needed to overcome resistance to FGFR-directed therapies.
- Combination approaches hold promise for enhancing treatment outcomes in FGFR-altered lung cancer.
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