Personalized treatments in lung cancer

سال انتشار: 1395
محل انتشار: اولین کنگره پزشکی شخصی
کد COI اختصاصی: IPMCMED01_004
زبان مقاله: انگلیسی
تعداد مشاهده: 429

نویسندگان

Firoozgar Hospital, Tehran, Iran

چکیده

The past decade has seen an enormous advancement in the therapy for non-small cell lung cancer, predominantly seen in adenocarcinoma.The first achievement was the knowledge that certain histologies respond better to certain drugs. This was the introduction of histology-based drugs. Then came the discovery of targetable mutations. We have many mutations in this disease, mostly still untargettable. These events have led to a personalized therapeutic approach with the delivery of drugs that target specific oncogenic pathways active in a given tumor with the intent of acquiring the best response rate. Patients benefitting here were mostly non- or never smokers. The discovery of sensitizing mutation in the epidermal growth factor receptor gene as the basis for clinical response to tyrosine kinase inhibitors led to a systematic search for other molecular targets in lung cancer. Currently, there are several molecular alterations that can be targeted by experimental drugs, such as ALK and ROS. These new discoveries would not be possible without a parallel technological evolution in diagnostic molecular pathology. Next-generation sequencing (NGS) is a technology that allows for the evaluation of multiple molecular alterations in the same sample using a small amount of tissue. Selective evaluation of targeted cancer genes, instead of whole-genome evaluation, is the approach that is best suited to enter clinical practice. In the era of immunotherapy, another lesson was learnt and that was showing a benefit in patients who did not show any of the mutations mentioned above, thus a treatment was mainly for squamous cell lung cancer and smokers.

کلیدواژه ها

EGFR, ALK, Adenocarcinoma, mutations

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