1. Precision medicine in non-small cell lung cancer: Current applications and future directions
- Author
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Soo-Ryum Yang, Marc Ladanyi, Anne M. Schultheis, Reinhard Büttner, Helena A. Yu, and Diana Mandelker
- Subjects
0301 basic medicine ,Oncology ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Carcinoma, Non-Small-Cell Lung ,Proto-Oncogene Proteins ,Internal medicine ,Biomarkers, Tumor ,ROS1 ,Humans ,Medicine ,Precision Medicine ,Liquid biopsy ,Lung cancer ,Genotyping ,Predictive biomarker ,business.industry ,Protein-Tyrosine Kinases ,Precision medicine ,medicine.disease ,030104 developmental biology ,030220 oncology & carcinogenesis ,Mutation ,Non small cell ,KRAS ,business - Abstract
Advances in biomarkers, targeted therapies, and immuno-oncology have transformed the clinical management of patients with advanced NSCLC. For oncogene-driven tumors, there are highly effective targeted therapies against EGFR, ALK, ROS1, BRAF, TRK, RET, and MET. In addition, investigational therapies for KRAS, NRG1, and HER2 have shown promising results and may become standard-of-care in the near future. In parallel, immune-checkpoint therapy has emerged as an indispensable treatment modality, especially for patients lacking actionable oncogenic drivers. While PD-L1 expression has shown modest predictive utility, biomarkers for immune-checkpoint inhibition in NSCLC have remained elusive and represent an area of active investigation. Given the growing importance of biomarkers, optimal utilization of small tissue biopsies and alternative genotyping methods using circulating cell-free DNA have become increasingly integrated into clinical practice. In this review, we will summarize the current landscape and emerging trends in precision medicine for patients with advanced NSCLC with a special focus on predictive biomarker testing.
- Published
- 2022