December 2012
New Advances in the Precision Medicine of Lung Cancer
Abstract
First-generation tyrosine kinase inhibitors (TKIs) effective against non-small cell lung cancers (NSCLC) with epidermal growth factor receptor mutations or anaplastic lymphoma kinase fusion genes were initial steps in the precision medicine of lung cancer, but have significant limitations. Only about 19 % of NSCLC demonstrate predictive biomarkers that indicate that they are likely to respond to first-generation TKIs, and virtually all NSCLC that initially respond develop acquired resistance after several months. Ongoing developments in this field are expected to provide patients with improved diagnosis and treatment options. Next-generation sequencing offers superior options for genotyping tumors. Immunohistochemistry promises to allow predictive biomarkers analysis by direct observation of malignant cells using conventional tools and procedures. Treatment options that include repurposing of drugs for new targets and investigation of new clinically actionable targets will require greater knowledge and participation of the pathologist in personalized healthcare of lung cancer patients.
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