Arch Pathol Lab Med. 2012 Dec;136(12):1482-91. doi: 10.5858/arpa.2012-0508-RA.
Lung cancer genotype-based therapy and predictive biomarkers: present and future.
Source
From the Department of Pathology & Genomic Medicine, The Methodist Hospital, Houston, Texas (Dr Cagle); and the Department of Pathology, University of Texas Health Science Center at Tyler (Dr Allen).
Abstract
Context.-The advent of genotype-based therapy and predictive biomarkers for lung cancer has thrust the pathologist into the front lines of precision medicine for this deadly disease.
Objective.-To provide the clinical background, current status, and future perspectives of molecular targeted therapy for lung cancer patients, including the pivotal participation of the pathologist.
Data Sources.-Data were obtained from review of the pertinent peer-reviewed literature.
Conclusions.-First-generation tyrosine kinase inhibitors have produced clinical response in a limited number of non-small cell lung cancers demonstrated to have activating mutations of epidermal growth factor receptor or anaplastic lymphoma kinase rearrangements with fusion partners. Patients treated with first-generation tyrosine kinase inhibitors develop acquired resistance to their therapy. Ongoing investigations of second-generation tyrosine kinase inhibitors and new druggable targets as well as the development of next-generation genotyping and new antibodies for immunohistochemistry promise to significantly expand the pathologist's already crucial role in precision medicine of lung cancer.
Objective.-To provide the clinical background, current status, and future perspectives of molecular targeted therapy for lung cancer patients, including the pivotal participation of the pathologist.
Data Sources.-Data were obtained from review of the pertinent peer-reviewed literature.
Conclusions.-First-generation tyrosine kinase inhibitors have produced clinical response in a limited number of non-small cell lung cancers demonstrated to have activating mutations of epidermal growth factor receptor or anaplastic lymphoma kinase rearrangements with fusion partners. Patients treated with first-generation tyrosine kinase inhibitors develop acquired resistance to their therapy. Ongoing investigations of second-generation tyrosine kinase inhibitors and new druggable targets as well as the development of next-generation genotyping and new antibodies for immunohistochemistry promise to significantly expand the pathologist's already crucial role in precision medicine of lung cancer.
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