"For non–East Asian smokers with lung cancer, the exuberance over targeted therapies may not resonate"

http://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2012-0738-ED

Arch Pathol Lab Med. 2013 Jun;137(6):747. doi: 10.5858/arpa.2012-0738-ED.

Targeted molecular therapy for lung cancer: exuberance reestablished.

Allen TC.

For lung cancer, the world's number one cancer killer, there has been—unlike the other common cancers (colon, breast, and prostate)—no significant increase in survival or cure rate since the dawn of modern oncology and surgery in the mid-20th century. As such, the exuberance expressed over the recent emergence of molecular-based targeted lung cancer therapies—specifically, EGFR- and ALK-based therapies—showing improved survival, is that much the more satisfying. Yet unfortunately, relatively few patients with lung cancer can benefit from them. Patients with squamous cell carcinoma do not. Even among patients with lung adenocarcinoma, only a minority—and in some groups a small minority—may benefit. EGFR-targeted therapy could potentially benefit almost a third of East Asian patients. But only 7% of white patients with lung cancer have EGFR mutations; African Americans, only 2%.^1,2 ALK-based targeted therapy may benefit some patients with lung adenocarcinoma who have the ALK rearrangement, predominantly never-smokers. But smokers, whose lung cancers generally do not possess the ALK rearrangement? Not so much.^3,4 For non–East Asian smokers with lung cancer, the exuberance over targeted therapies may not resonate.