Non-small Cell Lung Cancer: Current Therapies and New Targeted Treatments

Conventional lung cancer treatments were once limited to surgery, radiation, and chemotherapy. However, gefitinib, a targeted drug, was launched in 2004, and the situation changed. Cancer cases that were highly responsive to gefitinib were later discovered to have epithelial growth factor receptor (...

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प्रकाशित: MDPI - Multidisciplinary Digital Publishing Institute 2022
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ऑनलाइन पहुंच:ONIX_20220111_9783036501307_883
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collection Directory of Open Access Books
description Conventional lung cancer treatments were once limited to surgery, radiation, and chemotherapy. However, gefitinib, a targeted drug, was launched in 2004, and the situation changed. Cancer cases that were highly responsive to gefitinib were later discovered to have epithelial growth factor receptor (EGFR) mutations. This discovery opened the door for biomarker-based treatment strategies. Subsequently, several EGFR-tyrosine kinase inhibitors (TKI) were developed, and they became a new mainstay of treatment for non-small cell lung cancer. In recent years, many mechanisms of resistance to EGFR-TKI have been elucidated; a mutation in the T790M gene at exon 20 is found in half of the resistant cases. Hence, osimertinib, which specifically inhibits EGFR despite this T790M gene mutation, was developed to achieve long-term progression-free survival. Other driver mutations that are similar to the EGFR mutation were discovered, including the EML4-ALK fusion gene (discovered in 2007), ROS1 gene, and BRAF gene mutations. The TKIs for each of these fusion genes were developed and are used as therapeutic agents. Another advancement in advanced non-small cell lung cancer is the development of immune checkpoint inhibitors. Four PD-1/PD-L1 inhibitors, including nivolumab, are currently available for treatment of lung cancer. These drugs prevent an escape from the cancer immunity cycle. This ensures that cancer cells will express cancer antigens, causing an anticancer immune response. Due to cancer immunotherapy, long-term survival is possible. The biomarker development for cancer immunotherapy and its side effects are actively being studied.
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spelling doab-20.500.12854ir-770512024-03-30T23:21:56Z Non-small Cell Lung Cancer: Current Therapies and New Targeted Treatments Uchino, Junji non-small cell lung cancer previously treated patients phase I/II trial chemotherapy docetaxel S-1 immunotherapy rechallenge retrospective analysis pulmonary pleomorphic carcinoma prognostic factor glucose transporter 1 lung cancer multiple cancers metastasis sequencing mutation genomic diagnosis FDG-PET immune checkpoint inhibitor PD-1 prognosis RAD51B methylation PD-L1 expression predictive biomarker PD-1 blockade interstitial lung disease pulmonary fibrosis radiology and other imaging non-small-cell lung cancer epidermal growth factor receptor tyrosine kinase inhibitors TP53 mutations responsiveness targeted therapy network meta-analysis stage IIIA-N2 surgery immune checkpoint inhibitors biomarker nonsmall cell lung cancer HIP1R PD-L1 RUNX1 methylation survival EGFR-TKI T790M osimertinib immune-related adverse events endocrine disorders tumor-bearing patients PD-1 inhibitors PD-L1 inhibitors meta-analysis nivolumab Expanded Access Program real-world data daily practice prognostic factors NSCLC KRAS DNA polymerase beta platinum-based first-line adjuvant chemotherapy β-catenin lung neoplasms nucleotide-diphosphate kinase recurrence unresectable salvage surgery oligometastasis thema EDItEUR::M Medicine and Nursing Conventional lung cancer treatments were once limited to surgery, radiation, and chemotherapy. However, gefitinib, a targeted drug, was launched in 2004, and the situation changed. Cancer cases that were highly responsive to gefitinib were later discovered to have epithelial growth factor receptor (EGFR) mutations. This discovery opened the door for biomarker-based treatment strategies. Subsequently, several EGFR-tyrosine kinase inhibitors (TKI) were developed, and they became a new mainstay of treatment for non-small cell lung cancer. In recent years, many mechanisms of resistance to EGFR-TKI have been elucidated; a mutation in the T790M gene at exon 20 is found in half of the resistant cases. Hence, osimertinib, which specifically inhibits EGFR despite this T790M gene mutation, was developed to achieve long-term progression-free survival. Other driver mutations that are similar to the EGFR mutation were discovered, including the EML4-ALK fusion gene (discovered in 2007), ROS1 gene, and BRAF gene mutations. The TKIs for each of these fusion genes were developed and are used as therapeutic agents. Another advancement in advanced non-small cell lung cancer is the development of immune checkpoint inhibitors. Four PD-1/PD-L1 inhibitors, including nivolumab, are currently available for treatment of lung cancer. These drugs prevent an escape from the cancer immunity cycle. This ensures that cancer cells will express cancer antigens, causing an anticancer immune response. Due to cancer immunotherapy, long-term survival is possible. The biomarker development for cancer immunotherapy and its side effects are actively being studied. 2022-01-11T13:50:34Z 2022-01-11T13:50:34Z 2021 book ONIX_20220111_9783036501307_883 9783036501307 9783036501314 https://directory.doabooks.org/handle/20.500.12854/77051 eng image/jpeg Attribution 4.0 International https://mdpi.com/books/pdfview/book/4666 https://mdpi.com/books/pdfview/book/4666 MDPI - Multidisciplinary Digital Publishing Institute 10.3390/books978-3-0365-0131-4 10.3390/books978-3-0365-0131-4 46cabcaa-dd94-4bfe-87b4-55023c1b36d0 9783036501307 9783036501314 258 Basel, Switzerland open access
spellingShingle non-small cell lung cancer
previously treated patients
phase I/II trial
chemotherapy
docetaxel
S-1
immunotherapy
rechallenge
retrospective analysis
pulmonary pleomorphic carcinoma
prognostic factor
glucose transporter 1
lung cancer
multiple cancers
metastasis
sequencing
mutation
genomic diagnosis
FDG-PET
immune checkpoint inhibitor
PD-1
prognosis
RAD51B methylation
PD-L1 expression
predictive biomarker
PD-1 blockade
interstitial lung disease
pulmonary fibrosis
radiology and other imaging
non-small-cell lung cancer
epidermal growth factor receptor
tyrosine kinase inhibitors
TP53 mutations
responsiveness
targeted therapy
network meta-analysis
stage IIIA-N2
surgery
immune checkpoint inhibitors
biomarker
nonsmall cell lung cancer
HIP1R
PD-L1
RUNX1
methylation
survival
EGFR-TKI
T790M
osimertinib
immune-related adverse events
endocrine disorders
tumor-bearing patients
PD-1 inhibitors
PD-L1 inhibitors
meta-analysis
nivolumab
Expanded Access Program
real-world data
daily practice
prognostic factors
NSCLC
KRAS
DNA polymerase beta
platinum-based first-line
adjuvant chemotherapy
β-catenin
lung neoplasms
nucleotide-diphosphate kinase
recurrence
unresectable
salvage surgery
oligometastasis
thema EDItEUR::M Medicine and Nursing
Non-small Cell Lung Cancer: Current Therapies and New Targeted Treatments
title Non-small Cell Lung Cancer: Current Therapies and New Targeted Treatments
title_full Non-small Cell Lung Cancer: Current Therapies and New Targeted Treatments
title_fullStr Non-small Cell Lung Cancer: Current Therapies and New Targeted Treatments
title_full_unstemmed Non-small Cell Lung Cancer: Current Therapies and New Targeted Treatments
title_short Non-small Cell Lung Cancer: Current Therapies and New Targeted Treatments
title_sort non small cell lung cancer current therapies and new targeted treatments
topic non-small cell lung cancer
previously treated patients
phase I/II trial
chemotherapy
docetaxel
S-1
immunotherapy
rechallenge
retrospective analysis
pulmonary pleomorphic carcinoma
prognostic factor
glucose transporter 1
lung cancer
multiple cancers
metastasis
sequencing
mutation
genomic diagnosis
FDG-PET
immune checkpoint inhibitor
PD-1
prognosis
RAD51B methylation
PD-L1 expression
predictive biomarker
PD-1 blockade
interstitial lung disease
pulmonary fibrosis
radiology and other imaging
non-small-cell lung cancer
epidermal growth factor receptor
tyrosine kinase inhibitors
TP53 mutations
responsiveness
targeted therapy
network meta-analysis
stage IIIA-N2
surgery
immune checkpoint inhibitors
biomarker
nonsmall cell lung cancer
HIP1R
PD-L1
RUNX1
methylation
survival
EGFR-TKI
T790M
osimertinib
immune-related adverse events
endocrine disorders
tumor-bearing patients
PD-1 inhibitors
PD-L1 inhibitors
meta-analysis
nivolumab
Expanded Access Program
real-world data
daily practice
prognostic factors
NSCLC
KRAS
DNA polymerase beta
platinum-based first-line
adjuvant chemotherapy
β-catenin
lung neoplasms
nucleotide-diphosphate kinase
recurrence
unresectable
salvage surgery
oligometastasis
thema EDItEUR::M Medicine and Nursing
topic_facet non-small cell lung cancer
previously treated patients
phase I/II trial
chemotherapy
docetaxel
S-1
immunotherapy
rechallenge
retrospective analysis
pulmonary pleomorphic carcinoma
prognostic factor
glucose transporter 1
lung cancer
multiple cancers
metastasis
sequencing
mutation
genomic diagnosis
FDG-PET
immune checkpoint inhibitor
PD-1
prognosis
RAD51B methylation
PD-L1 expression
predictive biomarker
PD-1 blockade
interstitial lung disease
pulmonary fibrosis
radiology and other imaging
non-small-cell lung cancer
epidermal growth factor receptor
tyrosine kinase inhibitors
TP53 mutations
responsiveness
targeted therapy
network meta-analysis
stage IIIA-N2
surgery
immune checkpoint inhibitors
biomarker
nonsmall cell lung cancer
HIP1R
PD-L1
RUNX1
methylation
survival
EGFR-TKI
T790M
osimertinib
immune-related adverse events
endocrine disorders
tumor-bearing patients
PD-1 inhibitors
PD-L1 inhibitors
meta-analysis
nivolumab
Expanded Access Program
real-world data
daily practice
prognostic factors
NSCLC
KRAS
DNA polymerase beta
platinum-based first-line
adjuvant chemotherapy
β-catenin
lung neoplasms
nucleotide-diphosphate kinase
recurrence
unresectable
salvage surgery
oligometastasis
thema EDItEUR::M Medicine and Nursing
url ONIX_20220111_9783036501307_883