Lung cancer: current therapies and new targeted treatments

Abstract

Lung cancer is the most frequent cause of cancer-related deaths worldwide. Every year, 1·8 million people are diagnosed with lung cancer, and 1·6 million people die as a result of the disease. 5-year survival rates vary from 4-17% depending on stage and regional differences. In this Seminar, we discuss existing treatment for patients with lung cancer and the promise of precision medicine, with special emphasis on new targeted therapies. Some subgroups, eg-patients with poor performance status and elderly patients-are not specifically addressed, because these groups require special treatment considerations and no frameworks have been established in terms of new targeted therapies. We discuss prevention and early detection of lung cancer with an emphasis on lung cancer screening. Although we acknowledge the importance of smoking prevention and cessation, this is a large topic beyond the scope of this Seminar.

Tumor-infiltrating CD45RO+ memory cells correlate with favorable prognosis in patients with lung adenocarcinoma

“…The main classification of lung cancer includes small cell lung carcinoma (SCLC) and non-small cell lung cancer (NSCLC) (2). NSCLC, which accounts for 85% of all lung cancers, primarily comprises adenocarcinoma, squamous cell carcinoma, large cell carcinoma, sarcomatoid carcinoma, and adenosquamous cell carcinoma, among which lung adenocarcinoma is one of the most aggressive histological types in lung cancer and is the main subtype of NSCLC (3).…”

The integration of genomics testing and functional proteomics in the era of personalized medicine

“…ALK inhibitors (alectinib, ceritinib, and crizotinib) and EGFR inhibitors (afatinib, erlotinib, gefitinib, and osimertinib) are approved for the treatment of lung cancer patients with ALK fusions and EGFR mutations, respectively [16,17]. In contrast, FGFR inhibitors, such as AZD4547 [18], derazantinib (ARQ 087) [19], erdafitinib (JNJ-42756493) [20], infigratinib (BGJ398) [21], and LY2874455 [22], are in clinical trials for the treatment of cancer patients with alterations in FGFR family genes [23].…”

Can radiotherapy potentiate the effectiveness of immune checkpoint inhibitors in lung cancer?

“…By activating the immune system to recognize and eliminate cancer, immune checkpoint blockade has the potential to elicit durable responses and augment survival outcomes for a subset of patients [1,2]. In addition, the ability of radiotherapy to induce an immunogenic response and neutralize the immune-suppressive effects of the tumor microenvironment, uniquely positions it as a synergistic tool at the center of emerging multimodal therapies utilizing immune checkpoint blockade [3][4][5][6][7].Immune checkpoint inhibitors of the PD-1/PD-L1 pathway have emerged as a promising new therapeutic strategy [8][9][10][11]. These agents have produced durable clinical responses and antitumor activity in Phase I trials, leading to subsequent randomized Phase II and III trials that demonstrated significant improvements in overall survival when compared with cytotoxic chemotherapy alone [12][13][14][15][16].…”

“…Immune checkpoint inhibitors of the PD-1/PD-L1 pathway have emerged as a promising new therapeutic strategy [8][9][10][11]. These agents have produced durable clinical responses and antitumor activity in Phase I trials, leading to subsequent randomized Phase II and III trials that demonstrated significant improvements in overall survival when compared with cytotoxic chemotherapy alone [12][13][14][15][16].…”