Personalized medicine in non-small cell lung cancer: a review from a pharmacogenomics perspective

Abstract

Non-small cell lung cancer is a prevalent and rapidly-expanding challenge to modern medicine. While generalized medicine with traditional chemotherapy yielded comparatively poor response rates and treatment results, the cornerstone of personalized medicine using genetic profiling to direct treatment has exalted the successes seen in the field and raised the standard for patient treatment in lung and other cancers. Here, we discuss the current state and advances in the field of personalized medicine for lung cancer, reviewing several of the mutation-targeting strategies that are approved for clinical use and how they are guided by patient genetic information. These classes include inhibitors of tyrosine kinase (TKI), anaplastic lymphoma kinase (ALK), and monoclonal antibodies. Selecting from these treatment plans and determining the optimal dosage requires in-depth genetic guidance with consideration towards not only the underlying target genes but also other factors such as individual metabolic capability and presence of resistance-conferring mutations both directly on the target gene and along its cascade(s). Finally, we provide our viewpoints on the future of personalized medicine in lung cancer, including target-based drug combination, mutation-guided drug design and the necessity for data of population genetics, to provide rough guidance on treating patients who are unable to get genetic testing.

Exosomes with low miR-34c-3p expression promote invasion and migration of non-small cell lung cancer by upregulating integrin α2β1

“…3 Understanding the molecular mechanisms involved in the development of NSCLC will help in prognosis and in the development of novel therapeutic targets. 4 Exosomes are endosome-derived vesicles (30-120 nm in size) formed in the vesicular bodies of the endosomal network. They serve an essential function in cellular communication.…”

CD44 inhibition attenuates EGFR signaling and enhances cisplatin sensitivity in human EGFR wild‑type non‑small‑cell lung cancer cells

“…Non-small cell lung cancer (NSCLC) is one of the leading causes of cancer related death in the world, with its 5-year survival rate <20% after diagnosis (1). Although targeted molecular therapy has achieved great success in treatment of NSCLC, it is usually limited to a group of patients harboring drug-sensitive epidermal growth factor receptor (EGFR) mutations (2). Platinum-based chemotherapy remains the main treatment option for NSCLC with wild-type EGFR, but the efficacy is still not satisfactory.…”

Apatinib induces 3‐hydroxybutyric acid production in the liver of mice by peroxisome proliferator‐activated receptor α activation to aid its antitumor effect

“…Apatinib was obtained from Jiangsu Hengrui Medicine Co. Purified water was produced by a Milli-Q system (Millipore). [1,[2][3][4][5][6][7][8][9][10][11][12][13] C 2 ] Myristic acid, methoxyamine hydrochloride (purity 98%), alkane solution (C8-C40), and pyridine (99.8% GC) were purchased from Sigma-Aldrich. MSTFA (N-methyl-N-trimethylsilyltrifluoroacetamide) and 1% TMCS (trimethylchlorosilane) were obtained from Pierce Chemical Company.…”