Treatment of subtypes in non-small cell lung cancer

Abstract

Lung cancer accounts for the highest number of cancer related deaths among all cancer patients. It has been well established that exposure to tobacco significantly increases the risk of developing lung cancer. Non-small cell lung cancer (NSCLC) is diagnosed in almost 80% of all lung cancer patients. Despite different subtypes of NSCLC, treatment regimens to not distinguish between subtypes. Different stages and localization of determine treatment with surgery, radiotherapy or systemic cytotoxic agents. Adenocarcinoma, squamous cell carcinoma and large cell carcinoma are the three major subtypes make up 90% of all NSCLC patients. Differences in morphology, differentiation, smoking history and genetic alterations determine these subtypes. A new generation anti-cancer drugs have been designed to specifically target tumor-specific alterations such as amplifications or mutations. Various clinical trials have shown the importance of pretreatment screening for specific alterations that can be targeted by targeted therapies. Mutations and amplification of the epidermal growth factor have made it an interesting target for new drug development with tyrosine kinase inhibitors and mono-clonal antibodies as result. The future of NSCLC treatment will be based on individualized medicine in which molecular mechanisms underlying tumor development will be of most importance.