Personalized therapy of lung cancer

Abstract

The implementation of personalized approaches in the treatment of patients with non-small cell lung cancer (NSCLC) requires a precise understanding of tumor biology, a reorientation of clinical development with a strong focus on genetically stratified early phase 'proof of concept' trials, the availability of high-quality 'realtime' genetic diagnostics, and the establishment of networks for molecular screening of lung cancer patients. To achieve this goal, a close interaction between basic researchers, clinical scientists, molecular pathologists, and pharmaceutical companies is essential. We believe that this approach is worth the effort, since personalized therapy in lung cancer has the potential to substantially improve survival in an increasing number of patients. At the moment, established personalized treatment approaches include treatment of patients with NSCLC and activating epidermal growth factor receptor (EGFR) mutations with the EGFR-directed tyrosine kinase inhibitors gefitinib or erlotinib, and treatment of NSCLC patients with genetic aberrations in the anaplastic lymphoma kinase (ALK) oncogene with the mesenchymal-epithelial transition factor (MET)/ALK inhibitor crizotinib. A new approach, the treatment of fibroblast growth factor receptor 1 (FGFR1)-amplified squamous cell lung cancer patients with FGFR inhibitors, is currently being tested in phase I clinical trials.