Published On: 26th March, 2024
ABSTARCT
In the field of lung cancer research with recent advancements the focus has lately been towards personalized treatment strategies in which molecular targeted therapies and immunotherapies are being commonly used. Among these, the arrival of EGFR and ALK inhibitors has revolutionized the management of non-small cell lung cancer (NSCLC).Especially agents like osimertinib and alectinib have demonstrated remarkable efficacy in overcoming resistance mechanisms. There are also targeted approaches such as immunotherapy which uses the body’s own immune system to combat cancer. The effectiveness of drugs like pembrolizumab and nivolumab shows how important immunotherapy is for treating lung cancer. Also, by using biomarkers to guide treatment has made lung cancer care more accurate and successful.
KEYWORDS:
Lung cancer, Molecular Targeted Therapies, Biomarker-Directed Therapies.
INTRODUCTION
Lung cancer stands as the foremost contributor to cancer-related mortality worldwide. Significant risk factors include exposure to asbestos, radon, air pollution and infections like TB and HIV[1].Two primary types of cancer include non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC)[2]. Approximately 84% of lung cancer cases are classified as non–small cell lung cancer (NSCLC), while about 13% are categorized as small-cell lung cancer (SCLC)[3]. Recent advancements in thoracic oncology have led to the emergence of promising treatment combinations like paclitaxel, atezolizumab and bevacizumab for lung cancer patients highlighting the importance of tailored approaches guided by factors such as PD-L1 status and mutational profiling[4].This review will take a closer look at lung cancer research and discuss recent discoveries and promising treatments.
LITERATURE REVIEW
Molecular Targeted Therapies
Patients with non-small cell lung cancer (NSCLC) with ALK gene rearrangements, alectinib has emerged as the preferred first-line therapy due to its superior efficacy in extending progression-free survival (PFS). BRAF-mutant NSCLC may benefit from combined BRAF and MEK inhibition as the primary treatment choice. while ongoing exploration of targeted agents holds promise for improving outcomes in HER2-altered NSCLC[5]. Dacomitinib is a second-generation EGFR inhibitor which has demonstrated PFS. Meanwhile, osimertinib a third-generation EGFR inhibitor has shown significant efficacy in both first-line and T790M mutation-positive metastatic NSCLC. EGFR antibodies such as necitumumab and inhibitors targeting anaplastic lymphoma kinase (ALK)[6].
Immunotherapy
Immunotherapy revolutionizes lung cancer treatment with FDA-approved medications like Nivolumab and Pembrolizumab. Antibody-based therapies including antibody-drug conjugates (ADCs) and bispecific antibodies (BiTEs) expand treatment options for refractory lung cancer. Oncolytic viruses (OVs) show promise in inducing anti-tumor immune responses and overcoming immune evasion mechanisms[7]. Immunotherapy including anti-PD-1/anti-PD-L1 and anti-CTLA4 agents has revolutionized NSCLC treatment and combinations with chemotherapy show superior efficacy in first-line treatment[8]. Novel immune checkpoint targets like TIGIT, LAG-3, TIM-3, NKG2A and CD73 show promise in overcoming resistance to traditional ICIs in lung cancer and by combining therapies targeting these checkpoints have demonstrated improved response in early clinical trials[9].
Biomarker-Directed Therapies
Recent advances in lung cancer treatment have used mutation-based biomarkers like EGFR, ALK, ROS1, BRAF and MET which offers nearly 100% predictive value for guiding targeted therapy decisions. PD-L1 expression and tumour mutation burden (TMB) also holds promise in optimizing treatment responses. [10]. Other potential biomarkers include the prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio (NLR), enterobacterial status and early reduction in tumor markers. High PNI and irAE frequency are associated with improved ICI efficacy[11].Molecular tumour boards can help with treatment classification and biomarker identification .Patients with advanced cancer must ideally get biomarker-directed therapy as soon as possible since doing so increases response rates and overall survival [12].
CONCLUSION
To sum up, the landscape of lung cancer treatment has been evolved significantly, with a focus on precision medicine and immunotherapy. These emerging therapies hold the potential to transform the prognosis for patients with lung cancer and using immunomodulatory agents and by targeting specific genetic alterations.
REFERNCES (APA)
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