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, t...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.展开更多
Non-small cell lung cancer is recognized as the deadliest cancer across the globe.In some areas,it is more common in women than even breast and cervical cancer.Its rise,vaulted by smoking habits and increasing air pol...Non-small cell lung cancer is recognized as the deadliest cancer across the globe.In some areas,it is more common in women than even breast and cervical cancer.Its rise,vaulted by smoking habits and increasing air pollution,has garnered much attention and resource in the medical field.The first lung cancer treatments were developed more than half a century ago.Unfortunately,many of the earlier chemotherapies often did more harm than good,especially when they were used to treat genetically unsuitable patients.With the introduction of personalized medicine,physicians are increasingly aware of when,how,and in whom,to use certain anti-cancer agents.Drugs such as tyrosine kinase inhibitors,anaplastic lymphoma kinase inhibitors,and monoclonal antibodies possess limited utility because they target specific oncogenic mutations,but other drugs that target mechanisms universal to all cancers do not.In this review,we discuss many of these non-oncogene-targeting anti-cancer agents including DNA replication inhibitors(i.e.,alkylating agents and topoisomerase inhibitors)and cytoskeletal function inhibitors to highlight their application in the setting of personalized medicine as well as their limitations and resistance factors.展开更多
文摘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.
文摘Non-small cell lung cancer is recognized as the deadliest cancer across the globe.In some areas,it is more common in women than even breast and cervical cancer.Its rise,vaulted by smoking habits and increasing air pollution,has garnered much attention and resource in the medical field.The first lung cancer treatments were developed more than half a century ago.Unfortunately,many of the earlier chemotherapies often did more harm than good,especially when they were used to treat genetically unsuitable patients.With the introduction of personalized medicine,physicians are increasingly aware of when,how,and in whom,to use certain anti-cancer agents.Drugs such as tyrosine kinase inhibitors,anaplastic lymphoma kinase inhibitors,and monoclonal antibodies possess limited utility because they target specific oncogenic mutations,but other drugs that target mechanisms universal to all cancers do not.In this review,we discuss many of these non-oncogene-targeting anti-cancer agents including DNA replication inhibitors(i.e.,alkylating agents and topoisomerase inhibitors)and cytoskeletal function inhibitors to highlight their application in the setting of personalized medicine as well as their limitations and resistance factors.
