Affiliation:
1. Department of Clinical Medicine and Surgery, University Federico II of Naples, Italy
2. Department of Medicine, Division of Hematology-Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, United States
Abstract
Lung cancer is the leading cause of cancer-related mortality around the world, despite effective chemotherapeutic
agents, the prognosis has remained poor for a long time. The discovery of molecular changes that
drive lung cancer has led to a dramatic shift in the therapeutic landscape of this disease. In “in vitro” and “in
vivo” models of NSCLC (Non-Small Cell Lung Cancer), angiogenesis blockade has demonstrated an excellent
anti-tumor activity, thus, a number of anti-angiogenic drugs have been approved by regulatory authorities for
use in clinical practice. Much more interesting is the discovery of EGFR (Epithelial Growth Factor Receptor)
mutations that predict sensitivity to the anti-EGFR Tyrosine Kinase Inhibitors (TKIs), a class of drugs that has
shown to significantly improve survival when compared with standard chemotherapy in the first-line treatment
of metastatic NSCLC. Nevertheless, after an initial response, resistance often occurs and prognosis becomes
dismal. Biomolecular studies on cell line models have led to the discovery of mutations (e.g., T790M) that confer
resistance to anti-EGFR inhibitors. Fortunately, drugs that are able to circumvent this mechanism of resistance
have been developed and have been recently approved for clinical use. The discovery of robust intratumor
lymphocyte infiltration in NSCLC has paved the way to several strategies able to restore the immune
response. Thus, agents interfering with PD-1/PD-L1 (Programmed Death) pathways make up a significant portion
of the armamentarium of cancer therapies for NSCLC. In all the above-mentioned situations, the basis of
the success in treating NSCLC has started from understanding of the mutational landscape of the tumor.
Publisher
Bentham Science Publishers Ltd.
Subject
Cancer Research,Pharmacology,Molecular Medicine
Cited by
8 articles.
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