Clinical testing for molecular targets for personalized treatment in lung cancer

Authors

  • DAVID C.L. LAM

    Corresponding author
    1. Department of Medicine, University of Hong Kong, Hong Kong, China
      David C.L. Lam, Department of Medicine, University of Hong Kong, Queen Mary Hospital, 102, Pokfulam Road, Hong Kong, China. Email: dcllam@hku.hk
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  • The Author: David C.L. Lam is Clinical Assistant Professor at the University of Hong Kong with research interests in molecular pathogenesis and clinical therapeutics of lung cancer, airway disorders, smoking and lung functions.

  • SERIES EDITORS: JOHN E. HEFFNER AND DAVID C.L. LAM

David C.L. Lam, Department of Medicine, University of Hong Kong, Queen Mary Hospital, 102, Pokfulam Road, Hong Kong, China. Email: dcllam@hku.hk

ABSTRACT

Lung cancer is the leading cause of cancer mortality worldwide. Over the past decades, the management of advanced stage lung cancer has been revolutionized from very limited options of systemic chemotherapy with limited efficacy to the present stage of testing for biomarkers (epidermal growth factor receptor (EGFR), gene mutations) to guide therapeutic decision and to improve efficacy of treatment. Relevant advancement in understanding of lung cancer biology also revealed that different lung tumours may carry different cancer driver gene mutations and thus adopt different carcinogenic pathways. These cancer driver gene mutations were found to be mutually exclusive in individual lung tumour further supporting the rationale of testing tumour sample for the presence of these mutations, especially when there could be corresponding specific agents against these molecular targets. The aim of this article is to review the current understanding of molecular targets that are important in the personalized therapy of lung cancer and how the testing for these molecular targets, namely EGFR, KRAS and ALK, will guide therapeutic decision in advanced stage lung cancer.

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