Lung cancer: New biological insights and recent therapeutic advances

Authors

  • Suresh S. Ramalingam MD,

    1. Associate Professor, Department of Hematology and Medical Oncology and The Winship Cancer Institute, Emory University, Atlanta, GA
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  • Taofeek K. Owonikoko MD, PhD,

    1. Assistant Professor, Department of Hematology and Medical Oncology and The Winship Cancer Institute, Emory University, Atlanta, GA
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  • Fadlo R. Khuri MD

    Corresponding author
    1. Professor and Chair of Hematology and Medical Oncology, Roberto C. Goizueta Distinguished Chair in Translational Cancer Research, Department of Hematology and Medical Oncology and The Winship Cancer Institute, Emory University, Atlanta, GA
    • Department of Hematology and Medical Oncology, Emory University School of Medicine, 1365 Clifton Road NE, Atlanta, GA 30322
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  • DISCLOSURES: Supported by National Cancer Institute grant 1PO1 CA116676 and the Distinguished Cancer Clinical Scholar Award by the Georgia Cancer Coalition to all the coauthors. Dr. Ramalingam has served on Ad Hoc Advisory Board for Lilly, Genentech, OSI Pharmaceuticals, Astellas, GlaxoSmithKline, and ImClone. Dr. Khuri serves as a consultant for Pfizer.

Abstract

Approximately 1.6 million new cases of lung cancer are diagnosed each year throughout the world. In many countries, the mortality related to lung cancer continues to rise. The outcomes for patients with all stages of lung cancer have improved in recent years. The use of systemic therapy in conjunction with local therapy has led to improved cure rates in both resectable and unresectable patient groups. For patients with advanced stage disease, modest but real improvements in overall survival and quality of life have been achieved with systemic chemotherapy. A major focus of research has been the development of molecularly targeted agents and the identification of biomarkers for patient selection. Patients with non-small cell lung cancer with mutations in the epidermal growth factor receptor (EGFR) tyrosine kinase domain achieve response rates of greater than 70% and superior progression-free survival when treated with an EGFR tyrosine kinase inhibitor compared with standard chemotherapy. This has now emerged as the preferred therapeutic approach for the subset of patients with a mutation in exons 19 or 21 of the EGFR. Another promising targeted approach involves the use of an anaplastic lymphoma kinase (ALK) inhibitor in patients with a translocation involving the echinoderm microtubule-associated protein-like 4 (EML4) and -ALK genes. Finally, a paradigm shift in favor of maintenance therapy for patients with advanced stage disease has gained strength from recent data. All of these advances have been made possible by developing a greater understanding of the biology, the discovery of novel anticancer agents, and improved supportive care measures. This article reviews the major strides made in the treatment of lung cancer in the recent past. CA Cancer J Clin 2011. © 2011 American Cancer Society, Inc.

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