Michels, Sebastian and Wolf, Juergen (2018). Treatment of stage IV non-small cell lung cancer with driver mutations. Onkologe, 24 (12). S. 983 - 992. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0415

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Abstract

BackgroundSystemic treatment of non-small cell lung cancer (NSCLC) is currently undergoing aparadigmatic change with impressive dynamics. Patients with advanced disease are treated based on the analysis of biomarkers either with immunotherapy, acombination of immunotherapy with chemotherapy or with driver mutation-directed targeted drugs. Treatment of acquired resistance remains aparticular challenge. An increasing knowledge of the molecular mechanisms underlying resistance enables the development of more potent inhibitors.ObjectiveThis review focuses on the state of the art and current developments in targeted therapy of advanced stage NSCLC.Material and methodsThis review is based on the summary and interpretation of publications on preclinical and clinical studies in the field of targeted treatment of advanced NSCLC.Results and conclusionTargeted treatments against activating mutations in the EGFR and BRAF genes as well as ALK and ROS1 fusions define the standard first line treatment for approximately 15% of patients with advanced NSCLC. In retrospective analyses this development has led to asubstantially prolonged overall survival in these subgroups. Targeted therapies against further aberrations are in clinical evaluation and atargeted treatment is currently available for approximately 30% of patients. Next generation inhibitors are characterized by a high effectiveness against tumors with acquired resistance to tyrosine kinase inhibitors (TKI) and improved tolerability and are increasingly being used as first line treatment. In order to understand the molecular causes and to select the most effective treatment, rebiopsies play a special role in resistance.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Michels, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wolf, JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-164173
DOI: 10.1007/s00761-018-0473-1
Journal or Publication Title: Onkologe
Volume: 24
Number: 12
Page Range: S. 983 - 992
Date: 2018
Publisher: SPRINGER HEIDELBERG
Place of Publication: HEIDELBERG
ISSN: 1433-0415
Language: German
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
OPEN-LABEL; ALK; CHEMOTHERAPY; ROS1; OSIMERTINIB; CRIZOTINIB; ADENOCARCINOMA; MULTICENTER; RESISTANCE; INHIBITORMultiple languages
OncologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/16417

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