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Personalized medicine in lung cancer: what we need to know

Nature Reviews Clinical Oncology volume 8, pages 661–668 (2011)Cite this article

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Abstract

Lung cancer is a complex and often fatal disease. The recent discovery of activating mutations in EGFR and fusion genes involving ALK has set the stage for personalized medicine for lung cancer. Patients selected using biomarkers have benefited from the development of EGFR tyrosine kinase inhibitors and ALK inhibitors with considerable improvement in tumor control and survival. Four key areas of knowledge that are essential to the development of targeted therapy are discussed in this Review: knowing the target, knowing the biomarker, knowing the end point and knowing the mechanisms of resistance.

Key Points

  • Personalized medicine should be based on a molecular target that drives cancer cell proliferation, the inhibition of which would cease tumor growth

  • Predictive biomarkers are crucial to identify patients with molecular targets, who are likely to respond better to targeted therapies than to standard therapy

  • Progression-free survival could be an appropriate primary end point in randomized comparative studies with considerable crossover, as overall survival of the two groups would be similar

  • It is likely that patients who benefit from molecular-targeted therapy will eventually become resistant to the drug; understanding the mechanisms of resistance is essential to prevent or defer this process

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Figure 1: Overall survival in patients with mutations in EGFR receiving TKIs and chemotherapy.

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Authors and Affiliations

  1. Department of Clinical Oncology, The Chinese University of Hong Kong, State Key Laboratory of South China, Sha Tin, Hong Kong, China

    Tony S. K. Mok

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Competing interests

T. S. K. Mok declares he is a consultant and receives honoraria from AstraZeneca, Boehringer Ingelheim, Merck Serono, Pfizer and Roche. He also receives research grants from AstraZeneca.

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Mok, T. Personalized medicine in lung cancer: what we need to know. Nat Rev Clin Oncol 8, 661–668 (2011). https://doi.org/10.1038/nrclinonc.2011.126

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