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Non-small Cell Lung Cancer: Current Therapies and New Targeted Treatments
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Year: 2021 Publisher: Basel, Switzerland MDPI - Multidisciplinary Digital Publishing Institute

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Abstract

Conventional lung cancer treatments were once limited to surgery, radiation, and chemotherapy. However, gefitinib, a targeted drug, was launched in 2004, and the situation changed. Cancer cases that were highly responsive to gefitinib were later discovered to have epithelial growth factor receptor (EGFR) mutations. This discovery opened the door for biomarker-based treatment strategies. Subsequently, several EGFR-tyrosine kinase inhibitors (TKI) were developed, and they became a new mainstay of treatment for non-small cell lung cancer. In recent years, many mechanisms of resistance to EGFR-TKI have been elucidated; a mutation in the T790M gene at exon 20 is found in half of the resistant cases. Hence, osimertinib, which specifically inhibits EGFR despite this T790M gene mutation, was developed to achieve long-term progression-free survival. Other driver mutations that are similar to the EGFR mutation were discovered, including the EML4-ALK fusion gene (discovered in 2007), ROS1 gene, and BRAF gene mutations. The TKIs for each of these fusion genes were developed and are used as therapeutic agents. Another advancement in advanced non-small cell lung cancer is the development of immune checkpoint inhibitors. Four PD-1/PD-L1 inhibitors, including nivolumab, are currently available for treatment of lung cancer. These drugs prevent an escape from the cancer immunity cycle. This ensures that cancer cells will express cancer antigens, causing an anticancer immune response. Due to cancer immunotherapy, long-term survival is possible. The biomarker development for cancer immunotherapy and its side effects are actively being studied.

Keywords

Medicine --- non-small cell lung cancer --- previously treated patients --- phase I/II trial --- chemotherapy --- docetaxel --- S-1 --- immunotherapy --- rechallenge --- retrospective analysis --- pulmonary pleomorphic carcinoma --- prognostic factor --- glucose transporter 1 --- lung cancer --- multiple cancers --- metastasis --- sequencing --- mutation --- genomic diagnosis --- FDG-PET --- immune checkpoint inhibitor --- PD-1 --- prognosis --- RAD51B methylation --- PD-L1 expression --- predictive biomarker --- PD-1 blockade --- interstitial lung disease --- pulmonary fibrosis --- radiology and other imaging --- non-small-cell lung cancer --- epidermal growth factor receptor --- tyrosine kinase inhibitors --- TP53 mutations --- responsiveness --- targeted therapy --- network meta-analysis --- stage IIIA-N2 --- surgery --- immune checkpoint inhibitors --- biomarker --- nonsmall cell lung cancer --- HIP1R --- PD-L1 --- RUNX1 --- methylation --- survival --- EGFR-TKI --- T790M --- osimertinib --- immune-related adverse events --- endocrine disorders --- tumor-bearing patients --- PD-1 inhibitors --- PD-L1 inhibitors --- meta-analysis --- nivolumab --- Expanded Access Program --- real-world data --- daily practice --- prognostic factors --- NSCLC --- KRAS --- DNA polymerase beta --- platinum-based first-line --- adjuvant chemotherapy --- β-catenin --- lung neoplasms --- nucleotide-diphosphate kinase --- recurrence --- unresectable --- salvage surgery --- oligometastasis


Book
Non-small Cell Lung Cancer: Current Therapies and New Targeted Treatments
Author:
Year: 2021 Publisher: Basel, Switzerland MDPI - Multidisciplinary Digital Publishing Institute

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Abstract

Conventional lung cancer treatments were once limited to surgery, radiation, and chemotherapy. However, gefitinib, a targeted drug, was launched in 2004, and the situation changed. Cancer cases that were highly responsive to gefitinib were later discovered to have epithelial growth factor receptor (EGFR) mutations. This discovery opened the door for biomarker-based treatment strategies. Subsequently, several EGFR-tyrosine kinase inhibitors (TKI) were developed, and they became a new mainstay of treatment for non-small cell lung cancer. In recent years, many mechanisms of resistance to EGFR-TKI have been elucidated; a mutation in the T790M gene at exon 20 is found in half of the resistant cases. Hence, osimertinib, which specifically inhibits EGFR despite this T790M gene mutation, was developed to achieve long-term progression-free survival. Other driver mutations that are similar to the EGFR mutation were discovered, including the EML4-ALK fusion gene (discovered in 2007), ROS1 gene, and BRAF gene mutations. The TKIs for each of these fusion genes were developed and are used as therapeutic agents. Another advancement in advanced non-small cell lung cancer is the development of immune checkpoint inhibitors. Four PD-1/PD-L1 inhibitors, including nivolumab, are currently available for treatment of lung cancer. These drugs prevent an escape from the cancer immunity cycle. This ensures that cancer cells will express cancer antigens, causing an anticancer immune response. Due to cancer immunotherapy, long-term survival is possible. The biomarker development for cancer immunotherapy and its side effects are actively being studied.


Book
Non-small Cell Lung Cancer: Current Therapies and New Targeted Treatments
Author:
Year: 2021 Publisher: Basel, Switzerland MDPI - Multidisciplinary Digital Publishing Institute

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Abstract

Conventional lung cancer treatments were once limited to surgery, radiation, and chemotherapy. However, gefitinib, a targeted drug, was launched in 2004, and the situation changed. Cancer cases that were highly responsive to gefitinib were later discovered to have epithelial growth factor receptor (EGFR) mutations. This discovery opened the door for biomarker-based treatment strategies. Subsequently, several EGFR-tyrosine kinase inhibitors (TKI) were developed, and they became a new mainstay of treatment for non-small cell lung cancer. In recent years, many mechanisms of resistance to EGFR-TKI have been elucidated; a mutation in the T790M gene at exon 20 is found in half of the resistant cases. Hence, osimertinib, which specifically inhibits EGFR despite this T790M gene mutation, was developed to achieve long-term progression-free survival. Other driver mutations that are similar to the EGFR mutation were discovered, including the EML4-ALK fusion gene (discovered in 2007), ROS1 gene, and BRAF gene mutations. The TKIs for each of these fusion genes were developed and are used as therapeutic agents. Another advancement in advanced non-small cell lung cancer is the development of immune checkpoint inhibitors. Four PD-1/PD-L1 inhibitors, including nivolumab, are currently available for treatment of lung cancer. These drugs prevent an escape from the cancer immunity cycle. This ensures that cancer cells will express cancer antigens, causing an anticancer immune response. Due to cancer immunotherapy, long-term survival is possible. The biomarker development for cancer immunotherapy and its side effects are actively being studied.

Keywords

Medicine --- non-small cell lung cancer --- previously treated patients --- phase I/II trial --- chemotherapy --- docetaxel --- S-1 --- immunotherapy --- rechallenge --- retrospective analysis --- pulmonary pleomorphic carcinoma --- prognostic factor --- glucose transporter 1 --- lung cancer --- multiple cancers --- metastasis --- sequencing --- mutation --- genomic diagnosis --- FDG-PET --- immune checkpoint inhibitor --- PD-1 --- prognosis --- RAD51B methylation --- PD-L1 expression --- predictive biomarker --- PD-1 blockade --- interstitial lung disease --- pulmonary fibrosis --- radiology and other imaging --- non-small-cell lung cancer --- epidermal growth factor receptor --- tyrosine kinase inhibitors --- TP53 mutations --- responsiveness --- targeted therapy --- network meta-analysis --- stage IIIA-N2 --- surgery --- immune checkpoint inhibitors --- biomarker --- nonsmall cell lung cancer --- HIP1R --- PD-L1 --- RUNX1 --- methylation --- survival --- EGFR-TKI --- T790M --- osimertinib --- immune-related adverse events --- endocrine disorders --- tumor-bearing patients --- PD-1 inhibitors --- PD-L1 inhibitors --- meta-analysis --- nivolumab --- Expanded Access Program --- real-world data --- daily practice --- prognostic factors --- NSCLC --- KRAS --- DNA polymerase beta --- platinum-based first-line --- adjuvant chemotherapy --- β-catenin --- lung neoplasms --- nucleotide-diphosphate kinase --- recurrence --- unresectable --- salvage surgery --- oligometastasis


Book
The Thorax
Authors: ---
ISBN: 3030272338 303027232X Year: 2020 Publisher: Cham : Springer International Publishing : Imprint: Springer,

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Abstract

This book highlights the differences, in terms of neoplastic dissemination pathways, between various types of thoracic cancers. It presents and discusses a comprehensive schematic overview of tumors of the lung parenchyma, of the mediastinum, of the pleura, and of the chest wall. For each tumor, it details the local spread and the lymphatic and vascular dissemination, and it describes the challenging staging of lung tumors with mutations. Illustrations and artwork enrich the content and help readers to understand and visualize tumor spread. The book is of great interest to professionals involved in the study, diagnosis and treatment of thoracic pathologies, as well as to residents in radiology, oncology and pulmonology.


Book
Overcoming resistance to EGFR inhibitors in EGFR mutant NSCLC
Author:
ISBN: 9780128228340 0128228342 9780128228333 0128228334 Year: 2023 Publisher: London, England ; San Diego, California ; Cambridge, Massachusetts : Academic press,

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Overcoming Resistance to EGFR Inhibitors in EGFR Mutant NSCLC presents updated information on how EGFR mutant lung cancers evolve to evade EGFR inhibitors, clinical strategies that identify these mechanisms, and how to implement newer therapeutic strategies to combat resistance and improve patient survival. As resistance to EGFR inhibitors is often through re-activation of MEK/ERK and PI3K pathways, or through loss of cell death responses, there is much overlap with resistance to targeted therapies in other paradigms, such as BRAF inhibitors in BRAF mutant melanoma, and HER2 inhibitors in HER2 amplified breast cancer.

Keywords

Antineoplastic Agents. --- Carcinoma, Non-Small-Cell Lung. --- Genes, erbB-1. --- Anticancer Agents --- Antineoplastic Drugs --- Antineoplastics --- Antitumor Agents --- Antitumor Drugs --- Cancer Chemotherapy Agents --- Cancer Chemotherapy Drugs --- Chemotherapeutic Anticancer Agents --- Chemotherapeutic Anticancer Drug --- Anticancer Agent --- Antineoplastic --- Antineoplastic Agent --- Antineoplastic Drug --- Antitumor Agent --- Antitumor Drug --- Cancer Chemotherapy Agent --- Cancer Chemotherapy Drug --- Agent, Anticancer --- Agent, Antineoplastic --- Agent, Antitumor --- Agent, Cancer Chemotherapy --- Agents, Anticancer --- Agents, Antineoplastic --- Agents, Antitumor --- Agents, Cancer Chemotherapy --- Agents, Chemotherapeutic Anticancer --- Chemotherapy Agent, Cancer --- Chemotherapy Agents, Cancer --- Chemotherapy Drug, Cancer --- Chemotherapy Drugs, Cancer --- Drug, Antineoplastic --- Drug, Antitumor --- Drug, Cancer Chemotherapy --- Drug, Chemotherapeutic Anticancer --- Drugs, Antineoplastic --- Drugs, Antitumor --- Drugs, Cancer Chemotherapy --- Cytotoxins --- Interferon Inducers --- Anticarcinogenic Agents --- Genes, erbB1 --- c-erbB-1 Proto-Oncogenes --- v-erbB Oncogenes --- EGFR Genes --- Epidermal Growth Factor Receptor Genes --- Genes, EGFR --- c-erbB-1 Genes --- erbB-1 Genes --- v-erbB Genes --- EGFR Gene --- Gene, erbB1 --- c erbB 1 Genes --- c erbB 1 Proto Oncogenes --- c-erbB-1 Gene --- c-erbB-1 Proto-Oncogene --- erbB 1 Genes --- erbB-1 Gene --- erbB1 Gene --- erbB1 Genes --- v erbB Genes --- v erbB Oncogenes --- v-erbB Gene --- v-erbB Oncogene --- Nonsmall Cell Lung Cancer --- Carcinoma, Non-Small Cell Lung --- Non-Small Cell Lung Cancer --- Non-Small Cell Lung Carcinoma --- Non-Small-Cell Lung Carcinoma --- Carcinoma, Non Small Cell Lung --- Carcinomas, Non-Small-Cell Lung --- Lung Carcinoma, Non-Small-Cell --- Lung Carcinomas, Non-Small-Cell --- Non Small Cell Lung Carcinoma --- Non-Small-Cell Lung Carcinomas --- Lung Neoplasms --- Carcinoma, Small Cell --- Drug resistance. --- Lungs --- Cancer --- Chemotherapy. --- Resistance to drugs --- Pharmacology --- ErbB Receptors --- Drug Resistance --- ErbB Receptors. --- Lung Neoplasms. --- Drug Resistance.

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