Lung Cancer: Precision Oncology and Immunotherapy in a Rapidly Advancing Landscape
Lung cancer remains the leading cause of cancer-related death worldwide and is broadly categorized into non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). NSCLC accounts for 85% of cases and includes adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.
Targeted Therapy and Biomarker Testing
Advances in genomic profiling have revolutionized treatment. Key actionable mutations include:
- EGFR – Targeted by osimertinib (Tagrisso®)
- ALK – Treated with alectinib (Alecensa®) or lorlatinib (Lorbrena®)
- ROS1, MET, RET, BRAF, NTRK, KRAS G12C – With their own specific inhibitors
Biomarker-driven therapy improves response rates and delays disease progression.
Immunotherapy
Checkpoint inhibitors like pembrolizumab (Keytruda®) and nivolumab (Opdivo®) target PD- 1/PD-L1, enabling the immune system to attack tumor cells. These agents are standard for advanced NSCLC, both as monotherapy and in combination with chemotherapy, and are also approved for limited-stage SCLC.
Future Directions
Next-generation inhibitors for resistance mutations (e.g., EGFR exon 20, KRAS G12D), novel ADCs, and combination immunotherapies are shaping a more personalized approach to lung cancer care.