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New Treatment Options for Lung Adenocarcinoma - in View of Molecular Background

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Pathology & Oncology Research

Abstract

Lung cancer is the leading cause of cancer related mortality all over the world, and a number of developments have indicated future clinical benefit recently. The development of molecular pathology methods has become increasingly important in the prediction of chemotherapy sensitivity and mutation analysis to identify driver mutations as important targets of new therapeutic agents. The most significant changes in the treatment of NSCLC revealed in new pathologic classification and in the introduction of molecularly targeted therapies, which include monoclonal antibodies and small molecule tyrosine kinase inhibitors. The side effects of these agents are generally better tolerated than those of conventional chemotherapy and show higher efficacy. The most important factor follows: histology subtypes, gene mutation status, patients’ selection, drug toxicities and occurence of drug resistance. In the advanced disease, the hope of cure is less than 3 %, but improvements in survival have been clearly achieved. Some years ago the median lung cancer survival rate was 10–12 months, now in case of available specific molecular targets, a significant increase in median survival rates to 24–36 months has been achieved. These agents give an opportunity to provide a new standard of care. Therefore testing EGFR mutations and ALK rearrangements in patients with advanced lung adenocarcinoma should be incorporated into routine clinical practice. This review focuses on the rationale for targeted agents and new treatment possibilities in case of advanced lung adenocarcinoma.

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Abbreviations

NSCLC:

Non-small cell lung cancer

SCLC:

Small cell lung cancer

NOS:

Not otherwise specified

EGFR:

Epidermal growth factor receptor

VEGFR:

Vascular endothelial growth factor receptor

PDGFR:

Platelet-derived growth factor receptor

ALK:

Anaplastic lymphoma kinase

TKI:

Tyrosine kinase inhibitor

PFS:

Progression free survival

OS:

Overall survival

ORR:

Overall response rate

QOL:

Quality of life

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Authors and Affiliations

  1. National Institute of Oncology, Budapest, Hungary

    Nora Bittner & Lajos Géczi

  2. National Korányi TB and Pulmonology Institute, Budapest, Hungary

    Gyula Ostoros

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  1. Nora Bittner
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  2. Gyula Ostoros
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  3. Lajos Géczi
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Correspondence to Nora Bittner.

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Bittner, N., Ostoros, G. & Géczi, L. New Treatment Options for Lung Adenocarcinoma - in View of Molecular Background. Pathol. Oncol. Res. 20, 11–25 (2014). https://doi.org/10.1007/s12253-013-9719-9

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