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Treatment of lung adenocarcinoma by molecular-targeted therapy and immunotherapy

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Abstract

Lung adenocarcinoma (LADC) is a cancer treatable using targeted therapies against driver gene aberrations. EGFR mutations and ALK fusions are frequent gene aberrations in LADC, and personalized therapies against those aberrations have become a standard therapy. These targeted therapies have shown significant positive efficacy and tolerable toxicity compared to conventional chemotherapy, so it is necessary to identify additional druggable genetic aberrations. Other than EGFR mutations and ALK fusions, mutations in KRAS, HER2, and BRAF, and driver fusions involving RET and ROS1, have also been identified in LADC. Interestingly, the frequency of driver gene aberrations differs according to ethnicity, sex, and smoking, which leads to differences in treatment efficacy. To date, several molecular-targeted drugs against driver genes have been developed, and several clinical trials have been conducted to evaluate the efficacy. However, targeted therapies against driver-gene-negative cases have not yet been well developed. Efforts to identify a new druggable target for such cases are currently underway. Furthermore, immune checkpoint blockade therapy might be effective for driver-negative cases, especially those with accumulated mutations.

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Acknowledgements

This work was supported by JSPS KAKENHI Grant Number 15K10275.

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Authors and Affiliations

  1. Division of Genome Biology, National Cancer Center Research Institute, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 1040045, Japan

    Motonobu Saito & Takashi Kohno

  2. Department of Chest Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan

    Motonobu Saito & Hiroyuki Suzuki

  3. Department of Gastrointestinal Tract Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan

    Motonobu Saito & Koji Kono

  4. Advanced Clinical Research Center, Fukushima Global Medical Science Center, Fukushima Medical University, Fukushima, Japan

    Seiichi Takenoshita

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  1. Motonobu Saito
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  2. Hiroyuki Suzuki
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  4. Seiichi Takenoshita
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  5. Takashi Kohno
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Correspondence to Motonobu Saito.

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Saito, M., Suzuki, H., Kono, K. et al. Treatment of lung adenocarcinoma by molecular-targeted therapy and immunotherapy. Surg Today 48, 1–8 (2018). https://doi.org/10.1007/s00595-017-1497-7

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