The Treatment of Metastatic Non-small Cell Lung Cancer (NSCLC) in New Era of Personalised Medicine

Abstract

Lung cancer is the leading cause of cancer related mortality in Canada and USA. Majority of the patients present in advanced stage of the disease and of these only about 2% will be alive at 5 years. NSCLC is the most common form of lung cancer, accounting for approximately 87% of cases. Systemic chemotherapies have been used to treat metastatic NSCLC for decades, but the improvements of outcomes have reached a plateau. Recent advances in understanding signalling pathways for malignant cells, their interconections,the importance of various receptors and biomarkers and the interplay between various oncogenes have led to the development of targeted treatments that are improving both efficacy and safety of the treatments. Knowledge about the advantages of treatments with the targeted agents in metastatic NSCLC is growing rapidly. Combining various targeted agents or sequencing them properly will be important in the era of personalised medicine and overcoming development of the resistence to various targeted agents will be challenging. The importance of a team work,from the diagnosis through various treatments, to supportive care, from the interventional radiologists, pneumologists or surgeons, who have to obtain a satisfactory tumor tissue specimen, to pathologists, radiation and medical oncologists, to supportive care specialists, will be described in our publications. We will cover completely present and future approaches to personalised medicine in this rapidly evolving field of metastatic NSCLC.