With the understanding of the molecular properties of cancer, studies have focused on targeted therapies. Thanks to the cellular and molecular mechanism studies on lung cancer, significant progress has been made in the epidemiology, prognosis, diagnosis, and treatment of the disease.
Lung cancer is one of the most common cancer types in the world with an incidence of 11.4% and a mortality rate of 18%. Smoking, age, race, gender, occupation, air pollution, radiation, and genetic and immunological factors are also among the etiological factors in the etiology of lung cancer. Lung cancer is divided into two main classes as small cell (15%) and non-small cell (85%) according to its biology, treatment, and prognosis.
Activation of oncogenes and inactivation of tumor suppressor genes are the most important genetic factors in the development of lung cancer. Targetable changes with approved agents currently used in lung adenocarcinomas include point mutations, in-frame deletions, splice variants, and translocations in genes such as EGFR, ALK, BRAF, RET, NTRK1-2-3, ROS1, MET, ERRB2, and KRAS.
The NCCN NSCLC Panel recommends molecular testing for eligible patients with metastatic NSCLC. Clinical guidelines emphasize that the EGFR-ALK-ROS panel should be requested by the clinician in all advanced or metastatic lung adenocarcinomas. The survival rate is longer in patients receiving targeted therapy.Especially in EGFR E19 del, L858R mutation, ALK and ROS rearrangements, there is a TKI response. Patients may develop resistance after treatment. Many promising studies continue on the development of therapeutic agents against these resistance mechanisms in targeted therapies. As the data obtained from the studies increase, personalized alternative treatment options will emerge in the future.