Non-small-cell lung cancer: molecular targeted therapy and personalized medicine - drug resistance, mechanisms, and strategies

Abstract

Targeted therapies for cancer bring the hope of specific treatment, providing high efficacy and in some cases lower toxicity than conventional treatment. Although targeted therapeutics have helped immensely in the treatment of several cancers, like chronic myelogenous leukemia, colon cancer, and breast cancer, the benefit of these agents in the treatment of lung cancer remains limited, in part due to the development of drug resistance. In this review, we discuss the mechanisms of drug resistance and the current strategies used to treat lung cancer. A better understanding of these drug-resistance mechanisms could potentially benefit from the development of a more robust personalized medicine approach for the treatment of lung cancer.

Keywords: NSCLC; drug targets; lung cancer; personalized medicine.

Figure 1

A hypothetical line of treatment based on the availability of a range of targeted therapies. Notes: An initial tumor is treated with its appropriate therapy. Upon resistance via mutations or clonal selection, the cancer can be sensitized with a different drug. This process of personalized medicine might not cure the disease, but rather keeps the disease under constant submission. Abbreviations: ALK, anaplastic lymphoma kinase; ELM4, echinoderm microtubule-associated protein-like 4; EGFR, epidermal growth factor receptor.