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Review
. 2017 Apr 10:4:39.
doi: 10.3389/fmed.2017.00039. eCollection 2017.

Imprecision in the Era of Precision Medicine in Non-Small Cell Lung Cancer

Raghav Sundar  1   2 , Maxime Chénard-Poirier  1   3 , Dearbhaile Catherine Collins  1   3 , Timothy A Yap  1   3
Affiliations
Review

Imprecision in the Era of Precision Medicine in Non-Small Cell Lung Cancer

Raghav Sundar et al. Front Med (Lausanne). .

Abstract

Over the past decade, major advances have been made in the management of advanced non-small cell lung cancer (NSCLC). There has been a particular focus on the identification and targeting of putative driver aberrations, which has propelled NSCLC to the forefront of precision medicine. Several novel molecularly targeted agents have now achieved regulatory approval, while many others are currently in late-phase clinical trial testing. These antitumor therapies have significantly impacted the clinical outcomes of advanced NSCLC and provided patients with much hope for the future. Despite this, multiple deficiencies still exist in our knowledge of this complex disease, and further research is urgently required to overcome these critical issues. This review traces the path undertaken by the different therapeutics assessed in NSCLC and the impact of precision medicine in this disease. We also discuss the areas of "imprecision" that still exist in NSCLC and the modern hypothesis-testing studies being conducted to address these key challenges.

Keywords: clinical trials; imprecision; lung cancer; precision medicine; targeted therapy.

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Figures

Figure 1
Figure 1
Oncogenic pathways currently being targeted in non-small cell lung cancer.
Figure 2
Figure 2
Relative frequency of genetic abnormalities in non-small cell lung cancer lung cancer. Note: some aberrations can occur concomitantly (not displayed in figure).
See this image and copyright information in PMC

References

    1. Non-small Cell Lung Cancer Collaborative Group. Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomised clinical trials. Non-small cell lung cancer collaborative group. BMJ (1995) 311:899–909.10.1136/bmj.311.7010.899 - DOI - PMC - PubMed
    1. Schiller JH, Harrington D, Belani CP, Langer C, Sandler A, Krook J, et al. Comparison of four chemotherapy regimens for advanced non-small-cell lung cancer. N Engl J Med (2002) 346:92–8.10.1056/NEJMoa011954 - DOI - PubMed
    1. Fossella F, Pereira JR, Von Pawel J, Pluzanska A, Gorbounova V, Kaukel E, et al. Randomized, multinational, phase III study of docetaxel plus platinum combinations versus vinorelbine plus cisplatin for advanced non-small-cell lung cancer: the TAX 326 study group. J Clin Oncol (2003) 21:3016–24.10.1200/JCO.2003.12.046 - DOI - PubMed
    1. Delbaldo C, Michiels S, Syz N, Soria JC, Le Chevalier T, Pignon JP. Benefits of adding a drug to a single-agent or a 2-agent chemotherapy regimen in advanced non-small-cell lung cancer: a meta-analysis. JAMA (2004) 292:470–84.10.1001/jama.292.4.470 - DOI - PubMed
    1. Scagliotti GV, Parikh P, Von Pawel J, Biesma B, Vansteenkiste J, Manegold C, et al. Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer. J Clin Oncol (2008) 26:3543–51.10.1200/JCO.2007.15.0375 - DOI - PubMed

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