Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Jun 5;11(6):518.
doi: 10.3390/jpm11060518.

Precision Medicine in Oncology: A Review of Multi-Tumor Actionable Molecular Targets with an Emphasis on Non-Small Cell Lung Cancer

Matthew K Stein  1 , Oluchukwu Oluoha  2 , Kruti Patel  2 , Ari VanderWalde  3
Affiliations
Review

Precision Medicine in Oncology: A Review of Multi-Tumor Actionable Molecular Targets with an Emphasis on Non-Small Cell Lung Cancer

Matthew K Stein et al. J Pers Med. .

Abstract

Precision medicine is essential for the modern care of a patient with cancer. Comprehensive molecular profiling of the tumor itself is necessary to determine the presence or absence of certain targetable abnormalities or biomarkers. In particular, lung cancer is a disease for which targetable genomic alterations will soon guide therapy in the majority of cases. In this comprehensive review of solid tumor-based biomarkers, we describe the genomic alterations for which targeted agents have been approved by the United States Food and Drug Administration (FDA). While focusing on alterations leading to approvals in a tumor-agnostic fashion (MSI-h, TMB-h, NTRK) and on those alterations with approvals in multiple malignancies (BRAF, ERBB2, RET, BRCA, PD-L1), we also describe several biomarkers or indications that are likely to lead to an approved drug in the near future (e.g., KRAS G12C, PD-L1 amplification, HER2 overexpression in colon cancer, HER2 mutations in lung cancer). Finally, we detail the current landscape of additional actionable alterations (EGFR, ALK, ROS1, MET) in lung cancer, a biomarker-rich malignancy that has greatly benefitted from the precision oncology revolution.

Keywords: FDA-approved therapeutics; cancer; next-generation sequencing; precision oncology; solid tumors; targeted therapy; tumor markers; tumor-agnostic indications.

PubMed Disclaimer

Conflict of interest statement

M.S.K., O.O. and K.P. declare no conflict of interest. A.V. has received research support from Amgen, is a consultant for Bristol-Myers Squibb and Elsevier, and participates in advisory boards for Roche/Genentech, Mirati, and Bristol-Myers Squibb.

References

    1. Schwartzberg L., Kim E.S., Liu D., Schrag D. Precision Oncology: Who, How, What, When, and When Not? Am. Soc. Clin. Oncol. Educ. Book. 2017;37:160–169. doi: 10.1200/EDBK_174176. - DOI - PubMed
    1. Venter J.C., Adams M.D., Myers E.W., Li P.W., Mural R.J., Sutton G.G., Smith H.O., Yandell M., Evans C.A., Holt R.A., et al. The sequence of the human genome. Science. 2001;291:1304–1351. doi: 10.1126/science.1058040. - DOI - PubMed
    1. Tao J.J., Schram A.M., Hyman D.M. Basket Studies: Redefining Clinical Trials in the Era of Genome-Driven Oncology. Annu. Rev. Med. 2018;69:319–331. doi: 10.1146/annurev-med-062016-050343. - DOI - PMC - PubMed
    1. Verma M. Personalized medicine and cancer. J. Pers Med. 2012;2:1–14. doi: 10.3390/jpm2010001. - DOI - PMC - PubMed
    1. Druker B.J., Talpaz M., Resta D.J., Peng B., Buchdunger E., Ford J.M., Lydon N.B., Kantarjian H., Capdeville R., Ohno-Jones S., et al. Efficacy and safety of a specific inhibitor of the BCR-ABL tyrosine kinase in chronic myeloid leukemia. N. Engl. J. Med. 2001;344:1031–1037. doi: 10.1056/NEJM200104053441401. - DOI - PubMed