Personalized medicine of non-gene-specific chemotherapies for non-small cell lung cancer

Abstract

Non-small cell lung cancer is recognized as the deadliest cancer across the globe. In some areas, it is more common in women than even breast and cervical cancer. Its rise, vaulted by smoking habits and increasing air pollution, has garnered much attention and resource in the medical field. The first lung cancer treatments were developed more than half a century ago. Unfortunately, many of the earlier chemotherapies often did more harm than good, especially when they were used to treat genetically unsuitable patients. With the introduction of personalized medicine, physicians are increasingly aware of when, how, and in whom, to use certain anti-cancer agents. Drugs such as tyrosine kinase inhibitors, anaplastic lymphoma kinase inhibitors, and monoclonal antibodies possess limited utility because they target specific oncogenic mutations, but other drugs that target mechanisms universal to all cancers do not. In this review, we discuss many of these non-oncogene-targeting anti-cancer agents including DNA replication inhibitors (i.e., alkylating agents and topoisomerase inhibitors) and cytoskeletal function inhibitors to highlight their application in the setting of personalized medicine as well as their limitations and resistance factors.

Keywords: DNA replication inhibitors; Drug resistance; Non-small cell lung cancer; Personalized medicine; Pharmacogenetics; Pharmacogenomics; Toxoids; Vinca alkaloids.

Graphical abstract

Figure 1

The types of genetic resistance factors within each patient and the available chemotherapies choices at the physician's disposal that are appropriate for use.