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Review
. 2024 Aug 24;404(10454):803-822.
doi: 10.1016/S0140-6736(24)01029-8. Epub 2024 Aug 6.

New promises and challenges in the treatment of advanced non-small-cell lung cancer

May-Lucie Meyer  1 , Bailey G Fitzgerald  2 , Luis Paz-Ares  3 , Federico Cappuzzo  4 , Pasi A Jänne  5 , Solange Peters  6 , Fred R Hirsch  7
Affiliations
Review

New promises and challenges in the treatment of advanced non-small-cell lung cancer

May-Lucie Meyer et al. Lancet. .

Abstract

Targeted therapies and immunotherapies have radically improved treatment for advanced non-small-cell lung cancer (NSCLC). Tyrosine kinase inhibitors targeting oncogenic driver mutations continue to evolve over multiple generations to enhance effectiveness and tackle drug resistance. Immune checkpoint inhibitors remain integral for the treatment of NSCLCs that do not have specific actionable genetic mutations. Antibody-drug conjugates and bispecific antibodies are being integrated into treatment guidelines, and emerging therapies include T-cell engagers, cellular therapies, cancer vaccines, and external devices. Despite these advances, challenges remain in identifying predictive biomarkers to individually tailor treatments, abrogate resistance, reduce costs, and ensure optimal cancer treatment accessibility.

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Conflict of interest statement

Declaration of interests LP-A reports giving scientific advice or being on advisory boards for AstraZeneca, Merck Sharp & Dohme, Daichii, Bristol Myers Squibb, Merck, Roche, Amgen, Mirati, Blueprint, Pharmamar, AbbVie, Gilead, Boehringer Ingelheim, Pfizer, Novartis, and Beigene; is a founder and board member of Altum sequencing and Stabs therapeutics; and reports grants to their institution from Pfizer, Bristol Myers Squibb, AstraZeneca, and Pharmamar. FRH is on scientific boards for AstraZeneca, Regeneron, Sanofi, AbbVie, G1 Therapeutics, Novartis, Merus Therapeutics, Merck, Novocure, NextCure, and OncoHost; reports patents: EGFR protein expression and copy number as predictive biomarkers for EGFR-directed therapies (through the University of Colorado); and reports sponsored research (through Icahn School of Medicine, Mount Sinai) from Novartis and through Stand-Up-To Cancer from Jazz Pharmaceuticals. PAJ reports giving scientific advice or being on advisory boards for AbbVie, Accutar Biotech, Allorion Therapeutics, AstraZeneca, Bayer, Biocartis, Blueprint Medicines, Boehringer Ingelheim, Chugai Pharmaceuticals, Daiichi Sankyo, Duality, Eli Lilly, Esai, Frontier Medicines, Hongyun Biotechnology, Merus, Mirati Therapeutics, Monte Rosa, Novartis, Nuvalent, Pfizer, Roche/Genentech, Scorpion Therapeutics, SFJ Pharmaceuticals, Silicon Therapeutics, Syndax, Takeda Oncology, Transcenta, and Voronoi; reports sponsored research (to the Dana Farber Cancer Institute) from AstraZeneca, Boehringer Ingelheim, Daiichi Sankyo, Eli Lilly, PUMA, Revolution Medicines, and Takeda Oncology; and reports patents and post-marketing royalties from Dana Farber Cancer Institute-owned intellectual property on EGFR mutations licensed to Lab Corp. SP reports consultation or advisory roles for AbbVie, Amgen, Arcus, AstraZeneca, Bayer, Beigene, BerGenBio, Biocartis, BioInvent, Blueprint Medicines, Boehringer Ingelheim, Bristol Myers Squibb, Clovis, Daiichi Sankyo, Debiopharm, Eli Lilly, F-Star, Fishawack, Foundation Medicine, Genzyme, Gilead, GSK, Hutchmed, Illumina, Incyte, Ipsen, iTeos, Janssen, Merck Sharp & Dohme, Merck Serono, Merrimack, Mirati, Nykode Therapeutics, Novartis, Novocure, Pharma Mar, Promontory Therapeutics, Pfizer, Regeneron, Roche/Genentech, Sanofi, Seattle Genetics, and Takeda; has a board of director position with Galenica; and reports giving talks in a company's organised public event for AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Foundation Medicine, GSK, Illumina, Ipsen, Merck Sharp & Dohme, Mirati, Novartis, Pfizer, Roche/Genentech, Sanofi, and Takeda. All other authors report no competing interests.

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