Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy.
Department of Internal Medicine and Medical Specialties (Di.M.I.), University of Genoa, 16132 Genoa, Italy.
Int J Mol Sci. 2021 Mar 5;22(5):2625. doi: 10.3390/ijms22052625.
In the scenario of systemic treatment for advanced non-small cell lung cancer (NSCLC) patients, one of the most relevant breakthroughs is represented by targeted therapies. Throughout the last years, inhibitors of the epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), c-Ros oncogene 1 (ROS1), and V-raf murine sarcoma viral oncogene homolog B (BRAF) have been approved and are currently used in clinical practice. However, other promising molecular drivers are rapidly emerging as therapeutic targets. This review aims to cover the molecular alterations with a potential clinical impact in NSCLC, including amplifications or mutations of the mesenchymal-epithelial transition factor (MET), fusions of rearranged during transfection (RET), rearrangements of the neurotrophic tyrosine kinase (NTRK) genes, mutations of the Kirsten rat sarcoma viral oncogene (KRAS) and phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha (PIK3CA), as well as amplifications or mutations of human epidermal growth factor receptor 2 (HER2). Additionally, we summarized the current status of targeted agents under investigation for such alterations. This revision of the current literature on emerging molecular targets is needed as the evolving knowledge on novel actionable oncogenic drivers and targeted agents is expected to increase the proportion of patients who will benefit from tailored therapeutic approaches.
在晚期非小细胞肺癌(NSCLC)患者的系统治疗方案中,最相关的突破之一是靶向治疗。在过去几年中,表皮生长因子受体(EGFR)、间变性淋巴瘤激酶(ALK)、c-Ros 原癌基因 1(ROS1)和 v-Raf 鼠肉瘤病毒癌基因同源物 B(BRAF)的抑制剂已经获得批准,并已在临床实践中使用。然而,其他有前途的分子靶点也迅速成为治疗目标。本文旨在综述 NSCLC 中具有潜在临床影响的分子改变,包括间质-上皮转化因子(MET)的扩增或突变、转染重排(RET)融合、神经营养酪氨酸激酶(NTRK)基因重排、 Kirsten 大鼠肉瘤病毒癌基因(KRAS)和磷脂酰肌醇-4,5-二磷酸 3-激酶,催化亚单位 alpha(PIK3CA)的突变,以及人表皮生长因子受体 2(HER2)的扩增或突变。此外,我们总结了针对这些改变正在研究的靶向药物的现状。需要对新兴分子靶点的当前文献进行综述,因为对新的可操作致癌驱动因素和靶向药物的不断发展的认识有望增加受益于针对性治疗方法的患者比例。