BMJ,
Journal Year:
2021,
Volume and Issue:
unknown, P. n2363 - n2363
Published: Nov. 9, 2021
ABSTRACT
Lung
cancer
remains
a
leading
cause
of
related
mortality
worldwide.
Despite
numerous
advances
in
treatments
over
the
past
decade,
non-small
cell
lung
(NSCLC)
an
incurable
disease
for
most
patients.
The
optimal
treatment
all
patients
with
locally
advanced,
but
surgically
resectable,
NSCLC
contains
at
least
chemoradiation.
Trimodality
surgical
resection
has
been
subject
debate
decades.
For
unresectable
or
inoperable
advanced
disease,
incorporation
immunotherapy
consolidation
after
chemoradiation
defined
new
standard
care.
decades,
care
stage
included
only
cytotoxic
chemotherapy.
However,
introduction
targeted
therapies
and
immunotherapy,
landscape
rapidly
evolved.
This
review
discusses
integration
these
innovative
management
newly
diagnosed
NSCLC.
New England Journal of Medicine,
Journal Year:
2020,
Volume and Issue:
383(18), P. 1711 - 1723
Published: Sept. 19, 2020
Osimertinib
is
standard-of-care
therapy
for
previously
untreated
epidermal
growth
factor
receptor
(EGFR)
mutation–positive
advanced
non–small-cell
lung
cancer
(NSCLC).
The
efficacy
and
safety
of
osimertinib
as
adjuvant
are
unknown.
Journal of the National Comprehensive Cancer Network,
Journal Year:
2022,
Volume and Issue:
20(5), P. 497 - 530
Published: May 1, 2022
NCCN
Clinical
Practice
Guidelines
in
Oncology
(NCCN
Guidelines)
for
Non-Small
Cell
Lung
Cancer
(NSCLC)
provide
recommended
management
patients
with
NSCLC,
including
diagnosis,
primary
treatment,
surveillance
relapse,
and
subsequent
treatment.
Patients
metastatic
lung
cancer
who
are
eligible
targeted
therapies
or
immunotherapies
now
surviving
longer.
This
selection
from
the
NSCLC
focuses
on
actionable
mutations.
Journal of Clinical Oncology,
Journal Year:
2022,
Volume and Issue:
40(6), P. 611 - 625
Published: Jan. 5, 2022
Lung
cancer
has
traditionally
been
classified
by
histology.
However,
a
greater
understanding
of
disease
biology
and
the
identification
oncogenic
driver
alterations
dramatically
altered
therapeutic
landscape.
Consequently,
new
classification
paradigm
non-small-cell
lung
is
further
characterized
molecularly
defined
subsets
actionable
with
targeted
therapies
treatment
landscape
becoming
increasingly
complex.
This
review
encompasses
current
standards
care
for
in
molecular
alterations.
Targeted
EGFR
exon
19
deletion
L858R
mutations,
ALK
ROS1
rearrangements
are
well
established.
there
an
expanding
list
approved
including
BRAF
V600E,
20
insertion,
KRAS
G12C
MET
14
alterations,
NTRK
RET
rearrangements.
In
addition,
numerous
other
drivers,
such
as
HER2
insertion
which
emerging
efficacy
data
therapies.
The
importance
diagnostic
testing,
intracranial
novel
therapies,
optimal
sequencing
role
early-stage
disease,
future
directions
precision
oncology
approaches
to
understand
tumor
evolution
resistance
also
discussed.
Journal of Clinical Oncology,
Journal Year:
2021,
Volume and Issue:
39(30), P. 3391 - 3402
Published: Aug. 2, 2021
Non-small-cell
lung
cancer
(NSCLC)
with
epidermal
growth
factor
receptor
(EGFR)
exon
20
insertion
(Exon20ins)
mutations
exhibits
inherent
resistance
to
approved
tyrosine
kinase
inhibitors.
Amivantamab,
an
EGFR-MET
bispecific
antibody
immune
cell-directing
activity,
binds
each
receptor's
extracellular
domain,
bypassing
at
the
inhibitor
binding
site.CHRYSALIS
is
a
phase
I,
open-label,
dose-escalation,
and
dose-expansion
study,
which
included
population
EGFR
Exon20ins
NSCLC.
The
primary
end
points
were
dose-limiting
toxicity
overall
response
rate.
We
report
findings
from
postplatinum
NSCLC
treated
recommended
II
dose
of
1,050
mg
amivantamab
(1,400
mg,
≥
80
kg)
given
once
weekly
for
first
4
weeks
then
every
2
starting
week
5.In
efficacy
(n
=
81),
median
age
was
62
years
(range,
42-84
years);
40
patients
(49%)
Asian,
number
previous
lines
therapy
two
1-7).
rate
40%
(95%
CI,
29
51),
including
three
complete
responses,
duration
11.1
months
6.9
not
reached).
progression-free
survival
8.3
6.5
10.9).
In
safety
114),
most
common
adverse
events
rash
in
98
(86%),
infusion-related
reactions
75
(66%),
paronychia
51
(45%).
grade
3-4
hypokalemia
six
(5%)
rash,
pulmonary
embolism,
diarrhea,
neutropenia
four
(4%)
each.
Treatment-related
reductions
discontinuations
reported
13%
4%
patients,
respectively.Amivantamab,
via
its
novel
mechanism
action,
yielded
robust
durable
responses
tolerable
after
progression
on
platinum-based
chemotherapy.
