What is the role of molecular-targeted therapy in the treatment of non–small cell lung cancer (NSCLC)?

Updated: Jun 05, 2020
  • Author: Winston W Tan, MD, FACP; Chief Editor: Nagla Abdel Karim, MD, PhD  more...
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In recent years, the increased understanding of molecular abnormalities in lung cancer, identification of molecular targets, and development of molecular-targeted therapies have produced a paradigm shift. The treatment of NSCLC has entered a new era.

The possibility of finding a mutation that is susceptible to molecular-targeted therapy is driving more frequent mutation testing in NSCLC. However, the likelihood of a mutation depends on the histologic subtype of the cancer. Consequently, histologic testing should precede mutation testing. [91]

All patients with NSCLC should have their tumor tissue tested for mutations, such as in the genes that code for endothelial growth factor receptor (EGFR), KRAS, anaplastic lymphoma kinase (ALK), ROS1, and programmed death ligand–1 (PDL-1). The results will help  determine the patient's eligibility for treatment with specific molecular-targeted agents.

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