Onkológia 4/2022

Targeted treatment of non-small cell lung cancer – update

Targeted therapy and immunotherapy have significantly changed and advanced the therapeutic management of patients with advanced non-small cell lung cancer. The major subgroups of targeted drugs effective for cancer with EGFR mutations, ALK and ROS1 rearrangements have grown into „generations“. New drugs for the other genetic alterations as KRAS, BRAF mutations, MET skipping mutations on exon 14, RET, NTRK fusions have been introduced. The most recently registered targeted drugs include sotorasib for KRASG12C-mutated non-small cell cancer and amivantamab for insertions in exon 20 of the EGFR gene. The first registered targeted drug in adjuvant setting was osimertinib in resected early-stage EGFR-mutated non-small cell cancer. Immunotherapy is not very effective (besides KRAS mutations) in patients with driver genetic alterations, it is used after all the options of targeted treatment have been exhausted.

Keywords: non-small cell lung cancer, driver mutations, new targeted drugs