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J Clin Med. 2018 Jun 15;7(6). pii: E153. doi: 10.3390/jcm7060153.

An Update on Predictive Biomarkers for Treatment Selection in Non-Small Cell Lung Cancer.

Ahmadzada T1, Kao S2,3,4, Reid G5,6, Boyer M7,8, Mahar A9,10, Cooper WA11,12,13.

Author information

1
Sydney Medical School, The University of Sydney, Sydney 2006, Australia. tahm4852@uni.sydney.edu.au.
2
Sydney Medical School, The University of Sydney, Sydney 2006, Australia. steven.kao@lh.org.au.
3
Chris O'Brien Lifehouse, Sydney 2050, Australia. steven.kao@lh.org.au.
4
Asbestos Diseases Research Institute (ADRI), Sydney 2139, Australia. steven.kao@lh.org.au.
5
Sydney Medical School, The University of Sydney, Sydney 2006, Australia. glen.reid@sydney.edu.au.
6
Asbestos Diseases Research Institute (ADRI), Sydney 2139, Australia. glen.reid@sydney.edu.au.
7
Sydney Medical School, The University of Sydney, Sydney 2006, Australia. michael.boyer@lh.org.au.
8
Chris O'Brien Lifehouse, Sydney 2050, Australia. michael.boyer@lh.org.au.
9
Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney 2050, Australia. annabelle.mahar@health.nsw.gov.au.
10
School of Medicine, Western Sydney University, Sydney 2560, Australia. annabelle.mahar@health.nsw.gov.au.
11
Sydney Medical School, The University of Sydney, Sydney 2006, Australia. wendy.cooper@health.nsw.gov.au.
12
Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney 2050, Australia. wendy.cooper@health.nsw.gov.au.
13
School of Medicine, Western Sydney University, Sydney 2560, Australia. wendy.cooper@health.nsw.gov.au.

Abstract

It is now widely established that management of lung cancer is much more complex and cannot be centered on the binary classification of small-cell versus non-small cell lung cancer (NSCLC). Lung cancer is now recognized as a highly heterogeneous disease that develops from genetic mutations and gene expression patterns, which initiate uncontrolled cellular growth, proliferation and progression, as well as immune evasion. Accurate biomarker assessment to determine the mutational status of driver mutations such as EGFR, ALK and ROS1, which can be targeted by specific tyrosine kinase inhibitors, is now essential for treatment decision making in advanced stage NSCLC and has shifted the treatment paradigm of NSCLC to more individualized therapy. Rapid advancements in immunotherapeutic approaches to NSCLC treatment have been paralleled by development of a range of potential predictive biomarkers that can enrich for patient response, including PD-L1 expression and tumor mutational burden. Here, we review the key biomarkers that help predict response to treatment options in NSCLC patients.

KEYWORDS:

NSCLC; immunotherapy; predictive biomarkers; targeted therapy

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