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Review

Changing paradigm in treatment of lung cancer

Sundaram Viswanath, Abhishek Pathak, Amul Kapoor, Anvesh Rathore, Bhupendra Nath Kapur
Medical Oncology, Army Hospital Research and Referral, New Delhi 110010, India.
Correspondence to: Dr. Abhishek Pathak, Medical Oncology, Army Hospital Research and Referral, New Delhi 110010, India.
E-mail: drabhipat@gmail.com

A B S T R AC T
Lung cancer is one of the most common and deadliest forms of cancer. It accounts for 13% of all new cancer cases and 19% of
cancer-related deaths. In India, lung cancer constitutes 6.9% of all new cancer cases and 9.3% of all cancer cases. There has also
been a dramatic rise worldwide in both the absolute and relative frequencies of lung cancer occurrence. In 1953 it became the most
common cause of cancer mortality in men. By 1985, it became the leading cause of cancer deaths in women, causing almost twice
as many deaths as breast cancer. The demographic profile of lung cancer has changed greatly over the years; however, methods for
diagnosing, screening, and managing lung cancer patients have improved. This is due to our growing understanding of the biology
of lung cancer. It is now possible to further define lung cancer types beyond small cell lung carcinoma and non-small cell lung
carcinoma. Moreover, new histology-based therapeutic modalities have been developed, and more new lung cancer biomarkers
have been uncovered. Therefore, more detailed histological characterization of lung cancer samples is warranted in order to
determine the best course of treatment for specific patients. This review article describes how these new molecular technologies
are shaping the way lung cancer can be treated in future.

Key words: Non-small cell lung carcinoma; epidermal growth factor receptor; anaplastic lymphoma kinase

INTRODUCTION genome. The researchers found a large number and variety
of DNA alterations, many of which seem to be the driving
Lung cancer is one of the most common and deadliest forms force behind the initiation and progression of lung cancer.
of cancer. Worldwide, it accounts for 13% of all new cancer TCGA is jointly funded and managed by the National
cases and 19% of cancer-related deaths. In India alone, lung Human Genome Research Institute (NHGRI) and the
cancer constitutes 6.9% of all new cancer cases and 9.3% National Cancer Institute (NCI), both of which are part
of all cancer-related deaths. There has been a dramatic rise of the National Institutes of Health. New histology-based
worldwide in both the absolute and relative frequencies of therapeutic modalities have been developed, and more new
lung cancer occurrence. By 1953, lung cancer was the lung cancer biomarkers have been uncovered. As a result,
[1]
most common cause of cancer mortality in men. By 1985, it more detailed histological characterization of lung cancer
was the leading cause of cancer deaths in women, causing samples is warranted in order to determine the best course
almost twice as many deaths as breast cancer. [2] of treatment for specific patients. [3]

The demographic profile of lung cancer has changed greatly For NSCLC, there are currently more than 50% of
over the years; however, methods for diagnosing, screening adenocarcinoma cases and around 15-20% of squamous
and managing lung cancer patients have also improved. cell carcinoma cases that need to be further characterized
This is due to our growing understanding of the biology of based on mutation analysis. Mutations in epidermal
lung cancer. It is now possible to further define lung cancer growth factor receptor (EGFR) gene strongly predict
types beyond small cell lung carcinoma (SCLC) and non- the efficacy of EGFR inhibitors, with response rates of
small cell lung carcinoma (NSCLC). In 2012, the Cancer over 70% in patients who have EGFR mutations. In
[4]
Genome Atlas (TCGA) Research Network published in
Nature that characterized the lung squamous cell carcinoma This is an open access article distributed under the terms of the Creative
Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows
others to remix, tweak, and build upon the work non-commercially, as long as
Access this article online the author is credited and the new creations are licensed under the identical
terms.
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How to cite this article: Viswanath S, Pathak A, Kapoor A, Rathore
A, Kapur BN. Changing paradigm in treatment of lung cancer. J Cancer
DOI: Metasta Treat 2016;2:214-9.
10.20517/2394-4722.2015.88
Received: 05-12-2015; Accepted: 17-03-2016.

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