A Personalized Treatment for Lung Cancer: Molecular Pathways, Targeted Therapies, and Genomic Characterization

  • Thomas Hensing
  • Apoorva Chawla
  • Rishi Batra
  • Ravi Salgia
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 799)


Lung cancer is a heterogeneous, complex, and challenging disease to treat. With the arrival of genotyping and genomic profiling, our simple binary division of lung cancer into non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC) is no longer acceptable. In the past decade and with the advent of personalized medicine, multiple advances have been made in understanding the underlying biology and molecular mechanisms of lung cancer. Lung cancer is no longer considered a single disease entity and is now being subdivided into molecular subtypes with dedicated targeted and chemotherapeutic strategies. The concept of using information from a patient’s tumor to make therapeutic and treatment decisions has revolutionized the landscape for cancer care and research in general.

Management of non-small-cell lung cancer, in particular, has seen several of these advances, with the understanding of activating mutations in EGFR, fusion genes involving ALK, rearrangements in ROS-1, and ongoing research in targeted therapies for K-RAS and MET. The next era of personalized treatment for lung cancer will involve a comprehensive genomic characterization of adenocarcinoma, squamous-cell carcinoma, and small-cell carcinoma into various subtypes. Future directions will involve incorporation of molecular characteristics and next generation sequencing into screening strategies to improve early detection, while also having applications for joint treatment decision making in the clinics with patients and practitioners. Personalization of therapy will involve close collaboration between the laboratory and the clinic. Given the heterogeneity and complexity of lung cancer treatment with respect to histology, tumor stage, and genomic characterization, mind mapping has been developed as one of many tools which can assist physicians in this era of personalized medicine. We attempt to utilize the above tool throughout this chapter, while reviewing lung cancer epidemiology, lung cancer treatment, and the genomic characterization of lung cancer.


Epidermal Growth Factor Receptor Hepatocyte Growth Factor Epidermal Growth Factor Receptor Mutation Anaplastic Lymphoma Kinase National Comprehensive Cancer Network 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Anaplastic lymphoma kinase


American Society of Clinical Oncology


Confidence interval


N-methyl-N’-nitro-N-nitroso-guanidine (MNNG) HOS transforming gene


Computed tomography


Epidermal growth factor


Epidermal growth factor receptor


Echinoderm microtubule-associated protein-like 4


Epithelial to mesenchymal transition


Excision repair cross-complementation group 1


Enhancer of zeste homolog 2


Food and Drug Administration


Fluorescence in situ hybridization


Guanosine diphosphate


Guanosine triphosphate


Histone deacetylase


Hepatocyte growth factor/scatter factor


Hepatocyte growth factor receptor


Hazard ratio


Heat shock protein-90


Insulin-like growth factor receptor 1




Iressa Pan-Asia Study


Low-dose computed tomography


Mitogen-activated protein kinase kinase


Maximum tolerated dose


Mammalian target of rapamycin


National Comprehensive Cancer Network


Next generation sequencing


Non-small-cell lung cancer


Odds ratio


Overall survival


Polymerase chain reaction


Positron emission tomography


Progression-free survival


Phosphatidylinositol 3-kinase


Reactive oxygen species-1


Radiation therapy


Receptor tyrosine kinase


Radiation Therapy Oncology Group


Small-cell lung cancer

Siah 2

Seven in absentia homolog 2


Tyrosine kinase inhibitor


Tumor protein 63


Thymidylate synthase


Thyroid transcription factor


Video-assisted thoracoscopic surgery


Vascular endothelial growth factor


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Thomas Hensing
    • 1
    • 2
  • Apoorva Chawla
    • 2
  • Rishi Batra
    • 3
  • Ravi Salgia
    • 2
  1. 1.Department of Medicine, Section of Hematology/OncologyNorthShore University Health System, Kellogg Cancer CenterEvanstonUSA
  2. 2.Department of Medicine, Section of Hematology/OncologyUniversity of ChicagoChicagoUSA
  3. 3.987400 Nebraska Medical CenterUniversity of Nebraska Medical CenterOmahaUSA

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