Advanced non-squamous non-small-cell lung cancer: who and when should be biologically screened today? Tomorrow?

摘要

There is a need for identification of prognostic and/or predictive biomarkers to improve the choice of therapeutic strategies for patients diagnosed with advanced non-squamous NSCLC. Only two predictive biomarkers have been validated: EGFR mutations and EML4-ALK translocations. These markers can be used to predict the response to targeted therapy (erlotinib and gefitinib or crizotinib). Several emerging biomarkers are being studied in ongoing clinical trials to predict the response of new targeted therapy or resistance to EGFR-TKI or ALK inhibitors. Every patient diagnosed with advanced NSCLC should be screened for prognostic and predictive biomarkers. There is no longer any place for clinical screening of patients potentially eligible for biological analysis. The ASCO recommends analysis of biomarkers at the time of diagnosis. However, there is evidence supporting the need for serial analysis. The purpose of these data and recommendations is to individualize therapeutic strategies for patients with advanced NSCLC and to improve their survival.