In order to choose the most appropriate treatment for lung cancer, it is essential to first identify the biomarkers and genetic mutations involved in the pathology. The genes whose mutations are most likely to influence lung cancer treatment, especially adenocarcinoma, are EGFR, KRAS, ALK, and ROS1.
The gene for Epidermal Growth Factor Receptors (EGFR) is a gene that codes for receptors on the surface of the cell that, once activated, allow cells to multiply. In some lung cancers, this gene can be mutated and cause cancer. Approximately 12% of patients with non-small cell lung cancer (NSCLC) carry this genetic mutation. The detection of this mutation can be done on a tissue biopsy, which consists of an analysis of a small fragment of tissue, or by liquid biopsy, i.e. a blood test.
To treat lung cancer patients who are carriers of this mutation, the main targeted therapies available are: Osimertinib (Tagrisso®), Gefitinib (Iressa®), Afatinib (Giotrif®), Erlotinib (Tarceva®)...
In some lung cancers, genes ALK or ROS1 can undergo a translocation, in which a segment of the chromosome that carries the gene binds abnormally to another gene. This rearrangement occurs in 3 to 5% of lung cancer cases for ALK and 1% of cases for ROS1.
For ALK+ patients, the most used targeted drugs are: Crizotinib (Xalkori®), Ceritinib (Zykadia®), Alectinib (Alecensaro®), Brigatinib (Alunbrig®)... For ROS1+ patients, we find in particular: Crizotinib (Xalkori®), Entrectinib (Rozlytrek®)...
The KRAS gene, in particular the mutation G12C, is relatively common in lung cancers. New treatments to treat lung cancer patients who carry the KRAS G12C gene are now available, such as Sotorasib (Lumakras®).
In addition, other anomalies are regularly identified and also benefit from new possibilities for targeted treatments: RET, PUT, NRG1, NTRK...
In case of doubt, all the biomarkers and genetic mutations specific to your lung cancer are indicated on the molecular biology report (NGS) or a consultation report.
In addition, the clinical trials currently available for these various lung cancer biomarkers can be found on Klineo.
Sources: Hospices Civils de Lyon, Roche, National Cancer Institute, National Cancer Institute, Canadian Cancer Society, Alk+Ros1 Association
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