50 Gene Panel Testing in Non-Small Cell Lung Cancer and Options for Targeted Therapy

Ajita Naik MBBS^1*, Mohamed Rahouma MD^*2, Ihab Eldesoki MD^3,7, Katherine D Gray MD⁴, Mohamed Kamel MD², Maha Yehia MD³, Galal Ghaly MD², Kritika Mehta MBBS⁵, Massimo Baudo MD⁶, Nagla Abdel Karim MD⁷ & Abdelrahman Mohamed MD²

¹K. J. Somaiya medical College/Maharashtra University of Health Sciences, Mumbai, India
²Surgical Oncology Department, National Cancer Institute, Cairo University, Egypt
³Medical Oncology Department, National Cancer Institute, Cairo University, Egypt
⁴Department of Surgery, New York Presbyterian Hospital - Weill Cornell Medicine, New York, USA
⁵D Y Patil University School of Medicine, Navi Mumbai, India
⁶IRCCS Vita-Salute San Raffaele Hospital Via Olgettina, 60, 20132 Milan, Italy
⁷Medical Oncology Department, University of Cincinnati Cancer Institute, Cincinnati, Ohio, USA

Mohamed Rahouma, mhmdrahouma@gmail.com, Surgical Oncology Department, National Cancer Institute, Cairo University, Egypt.

Keywords: Lung Cancer; Oncogenesis; Malignancy; Genetic Mutations; Epithelial Cancer

Abstract

Lung cancer is a common cause of cancer death. Progression free and overall survival is challenging to predict due to the variety of underlying genetic defects leading to cancer development. A number of gene mutations and subsequent downstream pathway alterations have been identified in oncogenesis of non-small cell lung cancer (NSCLC), and specific genes like EGFR, KRAS, ALK, TP53 and genetic signaling pathways like PI3K/ALT/mTOR have been found to affect the prognosis and allow for options for targeted therapy. Moreover, there is evidence of high incidence of changes in receptors leading to resistance of the target sites to the available drugs causing deleterious effects on prognosis. Herein, we reviewed the available methods of diagnosing these changes at a molecular level and the implications diagnosing these alterations on survival. Literature suggests that singling out causative factors can be of prognostic value as well as serve as specific targets for therapy. Currently, a number of targeted therapies are under development. However, knowledge of genetic information opens opportunities to provide patients with a more accurate prognosis, specific treatment options, and the potential for improved treatment modalities.

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