Personalized treatment of lung cancer

There have been fundamental changes in the treatment of lung cancer in recent years with advances in molecular biology leading to the approval of new medications. For patients with stageIV non-small cell lung cancer (NSCLC) targeted therapies are available for genetic driver mutations or fusions. Tumors with an epidermal growth factor receptor (EGFR) gene mutation or a translocation in the anaplastic lymphoma kinase (ALK) gene should receive specific treatment with atyrosine kinase inhibitor. For less common mutations, treatment is offered within the framework of clinical trials. In stageIV NSCLC without a driver mutation, the immunotherapeutic checkpoint inhibitor pembrolizumab can be administered in combination with aplatinum-containing cytostatic agent (cisplatin or carboplatin) and pemetrexed for non-squamous epithelium histology. In stageIII NSCLC, patients with a positive programmed cell death ligand 1 (PD-L1) status can be offered consolidation therapy with the checkpoint inhibitor durvalumab after radiochemotherapy. In advanced small cell lung cancer (SCLC) chemotherapy is still the most important pillar of treatment. There is also growing evidence for the use of immunotherapy in SCLC.