Precision Medicine in Treating Lung Cancer: A Narrative Review on Treatments Targeting Oncogenic Genetic Mutations

Abstract

Lung cancer is among the leading causes of cancer-related mortality worldwide. It is classified into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC), with NSCLC being more prevalent. There have been advancements in managing extensive research on immunotherapy agents, oncolytic viruses, and targeted therapies by understanding the genetic mutations and molecular mechanisms behind lung cancer. Targeted therapy is the new paradigm in the treatment of lung cancer, especially NSCLC, and the aim is to inhibit specific proteins involved in cancer growth and progression. They primarily utilize small molecule inhibitors, monoclonal antibodies (mAbs), and antibody-drug conjugates (ADCs) to attack specific oncogenic driver mutations such as epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), Kirsten rat sarcoma viral oncogene homolog (KRAS), c-ros oncogene 1 (ROS1), and immune checkpoint pathways. These agents have improved outcomes and have shown efficacy in clinical trials, making them a preferred option over traditional chemotherapy. However, the associated adverse effects of these agents, along with drug resistance, remain a challenge. In this review, we discuss targeted therapies for lung cancer, their efficacy, clinical trials, adverse effects, mechanisms of resistance, and future directions.