Molecular Markers, Immune Therapy, and Non-Small Cell Lung Cancer-State-of-the-Art Review for Surgeons

Authors

Robert W. Young, Department of Surgery, George Washington University Hospital, Washington, District of Columbia, USA.
Gustavo R. Rodriguez, Department of Surgery, George Washington University Hospital, Washington, District of Columbia, USA.
John Kucera, Department of Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
Daniel Carrera, Department of Surgery, George Washington University Hospital, Washington, District of Columbia, USA.
Jared L. Antevil, Department of Surgery, George Washington University Hospital, Washington, District of Columbia, USA.
Gregory D. Trachiotis, Department of Surgery, George Washington University Hospital, Washington, District of Columbia, USA.

Document Type

Journal Article

Publication Date

6-20-2024

Journal

Journal of laparoendoscopic & advanced surgical techniques. Part A

DOI

10.1089/lap.2024.0164

Keywords

biomarkers; immunotherapy; liquid biopsy; molecular markers; non-small cell lung cancer (NSCLC); tumor targeting

Abstract

Lung cancer is a leading cause of cancer deaths in the United States. An increasing understanding of relevant non-small cell lung cancer (NSCLC) biomarkers has led to the recent development of molecular-targeted therapies and immune checkpoint inhibitors that have revolutionized treatment for patients with advanced and metastatic disease. The purpose of this review is to provide surgeons with a state-of-the-art understanding of the current medical and surgical treatment trends and their implications in the future of management of NSCLC. A systematic search of PubMed was conducted to identify English language articles published between January 2010 and March 2024 focusing on molecular markers, tumor targeting, and immunotherapy in the diagnosis and treatment of NSCLC. Case series, observational studies, randomized trials, guidelines, narrative reviews, systematic reviews, and meta-analyses were included. There is now increasing data to suggest that molecular-targeted therapies and immune therapies have a role in the neoadjuvant setting. Advances in intraoperative imaging allow surgeons to perform increasingly parenchymal-sparing lung resections without compromising tumor margins. Liquid biopsies can noninvasively detect targetable mutations in cancer cells and DNA from a blood draw, potentially allowing for earlier diagnosis, personalized therapy, and long-term monitoring for disease recurrence. The management of NSCLC has advanced dramatically in recent years fueled by a growing understanding of the cancer biology of NSCLC. Advances in medical therapies, surgical techniques, and diagnostic and surveillance modalities continue to evolve but have already impacted current treatment strategies for NSCLC, which are encompassed in this review.

APA Citation

Young, Robert W.; Rodriguez, Gustavo R.; Kucera, John; Carrera, Daniel; Antevil, Jared L.; and Trachiotis, Gregory D., "Molecular Markers, Immune Therapy, and Non-Small Cell Lung Cancer-State-of-the-Art Review for Surgeons" (2024). GW Authored Works. Paper 5077.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5077

Department

Surgery