Path Less Traveled: Targeting Rare Driver Oncogenes in Non-Small-Cell Lung Cancer

JCO Oncol Pract. 2024 Jan;20(1):47-56. doi: 10.1200/OP.23.00273. Epub 2023 Sep 21.

Abstract

Over the past decade, tremendous efforts have been made in the development of targeted agents in non-small-cell lung cancer (NSCLC) with nonsquamous histology. Pivotal studies have used next-generation sequencing to select the patient population harboring oncogenic driver alterations that are targetable with targeted therapies. As treatment paradigm rapidly evolves for patients with rare oncogene-driven NSCLC, updated comprehensive overview of diagnostic approach and treatment options is paramount in clinical settings. In this review article, we discuss the epidemiology, molecular testing, and landmark clinical trials addressing the targeted agents for ROS1 rearrangement, METex14 skipping mutation, EGFR exon 20 insertion, KRAS G12C mutation, HER2 mutation, RET fusion, NTRK fusion, and BRAF mutations.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents* / therapeutic use
  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Humans
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / genetics
  • Oncogenes
  • Protein-Tyrosine Kinases / genetics
  • Proto-Oncogene Proteins / genetics

Substances

  • Protein-Tyrosine Kinases
  • Proto-Oncogene Proteins
  • Antineoplastic Agents