• Int. J. Clin. Pract. · Nov 2021

    Review

    Paradigm shift in the management of metastatic Non-small Cell Lung Cancer.

    • Ruby Gupta, Melanie Smalley, Nwabundo Anusim, Vishal Jindal, Mandeep Singh Rahi, Sorab Gupta, Sachin Gupta, and Ishmael Jaiyesimi.
    • Department of Hematology and Medical Oncology, William Beaumont Hospital, Royal Oak, MI, USA.
    • Int. J. Clin. Pract. 2021 Nov 1; 75 (11): e14533.

    BackgroundLung cancer is one of the leading causes of cancer mortality in the United States. The use of precision medicine in the past 10 years has significantly changed the therapeutic landscape of lung cancer. Management of advanced nonsmall cell lung cancer (NSCLC) has transitioned from a chemotherapeutic approach to targeted treatments and immunotherapeutic agents. Several tyrosine kinase inhibitors (TKIs) have been approved for patients with targeted mutations and patients who do not have driver mutations; immunotherapy has been recently approved as frontline therapy, which has resulted in marked improvement in overall survival and added a new tool in our armamentarium.AimsThe purpose of this review is to highlight recent advancements in diagnostic approach and management strategies in patients with metastatic NSCLC.Materials And MethodsA literature search was conducted on Medline (via PubMed) and National Comprehensive Cancer Network Guidelines using the keywords "precision diagnosis," "advanced non-small cell lung cancer," "target therapies," and "immunotherapy."ConclusionThe use of next-generation sequencing has significantly changed our understanding of molecular oncogenic mechanisms of lung cancer. These advancements have created a paradigm shift in the treatment strategies of metastatic lung cancer from primarily chemotherapeutic approach to increasing use of targeted therapies and immune checkpoint inhibitors (ICI) leading to better survival rates and lesser toxicity.© 2021 John Wiley & Sons Ltd.

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