Targeting Lung Cancer in Never-smokers

Lung cancer is the leading cause of cancer-related deaths worldwide, and between 10 percent and 15 percent of new cases arise in never-smokers. Never-smokers – as well as individuals of East-Asian ethnicity and those with adenocarcinoma tumors – appear more likely to respond to certain targeted therapies.

William Pao, M.D., Ph.D., and colleagues at Fudan University in Shanghai, China have taken a closer look at the genetic factors that may underlie these responses in lung adenocarcinomas from 52 Chinese patients classified as never-smokers. In these tumors, the investigators analyzed major known “driver mutations” – mutations in genes involved in cell proliferation and survival (e.g., EGFR, HER2, KRAS, BRAF, PI3KCA, and EML4-ALK).

They found that 88 percent of tumors harbored well-known mutations in EGFR, HER2 or ALK – all of which have corresponding targeted therapies now available. The results in the Oct. 20 issue of the Journal of Clinical Oncology indicate that prospective genetic testing in these patients would allow for the selection of an appropriate targeted therapy in the majority of cases.

For other research highlights from Vanderbilt University Medical Center laboratories, see ‘Aliquots‘ in the VUMC Reporter.