Advances in genomic and proteomic studies of non-small-cell lung cancer: Clinical and translational research perspective

Recent years have brought tremendous progress in the development of genomic and proteomic platforms to study cancer biology. Tests based on these platforms are helpful in early diagnosis, prognosis, and prediction of treatment benefit. Molecular studies performed on minimally invasive material (plasma, sputum) from individuals participating in longitudinal or case-control studies have approximately 70%-90% sensitivity and specificity to detect lung cancer. In operable non-small-cell lung cancer, genomic and proteomic studies yield better prognostic information than pathologic Staging. There are several examples of successful identification of predictive assays for benefit from chemotherapy (ERCC1, RRM1, p27^KiP1, and p53 expression) or targeted therapies (epidermal growth factor receptor [EGFR] gene copy number, EGFR activating mutations, EGFR protein expression, serum proteomic profile). These markers should be prospectively tested in clinical studies before they can be routinely used in the clinic. Several biomarker-driven trials are currently accruing patients, and the results of these studies will soon be available.