Strategies in patients with other molecular alterations

The paradigm of lung cancer treatment has rapidly changed in the last 10 years thanks to the introduction of molecularly tailored drugs, especially for lung adenocarcinoma. After the successes obtained with target agents in the treatment of EGFR mutation and ALK rearrangement positive patients, a number of new molecular markers have been identified, such as HER2 aberrations, MET and FGFR1 amplification, BRAF and DDR2 mutations, and others. A molecular driver may be identified in up to 60 % of adenocarcinoma, whereas biological knowledge of squamous cell carcinoma is at an earlier stage and a targetable alteration may be found in only 30 % of cases. Most of the molecular changes display low frequency (<5 %) but may represent appealing actionable targets for therapy. Drugs already approved for use in other tumors and novel agents are currently being explored in molecularly selected subcategories of lung cancer, such as neratinib in HER2 mutated patients or dabrafenib in subjects bearing BRAF mutation. Initial results of clinical studies and reports are promising and allow to envision a brighter future for research and treatment of lung cancer.