International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.
International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.
Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.
Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.
Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.
Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.
Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.
International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.
Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.
Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.
Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.
An International Open Access Journal Devoted to General Medicine.
Lung cancer remains one of the most common and lethal cancers worldwide, markedly contributing to cancer-related illness and death (1,2). It is the leading cause of cancer mortality, with >2 million new cases diagnosed each year and a persistently low 5-year survival rate, especially in advanced stages (3–5). The disease is mainly divided into two subtypes based on histological and molecular features: Non-small cell lung cancer (NSCLC), which accounts for ~85% of cases, and small cell lung cancer (SCLC), representing the remaining ~15% and known for its rapid growth and early spread (6). NSCLC includes adenocarcinoma, squamous cell carcinoma and large cell carcinoma, each with unique molecular profiles and clinical behaviors (7).
Lung cancer development and progression are driven by complex signaling pathways that regulate fundamental cellular processes such as proliferation, survival, metastasis and resistance to therapy (8–10). Dysregulation of these pathways often results from genetic mutations, epigenetic alterations or environmental exposures, including tobacco smoke, air pollution and carcinogens such as asbestos and radon (11–14). Over the past decade, notable progress has been made in elucidating the molecular mechanisms underlying lung cancer pathogenesis (15,16). Advances in genomic sequencing have enabled the identification of key oncogenic drivers, including mutations in EGFR, rearrangements in anaplastic lymphoma kinase (ALK), and mutations in KRAS (17–20). These discoveries have led to the development of targeted therapies that have fundamentally transformed the clinical management of lung cancer (21). For example, EGFR-tyrosine kinase inhibitors (TKIs), such as gefitinib, erlotinib and osimertinib, have demonstrated robust efficacy in patients with EGFR-mutant NSCLC, markedly improving both progression-free survival (PFS) and overall survival (OS) compared with conventional chemotherapy (22–25). Similarly, ALK inhibitors, including crizotinib, alectinib and lorlatinib, have markedly improved outcomes for patients with ALK-rearranged NSCLC, offering durable responses and enhanced quality of life (26–28). KRAS mutations are present in 25–30% of lung adenocarcinomas and have historically been considered untreatable with drugs due to the lack of suitable binding pockets for therapeutic intervention (29,30). However, recent breakthroughs, particularly the development of KRAS G12C inhibitors such as sotorasib and adagrasib, have yielded promising clinical results, opening new therapeutic avenues for this patient population (30–32).
In addition to well-characterized signaling pathways, the PI3K/AKT/mTOR axis serves a central role in tumor growth and survival in lung cancer (33). Activation of this pathway is frequently driven by mutations or amplifications in upstream regulators such as EGFR, KRAS and PI3K itself (34). Dysregulation of the PI3K/AKT/mTOR pathway contributes to resistance against both chemotherapy and targeted therapies, thereby positioning it as a key focus of ongoing research (35). Current preclinical and clinical investigations are assessing inhibitors targeting components of this pathway, including PI3K, AKT and mTOR, both as monotherapies and in combination regimens, with the aim of overcoming therapeutic resistance and improving patient outcomes (36–38). The involvement of immune checkpoint pathways, such as programmed cell death protein 1 (PD-1)/programmed death receptor ligand-1 (PD-L1) and cytotoxic T lymphocyte-associated antigen-4 (CTLA-4), in tumor immune evasion has been established (39,40). These insights have facilitated the development of immune checkpoint inhibitors (ICIs), which have markedly reshaped treatment paradigms for both NSCLC and SCLC (41). Therapeutic agents such as pembrolizumab, nivolumab and atezolizumab have demonstrated clinically meaningful improvements in survival, particularly among patients with high PD-L1 expression or elevated tumor mutational burden (42–44). Beyond enhancing clinical outcomes, these agents have also redefined standard treatment practices, with the combination of immunotherapy with chemotherapy now widely adopted as a first-line therapy (45).
The present review provides an overview of key signaling pathways involved in lung cancer pathogenesis, including EGFR, ALK, KRAS, PI3K/AKT/mTOR and immune checkpoint pathways. It also highlights recent advances in targeted therapies, such as next-generation TKIs, monoclonal antibodies and combination strategies, and their clinical implications.
The EGFR pathway represents one of the most extensively studied and clinically significant signaling cascades in NSCLC (46). This pathway is crucial for regulating essential cellular processes, including proliferation, survival, differentiation and migration (47,48). In NSCLC, specific genetic alterations in the EGFR gene, most notably exon 19 deletions and the L858R point mutation in exon 21, lead to constitutive activation of the receptor tyrosine kinase (RTK) (49,50) (Fig. 1). Such activation results in ligand-independent dimerization and subsequent autophosphorylation (48–50). These oncogenic changes initiate downstream signal transduction through key pathways including the PI3K/AKT/mTOR and RAS/RAF/MEK/ERK cascades, ultimately driving uncontrolled cell proliferation, suppression of apoptosis and enhanced tumor viability (51,52). The recognition of EGFR mutations as driver oncogenes in NSCLC has fundamentally reshaped the therapeutic approach to lung cancer (49). First-generation EGFR-TKIs, including gefitinib and erlotinib, have demonstrated notable efficacy in patients harboring these mutations, leading to a substantial improvement in PFS compared with conventional chemotherapy (53). These small-molecule inhibitors competitively bind to the ATP-binding site of the EGFR tyrosine kinase domain (TKD), effectively obstructing downstream signaling (54). The subsequent development of second-generation TKIs (such as afatinib and dacomitinib) alongside third-generation inhibitors (such as osimertinib) has further enhanced clinical outcomes by addressing resistance mechanisms whilst increasing target specificity (55–57).
Despite these advancements, the development of acquired resistance to EGFR-TKIs remains a major clinical challenge. The most common mechanism of resistance is the T790M gatekeeper mutation in exon 20, which increases the affinity of the receptor for ATP and physically impedes TKI binding (58). Other mechanisms contributing to resistance include MET amplification, human epidermal growth factor receptor (HER)2 amplification, histologic transformation into SCLC, and activation of alternative signaling pathways (59–64). To overcome these challenges, ongoing research is focused on the development of fourth-generation EGFR inhibitors, combination therapies targeting parallel signaling pathways and novel therapeutic approaches such as antibody-drug conjugates and bispecific antibodies directed against EGFR (65,66).
The evolution of EGFR-targeted therapies in NSCLC exemplifies a paradigm for precision medicine in oncology, wherein tumor molecular profiling directly informs clinical decision-making. Current clinical guidelines emphasize the importance of comprehensive molecular testing at both initial diagnosis and during disease progression to identify actionable genetic alterations and mechanisms of therapeutic resistance (66). Furthermore, the integration of liquid biopsy methodologies for ctDNA analysis has facilitated dynamic monitoring of EGFR mutation status and the detection of emerging resistance mutations, thereby enabling more timely and evidence-based treatment adjustments (67,68). As the understanding of EGFR signaling biology continues to advance, it is anticipated that novel therapeutic strategies will further improve clinical outcomes for patients with EGFR-mutated NSCLC.
ALK rearrangements, particularly the echinoderm microtubule-associated protein-like 4 (EML4)-ALK fusion, constitute a clinically distinct molecular subgroup in NSCLC, occurring in 3–7% of cases (69,70). This genetic aberration originates from a chromosomal inversion on chromosome 2p, leading to the fusion of the EML4 gene with the ALK gene (71). The resulting EML4-ALK fusion protein acts as a constitutively active tyrosine kinase that drives oncogenic signaling primarily through the MAPK/ERK and PI3K/AKT pathways, which are key regulators of cell proliferation, survival and metastasis (72–74) (Fig. 2). The identification of ALK rearrangements has fundamentally reshaped the therapeutic landscape for patients with ALK-positive NSCLC (75). Targeted ALK inhibitors, such as crizotinib, alectinib and lorlatinib, have demonstrated substantial clinical benefits (76–78). Crizotinib, as the first-generation ALK inhibitor, was the first to show marked improvements in PFS and overall response rates compared with conventional chemotherapy (76). However, despite its initial efficacy, resistance to crizotinib commonly develops (typically within 1 year of treatment initiation) due to secondary mutations within the ALK kinase domain or activation of alternative signaling pathways (79).
To overcome resistance mechanisms associated with ALK inhibition, next-generation agents, such as alectinib and lorlatinib, have been developed. Alectinib, classified as a second-generation ALK inhibitor, has demonstrated superior clinical efficacy in both treatment-naïve patients and those who have developed resistance to crizotinib (77). Its enhanced central nervous system (CNS) penetration markedly improves therapeutic effectiveness against brain metastases (77). Lorlatinib, a third-generation ALK inhibitor, is specifically designed to target a broad spectrum of ALK resistance mutations and has shown potent activity in patients who have progressed after prior ALK inhibitor therapy (78).
Despite these advancements, resistance to ALK inhibitors remains a notable clinical challenge. Resistance mechanisms include on-target mutations within the ALK gene, activation of alternative signaling pathways (referred to as off-target resistance) and histological transformation (69,80,81). Current research efforts are directed toward further characterizing these resistance mechanisms and developing innovative therapeutic strategies, including combination therapies and fourth-generation ALK inhibitors-to enhance clinical outcomes for patients with ALK-positive NSCLC (82–84). The ongoing advancement of ALK-targeted therapies underscores the essential role of precision medicine in the effective management of NSCLC.
KRAS mutations represent one of the most prevalent and clinically notable genetic alterations in NSCLC, occurring in 25–30% of cases, particularly among adenocarcinoma subtypes (85). These mutations are predominantly located at codon 12 (such as G12C, G12V and G12D), with lower frequencies observed at codons 13 and 61 (86). They result in constitutive activation of the KRAS protein, thereby promoting uncontrolled cellular proliferation and survival (87). The oncogenic activity of mutant KRAS is primarily mediated through sustained activation of downstream signaling pathways, most notably the MAPK/ERK and PI3K/AKT cascades (88). These pathways regulate essential cellular functions such as cell cycle progression, metabolic regulation and evasion of apoptosis, ultimately contributing to tumor growth, metastasis and therapeutic resistance (89,90) (Fig. 3).
For decades, KRAS was considered ‘undruggable’ due to its lack of conventional binding pockets and its high affinity for GTP/GDP, which posed substantial challenges in the development of small-molecule inhibitors (91). However, advances in structural biology and drug discovery have fundamentally transformed the therapeutic landscape for KRAS-mutant NSCLC (92). The identification of a unique, druggable pocket adjacent to the G12C mutation site has enabled the development of covalent inhibitors that selectively target the mutant cysteine residue (93). Among these agents, sotorasib (AMG 510) and adagrasib (MRTX849) have emerged as promising therapeutic options, demonstrating notable clinical efficacy in patients with KRAS G12C-mutant NSCLC (85,94). Sotorasib, recognized as the first US Food and Drug Administration-approved KRAS G12C inhibitor, has demonstrated an objective response rate of ~37% in pretreated patients (95). By contrast, adagrasib has shown both systemic and intracranial antitumor activity, achieving a response rate of ~43% in the KRYSTAL-1 trial (96).
These groundbreaking developments have not only introduced novel therapeutic opportunities for patients with KRAS-mutant NSCLC but have also spurred extensive research into combination strategies and next-generation KRAS inhibitors. Current clinical trials are actively evaluating the potential of combining KRAS G12C inhibitors with ICIs, Src homology 2 domain-containing protein tyrosine phosphatase 2 inhibitors or other targeted agents to overcome resistance mechanisms and improve long-term clinical outcomes (97–99). Additionally, ongoing efforts are focused on developing inhibitors specifically targeting alternative KRAS mutations (such as G12D and G12V), as well as pan-KRAS inhibitors designed to benefit a broader patient population (100). Despite these encouraging advances, several challenges remain, most notably the emergence of acquired resistance and the need for more effective therapeutic approaches targeting non-G12C KRAS mutations, which highlights the critical importance of continued research in this rapidly evolving field (101,102).
The PI3K/AKT/mTOR pathway is a highly conserved and tightly regulated signaling cascade that governs essential cellular functions such as growth, proliferation, metabolism and survival (103–105). It integrates signals from diverse extracellular stimuli, including growth factors, hormones and nutrients, to coordinate critical cellular responses necessary for maintaining homeostasis (106–108). Dysregulation of this pathway is frequently observed in multiple malignancies, particularly lung cancer, and is often driven by genetic alterations that result in constitutive activation (109). Among the most common are activating mutations in PI3K catalytic subunit α, which encodes the catalytic subunit of PI3K and leads to elevated PIP3 levels and enhanced signaling output (110). Concurrently, loss-of-function mutations or deletions in the tumor suppressor gene PTEN, a negative regulator of the pathway, further contribute to sustained pathway activation (74). Additionally, amplification or overexpression of AKT reinforces oncogenic signaling, promoting aberrant cell survival and proliferation (111). In lung cancer, these molecular alterations are associated with aggressive tumor phenotypes characterized by resistance to apoptosis, increased angiogenesis and metabolic reprogramming-all of which facilitate tumor progression and metastasis (112) (Fig. 4).
Despite compelling biological evidence supporting the therapeutic targeting of the PI3K/AKT/mTOR pathway in lung cancer, clinical development of inhibitors has encountered notable obstacles. Although preclinical studies demonstrate that PI3K, AKT and mTOR inhibitors can effectively suppress tumor growth and induce apoptosis (73,113), their clinical utility has been hampered by dose-limiting toxicities and the emergence of resistance mechanisms (73,113). Common adverse effects, such as hyperglycemia, rash, diarrhea and hepatotoxicity, frequently necessitate dose reductions or treatment discontinuation, thereby compromising therapeutic efficacy (51). Resistance typically develops through compensatory activation of alternative pathways (such as MAPK/ERK), feedback loops involving RTKs or mutations in downstream effectors (114–116). These findings underscore the complexity of pathway inhibition and highlight the urgent need for innovative therapeutic strategies.
To overcome these limitations, combination therapies targeting the PI3K/AKT/mTOR pathway are under intensive investigation (117). One promising strategy involves combining pathway inhibitors with other targeted agents, such as EGFR or MEK inhibitors, to simultaneously block multiple signaling nodes and prevent adaptive resistance (118–120). For instance, dual inhibition of EGFR and PI3K/AKT/mTOR has demonstrated robust synergistic effects in preclinical models of lung cancer harboring both EGFR mutations and pathway alterations (118). Another emerging approach combines PI3K/AKT/mTOR inhibitors with ICIs, such as anti-PD-1 or anti-PD-L1 antibodies, to enhance antitumor immune responses (121,122). Preclinical evidence indicates that pathway inhibition can modulate the tumor microenvironment by reducing immunosuppressive signals and promoting T-cell infiltration, thereby augmenting the efficacy of immunotherapy (33,123). Ongoing clinical trials are evaluating these combinatorial approaches with the goal of improving clinical outcomes and overcoming resistance in patients with lung cancer.
Immune checkpoint pathways, particularly the PD-1/PD-L1 axis and CTLA-4, serve as critical mechanisms by which tumors evade immune surveillance (124). Under normal physiological conditions, these pathways regulate T-cell activation and maintain immune self-tolerance (125). However, cancer cells exploit these regulatory mechanisms to suppress antitumor immune responses, thereby facilitating tumor growth and metastasis (126). The PD-1/PD-L1 interaction serves a central role in this immune evasion process (127). PD-1 is expressed on activated T cells and binds to PD-L1, which is frequently overexpressed on tumor cells and within the tumor microenvironment (124). This interaction inhibits T-cell proliferation and effector functions, ultimately leading to T-cell exhaustion and immune tolerance (128). Similarly, CTLA-4, expressed on both regulatory T cells and activated effector T cells, competes with CD28 for binding to B7 ligands on antigen-presenting cells, thereby dampening early T-cell activation and promoting an immunosuppressive environment (73,129) (Fig. 5).
The advent of ICIs has markedly transformed the treatment landscape for advanced NSCLC (130). Monoclonal antibodies targeting PD-1 (such as pembrolizumab and nivolumab), PD-L1 (such as atezolizumab) and CTLA-4 (such as ipilimumab) have demonstrated robust clinical activity by reinvigorating antitumor immunity. Pembrolizumab was the first ICI approved as a first-line therapy for patients with NSCLC and high PD-L1 expression (≥50%), based on the KEYNOTE-024 trial (131). It notably improved PFS and OS compared with platinum-based chemotherapy. Nivolumab and atezolizumab have also shown durable clinical benefit, particularly in patients with high PD-L1 expression or elevated tumor mutational burden (TMB) (132,133). These therapies offer a favorable toxicity profile relative to conventional chemotherapy, contributing to improved patient quality of life (132).
Despite these therapeutic advances, both primary and acquired resistance to ICIs remain notable clinical barriers (134). Primary resistance refers to the absence of an initial response, whereas acquired resistance develops following an initial positive response (135). Resistance mechanisms can be broadly categorized into tumor-intrinsic and tumor-extrinsic factors. Tumor-intrinsic mechanisms include loss of antigen presentation (such as mutations in human leukocyte antigen or β2-microglobulin), activation of alternative immune checkpoints (such as T-Cell immunoglobulin and mucin domain 3 or lymphocyte activating 3) and upregulation of immunosuppressive signaling pathways (such as TGF-β or indoleamine 2,3-dioxygenase) (136–138). Tumor-extrinsic mechanisms involve an immunosuppressive tumor microenvironment enriched with regulatory T cells, myeloid-derived suppressor cells and M2-polarized macrophages (139). Additionally, genomic alterations, such as mutations in serine/threonine kinase 11 or kelch-like ECH associated protein 1, have been associated with reduced responsiveness to ICIs in NSCLC (140).
To enhance patient selection and optimize treatment outcomes, there is a need for reliable predictive biomarkers. Currently, PD-L1 expression assessed using immunohistochemistry is the most widely used biomarker; however, its predictive value is limited. Certain patients with low PD-L1 expression demonstrate durable responses, whilst others with high expression fail to respond. TMB, which reflects the total number of somatic mutations per megabase of genome sequenced, has emerged as a complementary biomarker (141). Higher TMB levels are associated with increased neoantigen production and enhanced immune recognition. Nevertheless, standardization of TMB assessment remains a challenge. Other emerging biomarkers under investigation include gene expression signatures, spatial patterns of immune infiltration and ctDNA analysis (142).
To overcome resistance and improve ICI efficacy, several combination strategies are being evaluated in clinical trials. Dual checkpoint inhibition, such as combined PD-1 and CTLA-4 blockade, has demonstrated synergistic effects in NSCLC (143). Combinations of ICIs with targeted therapies (such as EGFR or ALK inhibitors) are also being explored in molecularly-defined NSCLC subpopulations (144). Another promising approach involves combining ICIs with agents that modulate the tumor microenvironment, including angiogenesis inhibitors (such as bevacizumab) and drugs targeting immunosuppressive myeloid cells [such as colony-stimulating factor 1 receptor inhibitors (CSF1R)] (145). Furthermore, integrating ICIs with conventional modalities such as chemotherapy or radiotherapy has shown potential to enhance antitumor immunity through mechanisms such as immunogenic cell death and increased antigen release (146–148).
Lung cancer is a heterogeneous disease that arises from complex interactions among multiple signaling pathways. Although targeted therapies have markedly transformed the treatment landscape for certain patient populations, the development of resistance mechanisms and pathway redundancies continue to pose substantial challenges. In addition to the well-established oncogenic drivers such as EGFR, ALK and KRAS, a multitude of other signaling pathways contribute to lung cancer pathogenesis, disease progression and therapeutic resistance. These pathways frequently interact with known oncogenic drivers, thereby modulating tumor proliferation, survival, metastasis and immune evasion. The following section provides an overview of several key signaling pathways implicated in lung cancer (Table I).
HER2, also known as ErbB2, is a transmembrane glycoprotein with intrinsic tyrosine kinase activity (149). It is encoded by the HER2/neu proto-oncogene located on chromosome 17q21 (149). As a core member of the EGFR/ErbB family, HER2 serves a pivotal role in regulating fundamental cellular processes such as proliferation, differentiation and survival (150). These functions underscore its significance in normal embryonic development as well as in the pathogenesis of several malignancies, particularly NSCLC (149,150). In lung tumorigenesis, HER2 alterations, including point mutations, gene amplifications and protein overexpression, drive uncontrolled tumor cell proliferation, enhance metastatic potential and contribute to resistance to conventional therapeutic strategies (151). Consequently, HER2 has emerged as a key therapeutic target in oncology, leading to the development of targeted agents such as monoclonal antibodies (such as trastuzumab) and TKIs (such as lapatinib), which are specifically designed to inhibit its oncogenic signaling (152).
FLT3, also known as CD135 or Flk-2, is a member of the RTK III family, which includes KIT proto-oncogene, receptor tyrosine kinase (KIT), platelet-derived growth factor receptor (PDGFR) and CSF1R (153). The receptor comprises an extracellular ligand-binding domain, a transmembrane region and an intracellular TKD (153). FLT3 is predominantly expressed in hematopoietic stem and progenitor cells within the bone marrow, thymus and lymph nodes, where it regulates myeloid and lymphoid cell proliferation, survival and differentiation (152,153). Although primarily associated with hematologic malignancies such as acute myeloid leukemia (AML), FLT3 dysregulation has also been implicated in solid tumors, including NSCLC (154,155). FLT3 aberrations in lung cancer occur through three major mechanisms: i) Overexpression associated with aggressive disease and poor clinical prognosis (155); ii) rare internal tandem duplication and TKD mutations that may drive tumor progression (155); and iii) crosstalk with EGFR, MET or ALK signaling pathways, contributing to drug resistance in lung adenocarcinoma (155). Given its oncogenic potential, FLT3 is currently under investigation as a therapeutic target in lung cancer. Small-molecule inhibitors such as midostaurin and quizartinib, originally developed for AML, are now being evaluated in clinical trials involving FLT3-altered NSCLC (156). To overcome resistance, combination therapies incorporating MEK or PI3K/AKT inhibitors are actively being explored (156).
The PDGFR is a single-chain transmembrane glycoprotein belonging to the Type III RTK family (157). It is widely expressed in several cell types, including smooth muscle cells, fibroblasts, endothelial cells, glial cells and chondrocytes (158). PDGFRα, one of its major isoforms, promotes tumor cell proliferation, invasion and neovascularization (159). Activation of the PDGFR signaling cascade engages key downstream effectors such as the RAS-MAPK and PI3K pathways (160). PDGFRα contributes to lung cancer progression through four well-defined mechanisms (159): i) Enhancing cyclin D1 expression and accelerating the G1/S phase transition; ii) increasing MMP-2 and MMP-9 levels to promote tumor invasion; iii) inducing VEGF secretion and recruiting tumor-associated fibroblasts to support angiogenesis; and iv) activating cancer-associated fibroblasts that release pro-tumorigenic cytokines. Dysregulation of PDGFR in lung cancer arises from multiple molecular alterations, including gene amplification, activating mutations, chromosomal rearrangements, and autocrine or paracrine activation loops (157–159). Therapeutic strategies targeting PDGFR include multitargeted TKIs (such as imatinib, sunitinib and sorafenib), selective inhibitors (such as crenolanib and olaratumab) and combination regimens with chemotherapy, anti-angiogenic agents or immunotherapy (159,160). Despite promising preclinical and clinical evidence, the development of drug resistance and challenges in patient stratification remain notable barriers (160). Further understanding of PDGFR biology may enable the design of more effective therapeutic strategies for PDGFR-driven lung cancers.
The KIT receptor (CD117) serves a notable role in lung cancer, particularly in neuroendocrine subtypes such as SCLC and large cell neuroendocrine carcinoma (161). As a type III RTK, KIT has a unique structural organization: Its extracellular domain binds stem cell factor (SCF) through five immunoglobulin-like loops, whilst the intracellular region contains a split TKD responsible for downstream signal transduction (161). This architecture enables KIT to regulate essential cellular functions, including proliferation, survival, differentiation and migration (162). A total of 15–20% of SCLC cases exhibit KIT overexpression coupled with autocrine SCF production, establishing a self-sustaining growth loop (162). Although TKIs, such as imatinib, demonstrate robust efficacy in other KIT-driven malignancies, most notably gastrointestinal stromal tumors, their clinical benefit in lung cancer is restricted to patients harboring specific activating mutations or gene amplifications (163). Therefore, comprehensive molecular profiling is crucial for identifying patients who may derive therapeutic benefit. Research efforts have been directed toward developing next-generation KIT inhibitors with enhanced CNS penetration, such as avapritinib, as well as exploring combination strategies involving ICIs or epigenetic modulators (162,163).
FGFR, a member of the RTK family, comprises four principal isoforms: FGFR1, FGFR2, FGFR3 and FGFR4 (164). Upon binding to its ligand, fibroblast growth factor, FGFR undergoes dimerization and autophosphorylation, leading to the activation of multiple downstream signaling pathways, including JAK/STAT, phospholipase Cγ, PI3K and MAPK (165). These signaling cascades regulate fundamental cellular processes such as chemotaxis, differentiation and proliferation, and also serve roles in the development of nerve cells and fibroblasts (166). Notably, the FGFR pathway functions as a key oncogenic driver in a subset of lung cancers, particularly squamous cell carcinomas (167). Although FGFR-targeted therapies show preclinical efficacy, their clinical translation requires more precise patient stratification and strategies to overcome resistance mechanisms (168). Further investigation into FGFR biology may facilitate the development of novel, molecularly tailored therapeutic approaches for distinct subtypes of lung cancer.
MET is a RTK encoded by the proto-oncogene MET that binds HGF (169). It is predominantly expressed on the cell membranes of epithelial and endothelial cells (170). The MET signaling pathway regulates critical cellular functions, including cell migration, apoptosis, proliferation and differentiation (170). Dysregulated MET activation contributes to aggressive tumor phenotypes, such as immune evasion, enhanced cell survival, infiltration and invasiveness (171). Key downstream signaling pathways include Ras/Raf/MEK/ERK/MAPK, PI3K/PDK1/Akt, PLC-γ and JAK/STAT (169–171). The HGF/MET axis serves as a major oncogenic driver in lung adenocarcinoma, particularly in tumors harboring MET exon 14 skipping mutations or other alterations (172). However, notable challenges persist in patient selection, resistance management and the optimization of therapeutic strategies (172). Future research should focus on elucidating context-specific MET signaling mechanisms, identifying robust predictive biomarkers and developing novel therapeutic agents to improve clinical outcomes. Combining molecular profiling with targeted treatments will be essential for advancing precision medicine in MET-dysregulated lung cancers.
The p53 signaling pathway interacts with multiple intracellular networks and is central to maintaining cellular homeostasis and normal physiological functions (173). It activates in response to DNA damage or abnormal proliferation, causing cell cycle arrest and DNA repair (174). If damage cannot be repaired, p53 induces apoptosis by activating pro-apoptotic genes (173). Normally, p53 mRNA levels are high, but protein levels stay low due to rapid mouse double minute 2 (MDM2)-mediated ubiquitination and degradation (173–175). MDM2 binds to p53 and promotes its breakdown, forming a key negative feedback loop (176). Due to its tumor-suppressive function, p53 pathway dysregulation serves a major role in lung cancer development (177). Targeting this pathway may offer potential for personalized treatment, though challenges remain due to mutations and complex regulation (178). Advances in targeted therapy have created new opportunities for leveraging p53 in precision oncology (179). Integrating comprehensive molecular profiling with the development of novel agents and rational combination strategies will be critical to unlocking the therapeutic potential of p53.
Abnormal activation of the Wnt signaling pathway is strongly associated with lung cancer development (180). Upon binding of Wnt ligands to the Frizzled-LDL receptor related protein receptor complex on the cell membrane, Axin translocation is initiated, allowing β-catenin to accumulate in the nucleus (181). There, β-catenin interacts with Tcf/Lef transcription factors and recruits co-activators to drive the expression of Wnt target genes (182). In the absence of Wnt signals, β-catenin is phosphorylated and subsequently degraded by a destruction complex composed of adenomatous polyposis coli protein, GSK3β and casein kinase 1 α1, thereby maintaining low intracellular levels of β-catenin (183–185). Under these conditions, Tcf/Lef functions as a transcriptional repressor, inhibiting gene expression (186). Mutations in β-catenin that disrupt the regulation of Wnt signaling have been identified in several malignancies, including lung, liver, ovarian, skin, prostate cancer and melanoma (187–191). The Wnt/β-catenin pathway serves a pivotal role in lung cancer pathogenesis, particularly in tumor initiation and the maintenance of cancer stem cell properties (184). Although therapeutic targeting of this pathway remains challenging due to its pleiotropic functions and intricate regulatory mechanisms, advances in molecular profiling and targeted therapies offer promising avenues for intervention (186,187). Future progress will depend on integrating molecular stratification with novel agents and rational combination strategies to fully exploit the therapeutic potential of the Wnt/β-catenin pathway in lung cancer treatment (187–191).
JAK is a non-RTK family composed of four members: JAK1, JAK2, JAK3 and TYK2 (192). STATs, which include STAT1-6, serve as direct substrates for JAKs and mediate signal transduction to the nucleus to regulate gene expression (193). The JAK-STAT pathway governs essential cellular functions such as growth, proliferation, differentiation and immune signaling (194,195). Activated JAK subsequently phosphorylates specific tyrosine residues on the receptor, generating docking sites for STAT proteins (193,195). Once phosphorylated, STATs form homo- or heterodimers and translocate into the nucleus, where they modulate gene transcription by binding to specific promoter regions (194). The JAK-STAT pathway functions as a central signaling axis in lung cancer, linking extracellular signals with nuclear gene regulation (196). Despite its structural simplicity and rapid signal transmission kinetics, therapeutic targeting of this pathway remains challenging. Ongoing research continues to elucidate the regulatory mechanisms of JAK-STAT signaling in lung cancer, offering novel opportunities for targeted intervention (197). Future advancements will hinge on the development of selective inhibitors, the characterization of context-dependent interactions, and the identification of predictive biomarkers to guide precision oncology strategies (198).
The TGFβ family includes cytokines that inhibit the growth of normal epithelial cells (199). It consists of TGFβ isoforms, Activins, Inhibins, Nodal, bone morphogenetic proteins, anti-Müllerian hormone, and growth and differentiation factors (200–202). This pathway regulates key cellular processes such as proliferation, apoptosis, invasion, metastasis, extracellular matrix remodeling, differentiation and immune responses (203). Dysregulated TGFβ signaling disrupts cellular homeostasis and is associated with tumor initiation, progression and immune evasion (203). TGFβ initiates signaling by binding to two transmembrane receptors, TβRI and TβRII, that activate a downstream signaling cascade (199,203). Upon binding to TβRII, TGFβ recruits and phosphorylates TβRI (203). Activated TβRI subsequently phosphorylates SMAD2 and SMAD3, which associate with SMAD4 to form a transcriptional complex that translocates into the nucleus to regulate gene expression (204). As a central regulator of lung cancer progression, aberrant TGFβ signaling serves a critical role in promoting metastasis and suppressing antitumor immunity (205). Although targeting this pathway holds therapeutic promise, further research is needed to clarify its context-dependent functions and optimize combination therapies (206). A deeper understanding of how TGFβ interacts with other oncogenic pathways-such as EGFR and KRAS-is essential for developing effective precision treatments in lung cancer (207).
The NF-κB family consists of transcription factors that regulate essential biological processes such as immunity, inflammation, cell survival, growth and differentiation (208–210). The mammalian NF-κB family consists of five members: NF-κB1 (p50), NF-κB2 (p65), RelA (p65), RelB and c-Rel (211). These proteins form homodimers or heterodimers, translocate into the nucleus, bind to κB sites in target genes and control their expression (212). Under normal conditions, NF-κB is sequestered in the cytoplasm by the inhibitory protein IκB, remaining in an inactive state (213). Aberrant NF-κB activation, driven by overexpression or mutations in pathway components, is strongly associated with lung cancer initiation and progression (214,215). As a central regulator of inflammation and oncogenesis, NF-κB promotes tumor survival, immune evasion and metastasis (216). Although therapeutic targeting is complicated by its essential physiological roles, precision strategies, such as selective inhibition and combination therapies, offer potential for improving lung cancer treatment (217). Further research on biomarker-guided modulation of NF-κB signaling is crucial for advancing clinical applications (218).
Insulin and IGF signaling pathways are central regulators of metabolic processes (219). Previous research demonstrated that these pathways contribute to tumor initiation and progression, positioning them as key therapeutic targets (220). The human insulin receptor and IGF1 receptor both have tetrameric structures with intrinsic tyrosine kinase activity (221). Upon ligand binding, they phosphorylate insulin receptor substrate proteins, which activate downstream pathways such as PI3K/AKT and MAPK, thereby promoting oncogenic processes (220,221). Studies have reported that insulin and IGF1 stimulate tumor cell proliferation, whereas inhibition of either pathway suppresses tumor growth (222). The insulin/IGF axis serves as a critical driver of lung cancer metabolism and progression, integrating metabolic dysregulation with oncogenic signaling (223,224). Although the clinical application of IGF-targeted therapies has encountered challenges, combination approaches and precision metabolic interventions offer promising avenues (225). Future research should focus on overcoming resistance mechanisms and targeting metabolic vulnerabilities in lung cancer (226).
The development of next-generation TKIs marks a notable advancement in the treatment of oncogene-driven NSCLC, particularly for patients exhibiting resistance to earlier-generation inhibitors (227). These next-generation TKIs, including osimertinib for EGFR-mutant NSCLC and lorlatinib for ALK-positive NSCLC, have been specifically designed to overcome the limitations associated with their predecessors (18,228). They offer enhanced efficacy, broader activity against resistance mutations and improved penetration into the CNS (229,230). Such advancements have transformed the therapeutic landscape, providing renewed hope for patients who develop resistance to initial therapies.
Osimertinib, a third-generation EGFR-TKI, has emerged as a cornerstone in the treatment of NSCLC with EGFR mutations (228). First- and second-generation EGFR TKIs, including erlotinib, gefitinib and afatinib, have demonstrated marked clinical benefits for patients harboring activating EGFR mutations such as exon 19 deletions and L858R mutations (53–57). However, resistance to these agents inevitably develops, often due to the acquisition of the EGFR T790M mutation, which diminishes the binding affinity of earlier-generation TKIs (228). Osimertinib was specifically designed to target both activating EGFR mutations and the T790M resistance mutation, rendering it an effective option for overcoming this resistance (231). Clinical trials, including the AURA series and the FLAURA study, have reported that osimertinib offers superior PFS and OS compared with earlier-generation TKIs, even in first-line settings (232–234). Furthermore, osimertinib demonstrates enhanced CNS penetration, making it particularly effective against brain metastases, a common and challenging complication associated with EGFR-mutant NSCLC (229). This CNS activity is especially critical given that 25–40% of patients with EGFR-mutant NSCLC develop brain metastases during their disease course (235).
Similarly, lorlatinib, a third-generation ALK-TKI, has emerged as a groundbreaking therapy for ALK-positive NSCLC (18). Earlier-generation ALK inhibitors, including crizotinib, ceritinib and alectinib, have demonstrated notable efficacy in treating ALK-rearranged NSCLC (78). However, resistance frequently develops due to secondary mutations in the ALK gene or activation of bypass signaling pathways (69). Lorlatinib was specifically designed to address these resistance mechanisms and exhibits potent activity against a broad spectrum of ALK resistance mutations, notably the highly resistant G1202R mutation (236). The CROWN trial provided compelling evidence of the superior efficacy of lorlatinib compared with crizotinib in the first-line treatment setting, showing notably prolonged PFS and higher intracranial response rates (237). Similar to osimertinib, lorlatinib also demonstrates marked CNS penetration, rendering it particularly effective in managing brain metastases, a complication that affects ≤60% of patients with ALK-positive NSCLC throughout their disease trajectory (230,238).
The enhanced CNS activity of next-generation TKIs represents a critical feature, particularly given that the brain is a common site for metastasis in oncogene-driven NSCLC (239). Traditional chemotherapy and earlier-generation TKIs frequently fail to achieve sufficient drug concentrations within the CNS due to the presence of the blood-brain barrier, resulting in inadequate control over brain metastases (240). By contrast, next-generation TKIs such as osimertinib and lorlatinib are specifically designed to penetrate the blood-brain barrier more effectively, thereby facilitating robust intracranial responses and delaying the progression of CNS disease (229,230). This capability not only enhances survival rates but also preserves neurological function and improves quality of life for patients.
Despite these advancements, resistance to next-generation TKIs continues to pose a significant challenge. In the case of osimertinib, resistance mechanisms include the emergence of EGFR C797S mutations, MET amplification and histological transformation to SCLC (57). For lorlatinib, resistance may arise through compound ALK mutations or activation of alternative signaling pathways (241). To address these challenges, ongoing research is focused on developing fourth-generation TKIs, exploring combination therapies, and investigating novel strategies, such as antibody-drug conjugates and immunotherapy in oncogene-driven NSCLC (242–244).
An ADC represents a sophisticated and innovative class of therapeutic agents that integrates the precision of monoclonal antibodies with the potent cytotoxic effects characteristic of chemotherapy (245). Structurally, an ADC consists of three core components: i) A monoclonal antibody engineered to selectively recognize and bind to a specific antigen expressed on the surface of tumor cells; ii) a cytotoxic agent, commonly referred to as the payload, which induces cell death in targeted cancer cells; and iii) a chemical linker that stably connects the antibody to the payload (245). The monoclonal antibody functions as a ‘guided missile’, selectively delivering the cytotoxic payload directly to tumor cells whilst minimizing damage to healthy tissues, thereby reducing off-target toxicity (246). This targeted delivery mechanism represents one of the key advantages of ADCs, enabling the use of highly potent cytotoxic agents that would be too toxic for systemic administration (246).
ADCs are increasingly being adopted in oncology, particularly in the treatment of lung cancer, where early clinical trials have shown encouraging results (247–249). In both NSCLC and SCLC, ADCs have demonstrated notable response rates and improved survival outcomes, especially among patients who have limited remaining treatment options (250,251). For example, ADCs targeting proteins such as HER2, HER3, trophoblast cell-surface antigen 2 (TROP2), carcinoembryonic antigen-related cell adhesion molecule 5 (CEACAM5) and MET in NSCLC, and delta-like ligand 3 (DLL3) in SCLC, have attracted considerable attention due to their ability to produce durable responses in heavily pretreated populations (251–254). These findings highlight the potential of ADCs to address notable unmet needs in lung cancer therapy, particularly for patients with limited therapeutic alternatives.
In NSCLC, several ADCs are currently under investigation, each targeting distinct tumor-associated antigens. HER2-targeted ADCs, such as trastuzumab deruxtecan, have demonstrated notable efficacy in NSCLC characterized by HER2 mutations or overexpression (255). Although HER2 mutations are rare in NSCLC, they are associated with aggressive disease and poor prognosis; therefore, HER2-targeted ADCs represent a promising therapeutic strategy for this specific patient population (256). Similarly, HER3-targeted ADCs, including patritumab deruxtecan, are being evaluated in EGFR-mutant NSCLC, particularly in patients who have developed resistance to EGFR-TKIs (257). HER3 is frequently overexpressed in EGFR-mutant NSCLC and serves a key role in mediating resistance to targeted therapies, making it an attractive target for ADC development (258).
TROP2 is another promising target in NSCLC, as it is overexpressed in a substantial proportion of lung adenocarcinomas and is associated with poor prognosis (259). Sacituzumab govitecan, a TROP2-targeted ADC, has demonstrated encouraging activity in NSCLC, with durable responses observed in patients with advanced disease (260). In addition, CEACAM5 and MET are actively being investigated as ADC targets in NSCLC (246). CEACAM5 is overexpressed in a subset of lung adenocarcinomas, whilst MET amplification or overexpression is a well-established driver of tumor growth and therapeutic resistance in NSCLC (246,261). ADCs directed against these proteins aim to deliver potent cytotoxic payloads specifically to tumor cells, thereby overcoming resistance mechanisms and improving clinical outcomes (262). In SCLC, DLL3 has emerged as a compelling target for ADC development (263). DLL3 is highly expressed on the surface of SCLC cells but is scarcely present in normal tissues, making it an ideal candidate for targeted therapy (263). Rovalpituzumab tesirine, a DLL3-targeted ADC, has shown promising activity in SCLC, particularly among patients with high DLL3 expression (264). Although early clinical trials encountered certain challenges, ongoing research is focused on optimizing the use of DLL3-targeted ADCs and identifying biomarkers that can predict treatment response (265–267).
However, the development of ADCs for lung cancer presents multiple challenges. Key considerations include the optimization of target selection, improvement of linker stability to prevent premature release of the cytotoxic payload, and effective management of toxicities such as interstitial lung disease, which has been reported with certain ADCs (268–270). Moreover, the identification of predictive biomarkers is crucial for selecting patients most likely to benefit from ADC therapy, thereby enhancing therapeutic efficacy (253).
Combination strategies, such as dual inhibition of EGFR and MET or concurrent targeting of the PI3K/AKT/mTOR pathway along with immune checkpoints, are currently under active investigation to overcome resistance and improve therapeutic outcomes (147,271,272). These approaches aim to address the complex and heterogeneous nature of cancer biology, where single-agent therapies often fail due to the development of resistance mechanisms and tumor heterogeneity (273).
For example, dual inhibition of EGFR and MET represents a promising therapeutic approach in cancers characterized by co-activation of these pathways or in cases where resistance to EGFR inhibitors arises from MET amplification or signaling activation (274). EGFR is a well-characterized oncogenic driver involved in tumor proliferation across multiple malignancies, including NSCLC (46). However, resistance to EGFR-TKIs frequently emerges through mechanisms such as activation of the MET pathway (275). By simultaneously targeting both EGFR and MET, researchers seek to block compensatory signaling pathways that tumors utilize to evade therapeutic pressure, thereby prolonging the duration of treatment response (276).
Similarly, the co-targeting of the PI3K/AKT/mTOR pathway and immune checkpoints represents a synergistic strategy in cancer therapy (277). The PI3K/AKT/mTOR pathway functions as a central regulator of cell growth, survival and metabolic processes, with its dysregulation commonly observed across multiple tumor types (120). However, inhibitors targeting this pathway frequently trigger feedback activation of compensatory signaling mechanisms, which can compromise their therapeutic effectiveness (122). Combining PI3K/AKT/mTOR inhibitors with ICIs, such as anti-PD-1 or anti-CTLA-4 antibodies, aims not only to suppress tumor proliferation directly but also to enhance the ability of the immune system to recognize and eradicate malignant cells (278). This combinatorial strategy leverages the potential of immunotherapy to counteract the immunosuppressive tumor microenvironment often reinforced by aberrant PI3K/AKT/mTOR signaling (279).
These combination strategies are supported by preclinical evidence and early-phase clinical trials, which have shown encouraging results in terms of tumor regression and prolonged PFS (280–282). Nonetheless, several challenges remain, including the optimization of dosing regimens, mitigation of overlapping toxicities and the identification of predictive biomarkers to guide patient selection for those most likely to derive clinical benefit (283). As research progresses, these combination therapies hold promise to transform the treatment paradigm for cancers that currently present major therapeutic challenges when managed with monotherapies.
Liquid biopsies, which analyze ctDNA, have emerged as a transformative, non-invasive tool for detecting targetable mutations and monitoring treatment responses in patients with cancer (284). By contrast to traditional tissue biopsies, often requiring invasive procedures and potentially failing to capture the full genetic heterogeneity of tumors, liquid biopsies offer a minimally invasive alternative that can be serially performed over time (285). This approach involves isolating ctDNA, which consists of DNA fragments shed by tumor cells into the bloodstream, and analyzing them for clinically relevant genetic alterations such as mutations, amplifications or gene fusions that drive tumorigenesis (286). By providing a real-time molecular profile of the tumor, liquid biopsies enable clinicians to identify actionable mutations, including EGFR, ALK or BRAF variants, and guide personalized therapeutic strategies accordingly (287).
One of the most notable advantages of liquid biopsies is their ability to monitor treatment response and detect emerging resistance mechanisms (288). For example, in patients receiving targeted therapies such as EGFR inhibitors, resistance mutations, such as T790M in NSCLC, can be detected early through ctDNA analysis (289). Such early identification allows for timely adjustments to treatment regimens. Moreover, liquid biopsies can assess tumor burden and minimal residual disease following surgical resection or systemic therapy, thereby offering valuable prognostic insights that support clinical decision-making regarding adjuvant or maintenance treatments (290).
Biomarker-driven approaches, which rely on the identification of specific molecular alterations, serve a fundamental role in personalizing cancer therapy and improving patient outcomes (291). By integrating liquid biopsy data with clinical and pathological information, clinicians can stratify patients into distinct molecular subgroups and select therapies most likely to achieve favorable outcomes (292,293). For instance, patients with HER2-positive breast cancer or KRAS-mutated colorectal cancer can be matched to targeted therapies or clinical trials evaluating novel agents specifically designed to target their unique genetic profiles (294,295). This precision medicine strategy not only enhances therapeutic efficacy but also minimizes unnecessary exposure to ineffective treatments and their associated adverse effects (296).
Furthermore, liquid biopsies serve an increasingly central role in clinical trials by facilitating patient selection, monitoring pharmacodynamic responses and evaluating the impact of investigational therapies on tumor genetics (297). As technological advancements, marked by improvements in sensitivity, specificity and the ability to detect low-frequency mutations, continue to evolve, liquid biopsies are poised to become a cornerstone of modern oncology care (298). These innovations hold the potential to transform how cancer is diagnosed, treated and monitored, ultimately advancing the development of more personalized, effective and patient-centered therapeutic strategies (298,299).
Despite marked advancements in targeted therapy for lung cancer, several critical challenges persist that require focused attention and innovative strategies. One of the most pressing concerns is the inevitable emergence of resistance to targeted therapies, which can occur through both on-target and off-target mechanisms (300). Primary resistance affects 20–30% of patients, whilst acquired resistance typically develops within 9–14 months after treatment initiation, substantially limiting the duration of clinical benefit (301). The underlying mechanisms of resistance are complex and heterogeneous, encompassing secondary mutations in the target gene (such as EGFR T790M and C797S), activation of bypass signaling pathways (such as MET amplification and HER2 activation) and histological transformations (such as conversion to SCLC) (302–304).
The identification and validation of predictive biomarkers remain a major challenge in optimizing targeted therapeutic strategies (305). Although considerable progress has been achieved in detecting common driver mutations (such as EGFR, ALK and ROS1), there is an urgent need for more sensitive and comprehensive biomarker platforms capable of detecting rare mutations, gene fusions and intricate molecular profiles (306–308). Liquid biopsy technologies, particularly ctDNA analysis, have shown promise in this regard; however, their application remains limited by issues of sensitivity and specificity, particularly in the context of early-stage disease and minimal residual disease monitoring (309).
Moreover, the development of effective therapies for rare molecular subtypes, collectively representing 10–15% of NSCLC cases, remains a notable unmet clinical need (227). These subtypes encompass rare genetic alterations such as EGFR exon 20 insertions, HER2 mutations, RET fusions, NTRK fusions and MET exon 14 skipping mutations (64–67). Although targeted therapies have been developed for several alterations, certain patients still lack effective treatment options (71). Furthermore, the limited size of patient populations associated with these rare subtypes poses substantial challenges for clinical trial enrollment and pharmaceutical development.
Future research should focus on several key areas to effectively address the aforementioned challenges: i) Elucidating the molecular mechanisms of resistance through comprehensive genomic profiling and functional investigations; ii) developing novel therapeutic agents, including fourth-generation EGFR inhibitors, covalent KRAS inhibitors and selective RET inhibitors; iii) optimizing combination strategies that target multiple pathways concurrently whilst maintaining acceptable toxicity profiles; iv) advancing biomarker discovery through multi-omics approaches and artificial intelligence-assisted data analysis; and v) innovating clinical trial designs, such as basket trials and platform trials, to accelerate drug development for rare molecular subtypes.
Additionally, there is an increasing necessity to integrate targeted therapies with other treatment modalities, such as immunotherapy and radiotherapy, to develop more comprehensive treatment strategies. The investigation of novel drug delivery systems, including antibody-drug conjugates and nanoparticle-based therapies, may also present new opportunities to enhance therapeutic efficacy whilst minimizing systemic toxicity.
Signaling pathways serve a crucial role in the pathogenesis of lung cancer, driving essential processes such as cell proliferation, survival, invasion and metastasis. The dysregulation of these pathways, often resulting from genetic mutations or amplifications, serves as a hallmark of lung cancer and contributes to its aggressive behavior and resistance to conventional therapies. Targeted therapies that specifically inhibit these aberrant signaling pathways have transformed the treatment landscape for lung cancer, particularly in NSCLC, which constitutes the majority of cases. Advancements in understanding of these signaling pathways have also facilitated the development of innovative therapeutic strategies, including combination therapies and next-generation inhibitors aimed at overcoming resistance mechanisms. Ongoing research and clinical trials are imperative to address existing challenges and further propel advancements in the field of precision oncology.
Not applicable.
Funding: No funding was received.
Not applicable.
ZT, WS and HaZ were responsible for conception and design, acquisition of data, and analysis and interpretation of data. SX, JZ and JR revised the article. XW and HuZ completed the final version of the manuscript. All authors read and approved the final manuscript. Data authentication is not applicable.
Not applicable.
Not applicable.
The authors declare that they have no competing interests.
|
Li Y, Wu X, Yang P, Jiang G and Luo Y: Machine learning for lung cancer diagnosis, treatment, and prognosis. Genomics Proteomics Bioinformatics. 20:850–866. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Bade BC and Dela Cruz CS: Lung cancer 2020: Epidemiology, etiology, and prevention. Clin Chest Med. 41:1–24. 2020. View Article : Google Scholar : PubMed/NCBI | |
|
Harðardottir H, Jonsson S, Gunnarsson O, Hilmarsdottir B, Asmundsson J, Gudmundsdottir I, Saevarsdottir VY, Hansdottir S, Hannesson P and Gudbjartsson T: Advances in lung cancer diagnosis and treatment-a review. Laeknabladid. 108:17–29. 2020.(In Icelandic). View Article : Google Scholar | |
|
Abu Rous F, Singhi EK, Sridhar A, Faisal MS and Desai A: Lung cancer treatment advances in 2022. Cancer Invest. 41:12–24. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Wu F, Wang L and Zhou C: Lung cancer in China: Current and prospect. Curr Opin Oncol. 33:40–46. 2021. View Article : Google Scholar : PubMed/NCBI | |
|
Rodriguez-Canales J, Parra-Cuentas E and Wistuba II: Diagnosis and molecular classification of lung cancer. Cancer Treat Res. 170:25–46. 2016. View Article : Google Scholar : PubMed/NCBI | |
|
de Sousa VML and Carvalho L: Heterogeneity in lung cancer. Pathobiology. 85:96–107. 2018. View Article : Google Scholar : PubMed/NCBI | |
|
Abolfathi H, Arabi M and Sheikhpour M: A literature review of microRNA and gene signaling pathways involved in the apoptosis pathway of lung cancer. Respir Res. 24:552023. View Article : Google Scholar : PubMed/NCBI | |
|
Niu Z, Jin R, Zhang Y and Li H: Signaling pathways and targeted therapies in lung squamous cell carcinoma: Mechanisms and clinical trials. Signal Transduct Target Ther. 7:3532022. View Article : Google Scholar : PubMed/NCBI | |
|
Yuan M, Zhao Y, Arkenau HT, Lao T, Chu L and Xu Q: Signal pathways and precision therapy of small-cell lung cancer. Signal Transduct Target Ther. 7:1872022. View Article : Google Scholar : PubMed/NCBI | |
|
Masciale V, Banchelli F, Grisendi G, Samarelli AV, Raineri G, Rossi T, Zanoni M, Cortesi M, Bandini S, Ulivi P, et al: The molecular features of lung cancer stem cells in dedifferentiation process-driven epigenetic alterations. J Biol Chem. 300:1079942024. View Article : Google Scholar : PubMed/NCBI | |
|
Hoque MO, Brait M, Rosenbaum E, Poeta ML, Pal P, Begum S, Dasgupta S, Carvalho AL, Ahrendt SA, Westra WH and Sidransky D: Genetic and epigenetic analysis of erbB signaling pathway genes in lung cancer. J Thorac Oncol. 5:1887–1893. 2010. View Article : Google Scholar : PubMed/NCBI | |
|
He H, He MM, Wang H, Qiu W, Liu L, Long L, Shen Q, Zhang S, Qin S, Lu Z, et al: In utero and childhood/adolescence exposure to tobacco smoke, genetic risk, and lung cancer incidence and mortality in adulthood. Am J Respir Crit Care Med. 207:173–182. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Chen CY, Huang KY, Chen CC, Chang YH, Li HJ, Wang TH and Yang PC: The role of PM2.5 exposure in lung cancer: Mechanisms, genetic factors, and clinical implications. EMBO Mol Med. 17:31–40. 2025. View Article : Google Scholar : PubMed/NCBI | |
|
Nagano T, Tachihara M and Nishimura Y: Molecular mechanisms and targeted therapies including immunotherapy for non-small cell lung cancer. Curr Cancer Drug Targets. 19:595–630. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Samarelli AV, Masciale V, Aramini B, Coló GP, Tonelli R, Marchioni A, Bruzzi G, Gozzi F, Andrisani D, Castaniere I, et al: Molecular mechanisms and cellular contribution from lung fibrosis to lung cancer development. Int J Mol Sci. 22:121792021. View Article : Google Scholar : PubMed/NCBI | |
|
Ohmori T, Yamaoka T, Ando K, Kusumoto S, Kishino Y, Manabe R and Sagara H: Molecular and clinical features of EGFR-TKI-associated lung injury. Int J Mol Sci. 22:7922021. View Article : Google Scholar : PubMed/NCBI | |
|
Schneider JL, Lin JJ and Shaw AT: ALK-positive lung cancer: A moving target. Nat Cancer. 4:330–343. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Reck M, Carbone DP, Garassino M and Barlesi F: Targeting KRAS in non-small-cell lung cancer: Recent progress and new approaches. Ann Oncol. 32:1101–1110. 2021. View Article : Google Scholar : PubMed/NCBI | |
|
Yoda S, Dagogo-Jack I and Hata AN: Targeting oncogenic drivers in lung cancer: Recent progress, current challenges and future opportunities. Pharmacol Ther. 193:20–30. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Herrera-Juárez M, Serrano-Gómez C, Bote-de-Cabo H and Paz-Ares L: Targeted therapy for lung cancer: Beyond EGFR and ALK. Cancer. 129:1803–1820. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Yoneda K, Imanishi N, Ichiki Y and Tanaka F: Treatment of non-small cell lung cancer with EGFR-mutations. J UOEH. 41:153–163. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Hosomi Y, Morita S, Sugawara S, Kato T, Fukuhara T, Gemma A, Takahashi K, Fujita Y, Harada T, Minato K, et al: Gefitinib alone versus gefitinib plus chemotherapy for non-small-cell lung cancer with mutated epidermal growth factor receptor: NEJ009 study. J Clin Oncol. 38:115–123. 2020. View Article : Google Scholar : PubMed/NCBI | |
|
Greenhalgh J, Bagust A, Boland A, Dwan K, Beale S, Hockenhull J, Proudlove C, Dundar Y, Richardson M, Dickson R, et al: Erlotinib and gefitinib for treating non-small cell lung cancer that has progressed following prior chemotherapy (review of NICE technology appraisals 162 and 175): A systematic review and economic evaluation. Health Technol Assess. 19:1–134. 2015. View Article : Google Scholar | |
|
Remon J, Besse B, Aix SP, Callejo A, Al-Rabi K, Bernabe R, Greillier L, Majem M, Reguart N, Monnet I, et al: Osimertinib treatment based on plasma T790M monitoring in patients with EGFR-mutant non-small-cell lung cancer (NSCLC): EORTC lung cancer group 1613 APPLE phase II randomized clinical trial. Ann Oncol. 34:468–476. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Abdelgalil AA and Alkahtani HM: Crizotinib: A comprehensive profile. Profiles Drug Subst Excip Relat Methodol. 48:39–69. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Peters S, Camidge DR, Shaw AT, Gadgeel S, Ahn JS, Kim DW, Ou SI, Pérol M, Dziadziuszko R, Rosell R, et al: Alectinib versus crizotinib in untreated ALK-positive non-small-cell lung cancer. N Engl J Med. 377:829–838. 2017. View Article : Google Scholar : PubMed/NCBI | |
|
Solomon BJ, Liu G, Felip E, Mok TSK, Soo RA, Mazieres J, Shaw AT, de Marinis F, Goto Y, Wu YL, et al: Lorlatinib versus crizotinib in patients with advanced ALK-positive non-small cell lung cancer: 5-Year outcomes from the phase III CROWN study. J Clin Oncol. 42:3400–3409. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Luo J, Ostrem J, Pellini B, Imbody D, Stern Y, Solanki HS, Haura EB and Villaruz LC: Overcoming KRAS-mutant lung cancer. Am Soc Clin Oncol Educ Book. 42:1–11. 2022.PubMed/NCBI | |
|
Jänne PA, Riely GJ, Gadgeel SM, Heist RS, Ou SI, Pacheco JM, Johnson ML, Sabari JK, Leventakos K, Yau E, et al: Adagrasib in non-small-cell lung cancer harboring a KRASG12C mutation. N Engl J Med. 387:120–131. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Skoulidis F, Li BT, Dy GK, Price TJ, Falchook GS, Wolf J, Italiano A, Schuler M, Borghaei H, Barlesi F, et al: Sotorasib for lung cancers with KRAS p.G12C mutation. N Engl J Med. 384:2371–2381. 2021. View Article : Google Scholar : PubMed/NCBI | |
|
Olivier T and Prasad V: Sotorasib in KRAS(G12C) mutated lung cancer. Lancet. 403:1452024. View Article : Google Scholar : PubMed/NCBI | |
|
Sanaei MJ, Razi S, Pourbagheri-Sigaroodi A and Bashash D: The PI3K/Akt/mTOR pathway in lung cancer; oncogenic alterations, therapeutic opportunities, challenges, and a glance at the application of nanoparticles. Transl Oncol. 18:1013642022. View Article : Google Scholar : PubMed/NCBI | |
|
Iksen, Pothongsrisit S and Pongrakhananon V: Targeting the PI3K/AKT/mTOR signaling pathway in lung cancer: An update regarding potential drugs and natural products. Molecules. 26:41002021. View Article : Google Scholar : PubMed/NCBI | |
|
Ghareghomi S, Atabaki V, Abdollahzadeh N, Ahmadian S and Hafez Ghoran S: Bioactive PI3-kinase/Akt/mTOR inhibitors in targeted lung cancer therapy. Adv Pharm Bull. 13:24–35. 2023.PubMed/NCBI | |
|
Tan AC: Targeting the PI3K/Akt/mTOR pathway in non-small cell lung cancer (NSCLC). Thorac Cancer. 11:511–518. 2020. View Article : Google Scholar : PubMed/NCBI | |
|
Chen B, Song Y, Zhan Y, Zhou S, Ke J, Ao W, Zhang Y, Liang Q, He M, Li S, et al: Fangchinoline inhibits non-small cell lung cancer metastasis by reversing epithelial-mesenchymal transition and suppressing the cytosolic ROS-related Akt-mTOR signaling pathway. Cancer Lett. 543:2157832022. View Article : Google Scholar : PubMed/NCBI | |
|
Li J, Zhang D, Wang S, Yu P, Sun J, Zhang Y, Meng X, Li J and Xiang L: Baicalein induces apoptosis by inhibiting the glutamine-mTOR metabolic pathway in lung cancer. J Adv Res. 68:341–357. 2025. View Article : Google Scholar : PubMed/NCBI | |
|
Cheng W, Kang K, Zhao A and Wu Y: Dual blockade immunotherapy targeting PD-1/PD-L1 and CTLA-4 in lung cancer. J Hematol Oncol. 17:542024. View Article : Google Scholar : PubMed/NCBI | |
|
Shen X, Huang S, Xiao H, Zeng S, Liu J, Ran Z and Xiong B: Efficacy and safety of PD-1/PD-L1 plus CTLA-4 antibodies ± other therapies in lung cancer: A systematic review and meta-analysis. Eur J Hosp Pharm. 30:3–8. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Vergnenegre A and Chouaid C: Economic analyses of immune-checkpoint inhibitors to treat lung cancer. Expert Rev Pharmacoecon Outcomes Res. 21:365–371. 2021. View Article : Google Scholar : PubMed/NCBI | |
|
Garon EB, Rizvi NA, Hui R, Leighl N, Balmanoukian AS, Eder JP, Patnaik A, Aggarwal C, Gubens M, Horn L, et al: Pembrolizumab for the treatment of non-small-cell lung cancer. N Engl J Med. 372:2018–2028. 2015. View Article : Google Scholar : PubMed/NCBI | |
|
Cascone T, Awad MM, Spicer JD, He J, Lu S, Sepesi B, Tanaka F, Taube JM, Cornelissen R, Havel L, et al: Perioperative nivolumab in resectable lung cancer. N Engl J Med. 390:1756–1769. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Felip E, Altorki N, Zhou C, Vallières E, Martínez-Martí A, Rittmeyer A, Chella A, Reck M, Goloborodko O, Huang M, et al: Overall survival with adjuvant atezolizumab after chemotherapy in resected stage II–IIIA non-small-cell lung cancer (IMpower010): A randomised, multicentre, open-label, phase III trial. Ann Oncol. 34:907–919. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Zhang T, Li W, Diwu D, Chen L, Chen X and Wang H: Efficacy and safety of first-line immunotherapy plus chemotherapy in treating patients with extensive-stage small cell lung cancer: A Bayesian network meta-analysis. Front Immunol. 14:11970442023. View Article : Google Scholar : PubMed/NCBI | |
|
da Cunha Santos G, Shepherd FA and Tsao MS: EGFR mutations and lung cancer. Annu Rev Pathol. 6:49–69. 2011. View Article : Google Scholar : PubMed/NCBI | |
|
Paez JG, Jänne PA, Lee JC, Tracy S, Greulich H, Gabriel S, Herman P, Kaye FJ, Lindeman N, Boggon TJ, et al: EGFR mutations in lung cancer: Correlation with clinical response to gefitinib therapy. Science. 304:1497–1500. 2004. View Article : Google Scholar : PubMed/NCBI | |
|
Liu X, Wang P, Zhang C and Ma Z: Epidermal growth factor receptor (EGFR): A rising star in the era of precision medicine of lung cancer. Oncotarget. 8:50209–50220. 2017. View Article : Google Scholar : PubMed/NCBI | |
|
Agraso S, Lázaro M, Firvida XL, Santomé L, Fernández N, Azpitarte C, Leon L, Garcia C, Hudobro G, Areses MC, et al: Real-world data with afatinib in Spanish patients with treatment-naïve non-small-cell lung cancer harboring exon 19 deletions in epidermal growth factor receptor (Del19 EGFR): Clinical experience of the Galician lung cancer group. Cancer Treat Res Commun. 33:1006462022.PubMed/NCBI | |
|
Matsui T, Tanizawa Y and Enatsu S: Exon 19 deletion and exon 21 L858R point mutation in EGFR Mutation-positive non-small cell lung cancer. Gan To Kagaku Ryoho. 48:673–676. 2021.(In Japanese). PubMed/NCBI | |
|
Yu J, Zhang L, Peng J, Ward R, Hao P, Wang J, Zhang N, Yang Y, Guo X, Xiang C, et al: Dictamnine, a novel c-Met inhibitor, suppresses the proliferation of lung cancer cells by downregulating the PI3K/AKT/mTOR and MAPK signaling pathways. Biochem Pharmacol. 195:1148642022. View Article : Google Scholar : PubMed/NCBI | |
|
Wen Z, Jiang R, Huang Y, Wen Z, Rui D, Liao X and Ling Z: Inhibition of lung cancer cells and Ras/Raf/MEK/ERK signal transduction by ectonucleoside triphosphate phosphohydrolase-7 (ENTPD7). Respir Res. 20:1942019. View Article : Google Scholar : PubMed/NCBI | |
|
Qin BM, Chen X, Zhu JD and Pei DQ: Identification of EGFR kinase domain mutations among lung cancer patients in China: Implication for targeted cancer therapy. Cell Res. 15:212–217. 2005. View Article : Google Scholar : PubMed/NCBI | |
|
Zhang Q, Dai HH, Dong HY, Sun CT, Yang Z and Han JQ: EGFR mutations and clinical outcomes of chemotherapy for advanced non-small cell lung cancer: A meta-analysis. Lung Cancer. 85:339–345. 2014. View Article : Google Scholar : PubMed/NCBI | |
|
Wang C, Zhao K, Hu S, Dong W, Gong Y and Xie C: Clinical outcomes of afatinib versus osimertinib in patients with non-small cell lung cancer with uncommon EGFR mutations: A pooled analysis. Oncologist. 28:e397–e405. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Sun H and Wu YL: Dacomitinib in non-small-cell lung cancer: A comprehensive review for clinical application. Future Oncol. 15:2769–2777. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Leonetti A, Sharma S, Minari R, Perego P, Giovannetti E and Tiseo M: Resistance mechanisms to osimertinib in EGFR-mutated non-small cell lung cancer. Br J Cancer. 121:725–737. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Skoulidis F and Papadimitrakopoulou VA: Targeting the gatekeeper: Osimertinib in EGFR T790M mutation-positive non-small cell lung cancer. Clin Cancer Res. 23:618–622. 2017. View Article : Google Scholar : PubMed/NCBI | |
|
Spagnolo CC, Ciappina G, Giovannetti E, Squeri A, Granata B, Lazzari C, Pretelli G, Pasello G and Santarpia M: Targeting MET in non-small cell lung cancer (NSCLC): A new old story? Int J Mol Sci. 24:101192023. View Article : Google Scholar : PubMed/NCBI | |
|
Oh DY and Bang YJ: HER2-targeted therapies-a role beyond breast cancer. Nat Rev Clin Oncol. 17:33–48. 2020. View Article : Google Scholar : PubMed/NCBI | |
|
Yin X, Li Y, Wang H, Jia T, Wang E, Luo Y, Wei Y, Qin Z and Ma X: Small cell lung cancer transformation: From pathogenesis to treatment. Semin Cancer Biol. 86:595–606. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Cheng WL, Feng PH, Lee KY, Chen KY, Sun WL, Van Hiep N, Luo CS and Wu SM: The role of EREG/EGFR pathway in tumor progression. Int J Mol Sci. 22:128282021. View Article : Google Scholar : PubMed/NCBI | |
|
Iqbal MA, Arora S, Prakasam G, Calin GA and Syed MA: MicroRNA in lung cancer: Role, mechanisms, pathways and therapeutic relevance. Mol Aspects Med. 70:3–20. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Lin L, Lu Q, Cao R, Ou Q, Ma Y, Bao H, Wu X, Shao Y, Wang Z and Shen B: Acquired rare recurrent EGFR mutations as mechanisms of resistance to osimertinib in lung cancer and in silico structural modelling. Am J Cancer Res. 10:4005–4015. 2020.PubMed/NCBI | |
|
Mansour MA, AboulMagd AM, Abbas SH, Abdel-Rahman HM and Abdel-Aziz M: Insights into fourth generation selective inhibitors of (C797S) EGFR mutation combating non-small cell lung cancer resistance: A critical review. RSC Adv. 13:18825–18853. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Singh D: Revolutionizing lung cancer treatment: Innovative CRISPR-Cas9 delivery strategies. AAPS PharmSciTech. 25:1292024. View Article : Google Scholar : PubMed/NCBI | |
|
Li L, Jiang H, Zeng B, Wang X, Bao Y, Chen C, Ma L and Yuan J: Liquid biopsy in lung cancer. Clin Chim Acta. 554:1177572024. View Article : Google Scholar : PubMed/NCBI | |
|
Hsu PC, Jablons DM, Yang CT and You L: Epidermal growth factor receptor (EGFR) pathway, yes-associated protein (YAP) and the regulation of programmed death-ligand 1 (PD-L1) in non-small cell lung cancer (NSCLC). Int J Mol Sci. 20:38212019. View Article : Google Scholar : PubMed/NCBI | |
|
Elshatlawy M, Sampson J, Clarke K and Bayliss R: EML4-ALK biology and drug resistance in non-small cell lung cancer: A new phase of discoveries. Mol Oncol. 17:950–963. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Camidge DR, Dziadziuszko R, Peters S, Mok T, Noe J, Nowicka M, Gadgeel SM, Cheema P, Pavlakis N, de Marinis F, et al: Updated efficacy and safety data and impact of the EML4-ALK fusion variant on the efficacy of alectinib in untreated ALK-positive advanced non-small cell lung cancer in the global phase III ALEX study. J Thorac Oncol. 14:1233–1243. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Paliouras AR, Buzzetti M, Shi L, Donaldson IJ, Magee P, Sahoo S, Leong HS, Fassan M, Carter M, Di Leva G, et al: Vulnerability of drug-resistant EML4-ALK rearranged lung cancer to transcriptional inhibition. EMBO Mol Med. 12:e110992020. View Article : Google Scholar : PubMed/NCBI | |
|
Li K, Liu Y, Ding Y, Zhang Z, Feng J, Hu J, Chen J, Lian Z, Chen Y, Hu K, et al: BCL6 is regulated by the MAPK/ELK1 axis and promotes KRAS-driven lung cancer. J Clin Invest. 132:e1613082022. View Article : Google Scholar : PubMed/NCBI | |
|
Gadgeel SM and Wozniak A: Preclinical rationale for PI3K/Akt/mTOR pathway inhibitors as therapy for epidermal growth factor receptor inhibitor-resistant non-small-cell lung cancer. Clin Lung Cancer. 14:322–332. 2013. View Article : Google Scholar : PubMed/NCBI | |
|
Shi L, Zhu W, Huang Y, Zhuo L, Wang S, Chen S, Zhang B and Ke B: Cancer-associated fibroblast-derived exosomal microRNA-20a suppresses the PTEN/PI3K-AKT pathway to promote the progression and chemoresistance of non-small cell lung cancer. Clin Transl Med. 12:e9892022. View Article : Google Scholar : PubMed/NCBI | |
|
Tan AC and Tan DSW: Targeted therapies for lung cancer patients with oncogenic driver molecular alterations. J Clin Oncol. 40:611–625. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Ahn MJ, Kim HR, Yang JCH, Han JY, Li JYC, Hochmair MJ, Chang GC, Delmonte A, Lee KH, Campelo RG, et al: Efficacy and safety of brigatinib compared with crizotinib in asian vs non-asian patients with locally advanced or metastatic ALK-inhibitor-naive ALK+ non-small cell lung cancer: Final results from the phase III ALTA-1L study. Clin Lung Cancer. 23:720–730. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Mok T, Camidge DR, Gadgeel SM, Rosell R, Dziadziuszko R, Kim DW, Pérol M, Ou SHI, Ahn JS, Shaw AT, et al: Updated overall survival and final progression-free survival data for patients with treatment-naive advanced ALK-positive non-small-cell lung cancer in the ALEX study. Ann Oncol. 31:1056–1064. 2020. View Article : Google Scholar : PubMed/NCBI | |
|
Baba K and Goto Y: Lorlatinib as a treatment for ALK-positive lung cancer. Future Oncol. 18:2745–2766. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Lin JJ, Zhu VW, Yoda S, Yeap BY, Schrock AB, Dagogo-Jack I, Jessop NA, Jiang GY, Le LP, Gowen K, et al: Impact of EML4-ALK variant on resistance mechanisms and clinical outcomes in ALK-positive lung cancer. J Clin Oncol. 36:1199–1206. 2018. View Article : Google Scholar : PubMed/NCBI | |
|
Pinto JA, Raez LE and Domingo G: Clinical consequences of resistance to ALK inhibitors in non-small cell lung cancer. Expert Rev Respir Med. 14:385–390. 2020. View Article : Google Scholar : PubMed/NCBI | |
|
Shaw AT, Solomon BJ, Besse B, Bauer TM, Lin CC, Soo RA, Riely GJ, Ou SHI, Clancy JS, Li S, et al: ALK resistance mutations and efficacy of lorlatinib in advanced anaplastic lymphoma kinase-positive non-small-cell lung cancer. J Clin Oncol. 37:1370–1379. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Desai A and Lovly CM: Strategies to overcome resistance to ALK inhibitors in non-small cell lung cancer: A narrative review. Transl Lung Cancer Res. 12:615–628. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Balasundaram A and Doss GPC: A computational examination of the therapeutic advantages of fourth-generation ALK inhibitors TPX-0131 and repotrectinib over third-generation lorlatinib for NSCLC with ALK F1174C/L/V mutations. Front Mol Biosci. 10:13060462024. View Article : Google Scholar : PubMed/NCBI | |
|
Golding B, Luu A, Jones R and Viloria-Petit AM: The function and therapeutic targeting of anaplastic lymphoma kinase (ALK) in non-small cell lung cancer (NSCLC). Mol Cancer. 17:522018. View Article : Google Scholar : PubMed/NCBI | |
|
Torres-Jiménez J, Espinar JB, de Cabo HB, Berjaga MZ, Esteban-Villarrubia J, Fraile JZ and Paz-Ares L: Targeting KRAS(G12C) in non-small-cell lung cancer: Current standards and developments. Drugs. 84:527–548. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Chang YS, Tu SJ, Chen YC, Liu TY, Lee YT, Yen JC, Fang HY and Chang JG: Mutation profile of non-small cell lung cancer revealed by next generation sequencing. Respir Res. 22:32021. View Article : Google Scholar : PubMed/NCBI | |
|
Mugarza E, van Maldegem F, Boumelha J, Moore C, Rana S, Llorian Sopena M, East P, Ambler R, Anastasiou P, Romero-Clavijo P, et al: Therapeutic KRASG12C inhibition drives effective interferon-mediated antitumor immunity in immunogenic lung cancers. Sci Adv. 8:eabm87802022. View Article : Google Scholar : PubMed/NCBI | |
|
Ceddia S, Landi L and Cappuzzo F: KRAS-mutant non-small-cell lung cancer: From past efforts to future challenges. Int J Mol Sci. 23:93912022. View Article : Google Scholar : PubMed/NCBI | |
|
Bironzo P, Cani M, Jacobs F, Napoli VM, Listì A, Passiglia F, Righi L, Di Maio M, Novello S and Scagliotti GV: Real-world retrospective study of KRAS mutations in advanced non-small cell lung cancer in the era of immunotherapy. Cancer. 129:1662–1671. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Ferrer I, Zugazagoitia J, Herbertz S, John W, Paz-Ares L and Schmid-Bindert G: KRAS-mutant non-small cell lung cancer: From biology to therapy. Lung Cancer. 124:53–64. 2018. View Article : Google Scholar : PubMed/NCBI | |
|
Xu K, Park D, Magis AT, Zhang J, Zhou W, Sica GL, Ramalingam SS, Curran WJ and Deng X: Small molecule KRAS agonist for mutant KRAS cancer therapy. Mol Cancer. 18:852019. View Article : Google Scholar : PubMed/NCBI | |
|
Brazel D, Arter Z and Nagasaka M: A long overdue targeted treatment for KRAS mutations in NSCLC: Spotlight on adagrasib. Lung Cancer (Auckl). 13:75–80. 2022.PubMed/NCBI | |
|
Di Federico A, Ricciotti I, Favorito V, Michelina SV, Scaparone P, Metro G, De Giglio A, Pecci F, Lamberti G, Ambrogio C and Ricciuti B: Resistance to KRAS G12C inhibition in non-small cell lung cancer. Curr Oncol Rep. 25:1017–1029. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Canon J, Rex K, Saiki AY, Mohr C, Cooke K, Bagal D, Gaida K, Holt T, Knutson CG, Koppada N, et al: The clinical KRAS(G12C) inhibitor AMG 510 drives anti-tumour immunity. Nature. 575:217–223. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Lee A: Sotorasib: A review in KRAS G12C mutation-positive non-small cell lung cancer. Target Oncol. 17:727–733. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Mausey N and Halford Z: Targeted therapies for previously ‘undruggable’ KRAS-mutated non-small cell lung cancer: A review of sotorasib and adagrasib. Ann Pharmacother. 58:622–635. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Briere DM, Li S, Calinisan A, Sudhakar N, Aranda R, Hargis L, Peng DH, Deng J, Engstrom LD, Hallin J, et al: The KRASG12C inhibitor MRTX849 reconditions the tumor immune microenvironment and sensitizes tumors to checkpoint inhibitor therapy. Mol Cancer Ther. 20:975–985. 2021. View Article : Google Scholar : PubMed/NCBI | |
|
Shi Z, Weng J, Niu H, Yang H, Liu R, Weng Y, Zhu Q, Zhang Y, Tao L, Wang Z, et al: D-1553: A novel KRASG12C inhibitor with potent and selective cellular and in vivo antitumor activity. Cancer Sci. 114:2951–2960. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Santarpia M, Ciappina G, Spagnolo CC, Squeri A, Passalacqua MI, Aguilar A, Gonzalez-Cao M, Giovannetti E, Silvestris N and Rosell R: Targeted therapies for KRAS-mutant non-small cell lung cancer: From preclinical studies to clinical development-a narrative review. Transl Lung Cancer Res. 12:346–368. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Yun J, Nakagawa R and Tham K: KRAS-targeted therapy in the treatment of non-small cell lung cancer. J Oncol Pharm Pract. 29:422–430. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Corral de la Fuente E, Olmedo Garcia ME, Gomez Rueda A, Lage Y and Garrido P: Targeting KRAS in non-small cell lung cancer. Front Oncol. 11:7926352022. View Article : Google Scholar : PubMed/NCBI | |
|
Tomasini P, Walia P, Labbe C, Jao K and Leighl NB: Targeting the KRAS pathway in non-small cell lung cancer. Oncologist. 21:1450–1460. 2016. View Article : Google Scholar : PubMed/NCBI | |
|
Li XQ, Cheng XJ, Wu J, Wu KF and Liu T: Targeted inhibition of the PI3K/AKT/mTOR pathway by (+)-anthrabenzoxocinone induces cell cycle arrest, apoptosis, and autophagy in non-small cell lung cancer. Cell Mol Biol Lett. 29:582024. View Article : Google Scholar : PubMed/NCBI | |
|
Gong G, Ganesan K, Xiong Q and Zheng Y: Antitumor effects of ononin by modulation of apoptosis in non-small-cell lung cancer through inhibiting PI3K/Akt/mTOR pathway. Oxid Med Cell Longev. 2022:51224482022. View Article : Google Scholar : PubMed/NCBI | |
|
Chandarlapaty S, Sawai A, Scaltriti M, Rodrik-Outmezguine V, Grbovic-Huezo O, Serra V, Majumder PK, Baselga J and Rosen N: AKT inhibition relieves feedback suppression of receptor tyrosine kinase expression and activity. Cancer Cell. 19:58–71. 2011. View Article : Google Scholar : PubMed/NCBI | |
|
Bellmunt J, Maroto P, Bonfill T, Vazquez F, Perez-Gracia JL, Juanpere N, Hernandez-Prat A, Hernandez-Llodra S, Rovira A, Juan O and Rodriguez-Vida A: Dual mTOR1/2 inhibitor sapanisertib (FTH-003/TAK-228) in combination with weekly paclitaxel in patients with previously treated metastatic urothelial carcinoma: A phase II open-label study: A phase II open-label study. Clin Genitourin Cancer. 22:1021232024. View Article : Google Scholar : PubMed/NCBI | |
|
Al-Bustany HA, Muhammad HA, Chawsheen MA and Dash PR: Fenretinide induces apoptosis and synergises the apoptosis inducing effect of gemcitabine through inhibition of key signalling molecules involved in A549 cell survival in in silico and in vitro analyses. Cell Signal. 111:1108852023. View Article : Google Scholar : PubMed/NCBI | |
|
Curless BP, Uko NE and Matesic DF: Modulator of the PI3K/Akt oncogenic pathway affects mTOR complex 2 in human adenocarcinoma cells. Invest New Drugs. 37:902–911. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Fang W, Huang Y, Gu W, Gan J, Wang W, Zhang S, Wang K, Zhan J, Yang Y, Huang Y, et al: PI3K-AKT-mTOR pathway alterations in advanced NSCLC patients after progression on EGFR-TKI and clinical response to EGFR-TKI plus everolimus combination therapy. Transl Lung Cancer Res. 9:1258–1267. 2020. View Article : Google Scholar : PubMed/NCBI | |
|
Pal I and Mandal M: PI3K and Akt as molecular targets for cancer therapy: Current clinical outcomes. Acta Pharmacol Sin. 33:1441–1458. 2012. View Article : Google Scholar : PubMed/NCBI | |
|
Xu Y, Hu Y, Xu T, Yan K, Zhang T, Li Q, Chang F, Guo X, Peng J, Li M, et al: RNF8-mediated regulation of Akt promotes lung cancer cell survival and resistance to DNA damage. Cell Rep. 37:1098542021. View Article : Google Scholar : PubMed/NCBI | |
|
He YM, Zhou XM, Jiang SY, Zhang ZB, Cao BY, Liu JB, Zeng YY, Zhao J and Mao XL: TRIM25 activates AKT/mTOR by inhibiting PTEN via K63-linked polyubiquitination in non-small cell lung cancer. Acta Pharmacol Sin. 43:681–691. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Alharbi KS, Shaikh MAJ, Almalki WH, Kazmi I, Al-Abbasi FA, Alzarea SI, Imam SS, Alshehri S, Ghoneim MM, Singh SK, et al: PI3K/Akt/mTOR pathways inhibitors with potential prospects in non-small-cell lung cancer. J Environ Pathol Toxicol Oncol. 41:85–102. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Yan D, Huelse JM, Kireev D, Tan Z, Chen L, Goyal S, Wang X, Frye SV, Behera M, Schneider F, et al: MERTK activation drives osimertinib resistance in EGFR-mutant non-small cell lung cancer. J Clin Invest. 132:e1505172022. View Article : Google Scholar : PubMed/NCBI | |
|
Coco S, Truini A, Alama A, Dal Bello MG, Venè R, Garuti A, Carminati E, Rijavec E, Genova C, Barletta G, et al: Afatinib resistance in non-small cell lung cancer involves the PI3K/AKT and MAPK/ERK signalling pathways and epithelial-to-mesenchymal transition. Target Oncol. 10:393–404. 2015. View Article : Google Scholar : PubMed/NCBI | |
|
Adachi Y, Watanabe K, Kita K, Kitai H, Kotani H, Sato Y, Inase N, Yano S and Ebi H: Resistance mediated by alternative receptor tyrosine kinases in FGFR1-amplified lung cancer. Carcinogenesis. 38:1063–1072. 2017. View Article : Google Scholar : PubMed/NCBI | |
|
Yu Y, Shang Y, Shi S, He Y, Shi W, Wang M, Wang Q, Xu D, Shi C and Chen H: Combination of arsenic trioxide and apatinib synergistically inhibits small cell lung cancer by down-regulating VEGFR2/mTOR and Akt/c-Myc signaling pathway via GRB10. Hereditas. 161:292024. View Article : Google Scholar : PubMed/NCBI | |
|
Wu YY, Wu HC, Wu JE, Huang KY, Yang SC, Chen SX, Tsao CJ, Hsu KF, Chen YL and Hong TM: The dual PI3K/mTOR inhibitor BEZ235 restricts the growth of lung cancer tumors regardless of EGFR status, as a potent accompanist in combined therapeutic regimens. J Exp Clin Cancer Res. 38:2822019. View Article : Google Scholar : PubMed/NCBI | |
|
Zhang J, Hong Y and Shen J: Combination treatment with perifosine and MEK-162 demonstrates synergism against lung cancer cells in vitro and in vivo. Tumour Biol. 36:5699–5706. 2015. View Article : Google Scholar : PubMed/NCBI | |
|
Quan Z, Yang Y, Zheng H, Zhan Y, Luo J, Ning Y and Fan S: Clinical implications of the interaction between PD-1/PD-L1 and PI3K/AKT/mTOR pathway in progression and treatment of non-small cell lung cancer. J Cancer. 13:3434–3443. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Wu J, Zhao X, Sun Q, Jiang Y, Zhang W, Luo J and Li Y: Synergic effect of PD-1 blockade and endostar on the PI3K/AKT/mTOR-mediated autophagy and angiogenesis in Lewis lung carcinoma mouse model. Biomed Pharmacother. 125:1097462020. View Article : Google Scholar : PubMed/NCBI | |
|
Liu Q, Chen X, Qi M, Li Y, Chen W and Zhang C, Wang J, Han Z and Zhang C: Combined cryoablation and PD-1 inhibitor synergistically enhance antitumor immune responses in Lewis lung adenocarcinoma mice via the PI3K/AKT/mTOR pathway. Biochim Biophys Acta Mol Basis Dis. 1870:1672622024. View Article : Google Scholar : PubMed/NCBI | |
|
Shi Z, Shen Y, Liu X and Zhang S: Sinensetin inhibits the movement ability and tumor immune microenvironment of non-small cell lung cancer through the inactivation of AKT/β-catenin axis. J Biochem Mol Toxicol. 38:e700242024. View Article : Google Scholar : PubMed/NCBI | |
|
Santini FC and Hellmann MD: PD-1/PD-L1 axis in lung cancer. Cancer J. 24:15–19. 2018. View Article : Google Scholar : PubMed/NCBI | |
|
Kumar R, Collins D, Dolly S, McDonald F, O'Brien MER and Yap TA: Targeting the PD-1/PD-L1 axis in non-small cell lung cancer. Curr Probl Cancer. 41:111–124. 2017. View Article : Google Scholar : PubMed/NCBI | |
|
Yadav R, Khatkar R, Yap KCH, Kang CYH, Lyu J, Singh RK, Mandal S, Mohanta A, Lam HY, Okina E, et al: The miRNA and PD-1/PD-L1 signaling axis: An arsenal of immunotherapeutic targets against lung cancer. Cell Death Discov. 10:4142024. View Article : Google Scholar : PubMed/NCBI | |
|
Lu M, Wang K, Ji W, Yu Y, Li Z, Xia W and Lu S: FGFR1 promotes tumor immune evasion via YAP-mediated PD-L1 expression upregulation in lung squamous cell carcinoma. Cell Immunol. 379:1045772022. View Article : Google Scholar : PubMed/NCBI | |
|
Qiao M, Jiang T, Liu X, Mao S, Zhou F, Li X, Zhao C, Chen X, Su C, Ren S and Zhou C: Immune checkpoint inhibitors in EGFR-mutated NSCLC: Dusk or dawn? J Thorac Oncol. 16:1267–1288. 2021. View Article : Google Scholar : PubMed/NCBI | |
|
Genova C, Dellepiane C, Carrega P, Sommariva S, Ferlazzo G, Pronzato P, Gangemi R, Filaci G, Coco S and Croce M: Therapeutic implications of tumor microenvironment in lung cancer: Focus on immune checkpoint blockade. Front Immunol. 12:7994552022. View Article : Google Scholar : PubMed/NCBI | |
|
Sholl LM: Biomarkers of response to checkpoint inhibitors beyond PD-L1 in lung cancer. Mod Pathol. 35 (Suppl 1):S66–S74. 2022. View Article : Google Scholar | |
|
Reck M, Rodríguez-Abreu D, Robinson AG, Hui R, Csőszi T, Fülöp A, Gottfried M, Peled N, Tafreshi A, Cuffe S, et al: Updated analysis of KEYNOTE-024: Pembrolizumab versus platinum-based chemotherapy for advanced non-small-cell lung cancer with PD-L1 tumor proportion score of 50% or greater. J Clin Oncol. 37:537–546. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Ready NE, Ott PA, Hellmann MD, Zugazagoitia J, Hann CL, de Braud F, Antonia SJ, Ascierto PA, Moreno V, Atmaca A, et al: Nivolumab monotherapy and nivolumab plus ipilimumab in recurrent small cell lung cancer: Results from the checkmate 032 randomized cohort. J Thorac Oncol. 15:426–435. 2020. View Article : Google Scholar : PubMed/NCBI | |
|
Liu SV, Reck M, Mansfield AS, Mok T, Scherpereel A, Reinmuth N, Garassino MC, De Castro Carpeno J, Califano R, Nishio M, et al: Updated overall survival and PD-L1 subgroup analysis of patients with extensive-stage small-cell lung cancer treated with atezolizumab, carboplatin, and etoposide (IMpower133). J Clin Oncol. 39:619–630. 2021. View Article : Google Scholar : PubMed/NCBI | |
|
Tang S, Qin C, Hu H, Liu T, He Y, Guo H, Yan H, Zhang J, Tang S and Zhou H: Immune checkpoint inhibitors in non-small cell lung cancer: Progress, challenges, and prospects. Cells. 11:3202022. View Article : Google Scholar : PubMed/NCBI | |
|
Passaro A, Brahmer J, Antonia S, Mok T and Peters S: Managing resistance to immune checkpoint inhibitors in lung cancer: Treatment and novel strategies. J Clin Oncol. 40:598–610. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Kejamurthy P and Devi KTR: Immune checkpoint inhibitors and cancer immunotherapy by aptamers: An overview. Med Oncol. 41:402023. View Article : Google Scholar : PubMed/NCBI | |
|
Li Y, Jiang M, Aye L, Luo L, Zhang Y, Xu F, Wei Y, Peng D, He X, Gu J, et al: UPP1 promotes lung adenocarcinoma progression through the induction of an immunosuppressive microenvironment. Nat Commun. 15:12002024. View Article : Google Scholar : PubMed/NCBI | |
|
Ghorani E, Swanton C and Quezada SA: Cancer cell-intrinsic mechanisms driving acquired immune tolerance. Immunity. 56:2270–2295. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Giatromanolaki A, Kouroupi M, Pouliliou S, Mitrakas A, Hasan F, Pappa A and Koukourakis MI: Ectonucleotidase CD73 and CD39 expression in non-small cell lung cancer relates to hypoxia and immunosuppressive pathways. Life Sci. 259:1183892020. View Article : Google Scholar : PubMed/NCBI | |
|
Best SA, Gubser PM, Sethumadhavan S, Kersbergen A, Negrón Abril YL, Goldford J, Sellers K, Abeysekera W, Garnham AL, McDonald JA, et al: Glutaminase inhibition impairs CD8 T cell activation in STK11-/Lkb1-deficient lung cancer. Cell Metab. 34:874–887.e6. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Zhu M, Kim J, Deng Q, Ricciuti B, Alessi JV, Eglenen-Polat B, Bender ME, Huang HC, Kowash RR, Cuevas I, et al: Loss of p53 and mutational heterogeneity drives immune resistance in an autochthonous mouse lung cancer model with high tumor mutational burden. Cancer Cell. 41:1731–1748.e8. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Zhu C, Zhuang W, Chen L, Yang W and Ou WB: Frontiers of ctDNA, targeted therapies, and immunotherapy in non-small-cell lung cancer. Transl Lung Cancer Res. 9:111–138. 2020. View Article : Google Scholar : PubMed/NCBI | |
|
Chu X, Tian W, Wang Z, Zhang J and Zhou R: Co-inhibition of TIGIT and PD-1/PD-L1 in cancer immunotherapy: Mechanisms and clinical trials. Mol Cancer. 22:932023. View Article : Google Scholar : PubMed/NCBI | |
|
Chen Y, Chen Z, Chen R, Fang C, Zhang C, Ji M and Yang X: Immunotherapy-based combination strategies for treatment of EGFR-TKI-resistant non-small-cell lung cancer. Future Oncol. 18:1757–1775. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
West HJ, McCleland M, Cappuzzo F, Reck M, Mok TS, Jotte RM, Nishio M, Kim E, Morris S, Zou W, et al: Clinical efficacy of atezolizumab plus bevacizumab and chemotherapy in KRAS-mutated non-small cell lung cancer with STK11, KEAP1, or TP53 comutations: Subgroup results from the phase III IMpower150 trial. J Immunother Cancer. 10:e0030272022. View Article : Google Scholar : PubMed/NCBI | |
|
Judd J and Borghaei H: Combining immunotherapy and chemotherapy for non-small cell lung cancer. Thorac Surg Clin. 30:199–206. 2020. View Article : Google Scholar : PubMed/NCBI | |
|
Shang S, Liu J, Verma V, Wu M, Welsh J, Yu J and Chen D: Combined treatment of non-small cell lung cancer using radiotherapy and immunotherapy: Challenges and updates. Cancer Commun (Lond). 41:1086–1099. 2021. View Article : Google Scholar : PubMed/NCBI | |
|
Chae YK, Arya A, Iams W, Cruz M, Mohindra N, Villaflor V and Giles FJ: Immune checkpoint pathways in non-small cell lung cancer. Ann Transl Med. 6:882018. View Article : Google Scholar : PubMed/NCBI | |
|
Raghav KPS and Moasser MM: Molecular pathways and mechanisms of HER2 in cancer therapy. Clin Cancer Res. 29:2351–2361. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Nützinger J, Bum Lee J, Li Low J, Ling Chia P, Talisa Wijaya S, Chul Cho B, Min Lim S and Soo RA: Management of HER2 alterations in non-small cell lung cancer-the past, present, and future. Lung Cancer. 186:1073852023. View Article : Google Scholar : PubMed/NCBI | |
|
Riudavets M, Sullivan I, Abdayem P and Planchard D: Targeting HER2 in non-small-cell lung cancer (NSCLC): A glimpse of hope? An updated review on therapeutic strategies in NSCLC harbouring HER2 alterations. ESMO Open. 6:1002602021. View Article : Google Scholar : PubMed/NCBI | |
|
Ghezzi C, Chen BY, Damoiseaux R and Clark PM: Pacritinib inhibits glucose consumption in squamous cell lung cancer cells by targeting. FLT3.Sci Rep. 13:14422023. View Article : Google Scholar : PubMed/NCBI | |
|
Kuncman Ł, Orzechowska M, Milecki T, Kucharz J and Fijuth J: High FLT3 expression increases immune-cell infiltration in the tumor microenvironment and correlates with prolonged disease-free survival in patients with non-small cell lung cancer. Mol Oncol. 18:1316–1326. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Dhillon S: Gilteritinib: First global approval. Drugs. 79:331–339. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Hu C, Zhang Y, Yang J, Xu Y, Deng T, Li Y, Xu S, Wang S and Wang P: Ningetinib, a novel FLT3 inhibitor, overcomes secondary drug resistance in acute myeloid leukemia. Cell Commun Signal. 22:3552024. View Article : Google Scholar : PubMed/NCBI | |
|
Bruner JK, Ma HS, Li L, Qin ACR, Rudek MA, Jones RJ, Levis MJ, Pratz KW, Pratilas CA and Small D: Adaptation to TKI treatment reactivates ERK signaling in tyrosine kinase-driven leukemias and other malignancies. Cancer Res. 77:5554–5563. 2017. View Article : Google Scholar : PubMed/NCBI | |
|
He L, Wang X, Liu K, Wu X, Yang X, Song G, Zhang B and Zhong L: Integrative PDGF/PDGFR and focal adhesion pathways are downregulated in ERCC1-defective non-small cell lung cancer undergoing sodium glycididazole-sensitized cisplatin treatment. Gene. 691:70–76. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Catena R, Luis-Ravelo D, Antón I, Zandueta C, Salazar-Colocho P, Larzábal L, Calvo A and Lecanda F: PDGFR signaling blockade in marrow stroma impairs lung cancer bone metastasis. Cancer Res. 71:164–174. 2011. View Article : Google Scholar : PubMed/NCBI | |
|
Riess JW and Neal JW: Targeting FGFR, ephrins, Mer, MET, and PDGFR-α in non-small cell lung cancer. J Thorac Oncol. 6 (11 Suppl 4):S1797–S1798. 2011. View Article : Google Scholar : PubMed/NCBI | |
|
Kranthi Reddy S, Reddy SVG and Hussain Basha S: Discovery of novel PDGFR inhibitors targeting non-small cell lung cancer using a multistep machine learning assisted hybrid virtual screening approach. RSC Adv. 15:851–869. 2025. View Article : Google Scholar : PubMed/NCBI | |
|
Xuan H, Jingshu G, Fang Y, Na L, Xiaolin S, Zhaoyang Y, Meng W and Gongyan C: Somatic mutation of KIT is rare in small cell lung cancer patients from Northeast China. Histol Histopathol. 29:273–278. 2014.PubMed/NCBI | |
|
Miettinen M and Lasota J: KIT (CD117): A review on expression in normal and neoplastic tissues, and mutations and their clinicopathologic correlation. Appl Immunohistochem Mol Morphol. 13:205–220. 2005. View Article : Google Scholar : PubMed/NCBI | |
|
Funkhouser AT, Strigenz AM, Blair BB, Miller AP, Shealy JC, Ewing JA, Martin JC, Funk CR, Edenfield WJ and Blenda AV: KIT mutations correlate with higher galectin levels and brain metastasis in breast and non-small cell lung cancer. Cancers (Basel). 14:27812022. View Article : Google Scholar : PubMed/NCBI | |
|
Yang L, Zhou F, Zheng D, Wang D, Li X, Zhao C and Huang X: FGF/FGFR signaling: From lung development to respiratory diseases. Cytokine Growth Factor Rev. 62:94–104. 2021. View Article : Google Scholar : PubMed/NCBI | |
|
Pacini L, Jenks AD, Lima NC and Huang PH: Targeting the fibroblast growth factor receptor (FGFR) family in lung cancer. Cells. 10:11542021. View Article : Google Scholar : PubMed/NCBI | |
|
Desai A and Adjei AA: FGFR signaling as a target for lung cancer therapy. J Thorac Oncol. 11:9–20. 2016. View Article : Google Scholar : PubMed/NCBI | |
|
Peng M, Deng J and Li X: Clinical advances and challenges in targeting FGF/FGFR signaling in lung cancer. Mol Cancer. 23:2562024. View Article : Google Scholar : PubMed/NCBI | |
|
Biello F, Burrafato G, Rijavec E, Genova C, Barletta G, Truini A, Coco S, Bello MG, Alama A, Boccardo F and Grossi F: Fibroblast growth factor receptor (FGFR): A new target for non-small cell lung cancer therapy. Anticancer Agents Med Chem. 16:1142–1154. 2016. View Article : Google Scholar : PubMed/NCBI | |
|
Cervantes-Villagrana RD, Mendoza V, Hinck CS, de la Fuente-León RL, Hinck AP, Reyes-Cruz G, Vázquez-Prado J and López-Casillas F: Betaglycan sustains HGF/Met signaling in lung cancer and endothelial cells promoting cell migration and tumor growth. Heliyon. 10:e305202024. View Article : Google Scholar : PubMed/NCBI | |
|
Huang G, Liu X, Jiang T, Cao Y, Sang M, Song X, Zhou B, Qu H, Cai H, Xing D, et al: Luteolin overcomes acquired resistance to osimertinib in non-small cell lung cancer cells by targeting the HGF-MET-Akt pathway. Am J Cancer Res. 13:4145–4162. 2023.PubMed/NCBI | |
|
Moosavi F, Giovannetti E, Peters GJ and Firuzi O: Combination of HGF/MET-targeting agents and other therapeutic strategies in cancer. Crit Rev Oncol Hematol. 160:1032342021. View Article : Google Scholar : PubMed/NCBI | |
|
Yin J, Hu W, Fu W, Dai L, Jiang Z, Zhong S, Deng B and Zhao J: HGF/MET regulated epithelial-mesenchymal transitions and metastasis by FOSL2 in non-small cell lung cancer. Onco Targets Ther. 12:9227–9237. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Fregni M, Ciribilli Y and Zawacka-Pankau JE: The therapeutic potential of the restoration of the p53 protein family members in the EGFR-mutated lung cancer. Int J Mol Sci. 23:72132022. View Article : Google Scholar : PubMed/NCBI | |
|
Lin CC, Liao WT, Yang TY, Lu HJ, Hsu SL and Wu CC: MicroRNA-10b modulates cisplatin tolerance by targeting p53 directly in lung cancer cells. Oncol Rep. 46:1672021. View Article : Google Scholar : PubMed/NCBI | |
|
Zhang H, Zhang G, Xiao M, Cui S, Jin C, Yang J, Wu S and Lu X: Two-polarized roles of transcription factor FOSB in lung cancer progression and prognosis: Dependent on p53 status. J Exp Clin Cancer Res. 43:2372024. View Article : Google Scholar : PubMed/NCBI | |
|
Chantarawong W, Kuncharoen N, Tanasupawat S and Chanvorachote P: Lumichrome inhibits human lung cancer cell growth and induces apoptosis via a p53-dependent mechanism. Nutr Cancer. 71:1390–1402. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Li L, Li P, Ma X, Zeng S, Peng Y and Zhang G: Therapeutic restoring p53 function with small molecule for oncogene-driven non-small cell lung cancer by targeting serine 392 phosphorylation. Biochem Pharmacol. 203:1151882022. View Article : Google Scholar : PubMed/NCBI | |
|
Wang J, Liu D, Sun Z, Ye T, Li J, Zeng B, Zhao Q and Rosie Xing H: Autophagy augments the self-renewal of lung cancer stem cells by the degradation of ubiquitinated p53. Cell Death Dis. 12:982021. View Article : Google Scholar : PubMed/NCBI | |
|
Tang X, Li Y, Liu L, Guo R, Zhang P, Zhang Y, Zhang Y, Zhao J, Su J, Sun L and Liu Y: Sirtuin 3 induces apoptosis and necroptosis by regulating mutant p53 expression in small-cell lung cancer. Oncol Rep. 43:591–600. 2020.PubMed/NCBI | |
|
Krishnamurthy N and Kurzrock R: Targeting the Wnt/beta-catenin pathway in cancer: Update on effectors and inhibitors. Cancer Treat Rev. 62:50–60. 2018. View Article : Google Scholar : PubMed/NCBI | |
|
He Y, Jiang X, Duan L, Xiong Q, Yuan Y, Liu P, Jiang L, Shen Q, Zhao S, Yang C and Chen Y: LncRNA PKMYT1AR promotes cancer stem cell maintenance in non-small cell lung cancer via activating Wnt signaling pathway. Mol Cancer. 20:1562021. View Article : Google Scholar : PubMed/NCBI | |
|
Li HJ, Ke FY, Lin CC, Lu MY, Kuo YH, Wang YP, Liang KH, Lin SC, Chang YH, Chen HY, et al: ENO1 promotes lung cancer metastasis via HGFR and WNT signaling-driven epithelial-to-mesenchymal transition. Cancer Res. 81:4094–4109. 2021. View Article : Google Scholar : PubMed/NCBI | |
|
Li Z, Wu S and Liu W: Advances of Wnt/β-catenin signaling pathway in lung cancer: A review. Altern Ther Health Med. 30:238–247. 2024. | |
|
Chen J, Wang D, Chen H, Gu J, Jiang X, Han F, Cao J, Liu W and Liu J: TMEM196 inhibits lung cancer metastasis by regulating the Wnt/β-catenin signaling pathway. J Cancer Res Clin Oncol. 149:653–667. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Shen Y, Yang Y, Zhao Y, Nuerlan S, Zhan Y and Liu C: YY1/circCTNNB1/miR-186-5p/YY1 positive loop aggravates lung cancer progression through the Wnt pathway. Epigenetics. 19:23690062024. View Article : Google Scholar : PubMed/NCBI | |
|
Malyla V, Paudel KR, De Rubis G, Hansbro NG, Hansbro PM and Dua K: Cigarette smoking induces lung cancer tumorigenesis via upregulation of the WNT/β-catenin signaling pathway. Life Sci. 326:1217872023. View Article : Google Scholar : PubMed/NCBI | |
|
Yang J, Chen J, He J, Li J, Shi J, Cho WC and Liu X: Wnt signaling as potential therapeutic target in lung cancer. Expert Opin Ther Targets. 20:999–1015. 2016. View Article : Google Scholar : PubMed/NCBI | |
|
Zhang Y and Wang X: Targeting the Wnt/β-catenin signaling pathway in cancer. J Hematol Oncol. 13:1652020. View Article : Google Scholar : PubMed/NCBI | |
|
Bugter JM, Fenderico N and Maurice MM: Mutations and mechanisms of WNT pathway tumour suppressors in cancer. Nat Rev Cancer. 21:5–21. 2021. View Article : Google Scholar : PubMed/NCBI | |
|
Neiheisel A, Kaur M, Ma N, Havard P and Shenoy AK: Wnt pathway modulators in cancer therapeutics: An update on completed and ongoing clinical trials. Int J Cancer. 150:727–740. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Song P, Gao Z, Bao Y, Chen L, Huang Y, Liu Y, Dong Q and Wei X: Wnt/β-catenin signaling pathway in carcinogenesis and cancer therapy. J Hematol Oncol. 17:462024. View Article : Google Scholar : PubMed/NCBI | |
|
Xue C, Yao Q, Gu X, Shi Q, Yuan X, Chu Q, Bao Z, Lu J and Li L: Evolving cognition of the JAK-STAT signaling pathway: Autoimmune disorders and cancer. Signal Transduct Target Ther. 8:2042023. View Article : Google Scholar : PubMed/NCBI | |
|
Hu X, Li J, Fu M, Zhao X and Wang W: The JAK/STAT signaling pathway: From bench to clinic. Signal Transduct Target Ther. 6:4022021. View Article : Google Scholar : PubMed/NCBI | |
|
Erdogan F, Radu TB, Orlova A, Qadree AK, de Araujo ED, Israelian J, Valent P, Mustjoki SM, Herling M, Moriggl R and Gunning PT: JAK-STAT core cancer pathway: An integrative cancer interactome analysis. J Cell Mol Med. 26:2049–2062. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Shen M, Xu Z, Xu W, Jiang K, Zhang F, Ding Q, Xu Z and Chen Y: Inhibition of ATM reverses EMT and decreases metastatic potential of cisplatin-resistant lung cancer cells through JAK/STAT3/PD-L1 pathway. J Exp Clin Cancer Res. 38:1492019. View Article : Google Scholar : PubMed/NCBI | |
|
Wu Q, Wu W, Fu B, Shi L, Wang X and Kuca K: JNK signaling in cancer cell survival. Med Res Rev. 39:2082–2104. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Patel MR, Dash A, Jacobson BA, Ji Y, Baumann D, Ismail K and Kratzke RA: JAK/STAT inhibition with ruxolitinib enhances oncolytic virotherapy in non-small cell lung cancer models. Cancer Gene Ther. 26:411–418. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Ding Y, Yuan X, Wang Y and Yan J: CASQ2 alleviates lung cancer by inhibiting M2 tumor-associated macrophage polarization and JAK/STAT pathway. J Biochem Mol Toxicol. 38:e238012024. View Article : Google Scholar : PubMed/NCBI | |
|
Saito A, Horie M and Nagase T: TGF-β signaling in lung health and disease. Int J Mol Sci. 19:24602018. View Article : Google Scholar : PubMed/NCBI | |
|
Kim BN, Ahn DH, Kang N, Yeo CD, Kim YK, Lee KY, Kim TJ, Lee SH, Park MS, Yim HW, et al: TGF-β induced EMT and stemness characteristics are associated with epigenetic regulation in lung cancer. Sci Rep. 10:105972020. View Article : Google Scholar : PubMed/NCBI | |
|
Huang Y, Chen Z, Lu T, Bi G, Li M, Liang J, Hu Z, Zheng Y, Yin J, Xi J, et al: HIF-1α switches the functionality of TGF-β signaling via changing the partners of smads to drive glucose metabolic reprogramming in non-small cell lung cancer. J Exp Clin Cancer Res. 40:3982021. View Article : Google Scholar : PubMed/NCBI | |
|
Deng X, Ma N, He J, Xu F and Zou G: The role of TGFBR3 in the development of lung cancer. Protein Pept Lett. 31:491–503. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Li J, Shen C, Wang X, Lai Y, Zhou K, Li P, Liu L and Che G: Prognostic value of TGF-beta in lung cancer: Systematic review and meta-analysis. BMC Cancer. 19:6912019. View Article : Google Scholar : PubMed/NCBI | |
|
Lai XN, Li J, Tang LB, Chen WT, Zhang L and Xiong LX: MiRNAs and LncRNAs: Dual roles in TGF-β signaling-regulated metastasis in lung cancer. Int J Mol Sci. 21:11932020. View Article : Google Scholar : PubMed/NCBI | |
|
Cui Z, Ruan Z, Li M, Ren R, Ma Y, Zeng J, Sun J, Ye W, Xu W, Guo X, et al: Obstructive sleep apnea promotes the progression of lung cancer by modulating cancer cell invasion and cancer-associated fibroblast activation via TGFβ signaling. Redox Rep. 28:22798132023. View Article : Google Scholar : PubMed/NCBI | |
|
Hedrick E, Mohankumar K and Safe S: TGFβ-induced lung cancer cell migration is NR4A1-dependent. Mol Cancer Res. 16:1991–2002. 2018. View Article : Google Scholar : PubMed/NCBI | |
|
Saito A, Horie M, Micke P and Nagase T: The role of TGF-β signaling in lung cancer associated with idiopathic pulmonary fibrosis. Int J Mol Sci. 19:36112018. View Article : Google Scholar : PubMed/NCBI | |
|
Yin Y, Dai H, Sun X, Xi Z, Zhang J, Pan Y, Huang Y, Ma X, Xia Q and He K: HRG inhibits liver cancer lung metastasis by suppressing neutrophil extracellular trap formation. Clin Transl Med. 13:e12832023. View Article : Google Scholar : PubMed/NCBI | |
|
Liu W, Wang H, Bai F, Ding L, Huang Y, Lu C, Chen S, Li C, Yue X, Liang X, et al: IL-6 promotes metastasis of non-small-cell lung cancer by up-regulating TIM-4 via NF-κB. Cell Prolif. 53:e127762020. View Article : Google Scholar : PubMed/NCBI | |
|
Wang Y, Liu F, Chen L, Fang C, Li S, Yuan S, Qian X, Yin Y, Yu B, Fu B, et al: Neutrophil extracellular traps (NETs) promote non-small cell lung cancer metastasis by suppressing lncRNA MIR503HG to activate the NF-κB/NLRP3 inflammasome pathway. Front Immunol. 13:8675162022. View Article : Google Scholar : PubMed/NCBI | |
|
Zhang J, Zhao K, Zhou W, Kang R, Wei S, Shu Y, Yu C, Ku Y, Mao Y, Luo H, et al: Tet methylcytosine dioxygenase 2 (TET2) deficiency elicits EGFR-TKI (tyrosine kinase inhibitors) resistance in non-small cell lung cancer. Signal Transduct Target Ther. 9:652024. View Article : Google Scholar : PubMed/NCBI | |
|
Rasmi RR, Sakthivel KM and Guruvayoorappan C: NF-κB inhibitors in treatment and prevention of lung cancer. Biomed Pharmacother. 130:1105692020. View Article : Google Scholar : PubMed/NCBI | |
|
Liu X, Liu X, Zhuo C, Shen J, Lu K, Sha M, Ye J, Huang J, Han H and Yu H: NAT10 promotes malignant progression of lung cancer via the NF-κB signaling pathway. Discov Med. 35:936–945. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Wei X, Liu Z, Shen Y, Dong H, Chen K, Shi X, Chen Y, Wang B and Dong S: Semaphorin4A promotes lung cancer by activation of NF-κB pathway mediated by PlexinB1. PeerJ. 11:e162922023. View Article : Google Scholar : PubMed/NCBI | |
|
Dimitrakopoulos FD, Kottorou AE, Kalofonou M and Kalofonos HP: The fire within: NF-κB involvement in non-small cell lung cancer. Cancer Res. 80:4025–4036. 2020. View Article : Google Scholar : PubMed/NCBI | |
|
Li Y, Zu L, Wu H, Zhang F, Fan Y, Pan H, Du X, Guo F and Zhou Q: MiR-192/NKRF axis confers lung cancer cell chemoresistance to cisplatin via the NF-κB pathway. Thorac Cancer. 13:430–441. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Jin Y, Zhang Y, Huang A, Chen Y, Wang J, Liu N, Wang X, Gong Y, Wang W and Pan J: Overexpression of SERPINA3 suppresses tumor progression by modulating SPOP/NF-κB in lung cancer. Int J Oncol. 63:962023. View Article : Google Scholar : PubMed/NCBI | |
|
Wang Y, Zhang J, Li YJ, Yu NN, Liu WT, Liang JZ, Xu WW, Sun ZH, Li B and He QY: MEST promotes lung cancer invasion and metastasis by interacting with VCP to activate NF-κB signaling. J Exp Clin Cancer Res. 40:3012021. View Article : Google Scholar : PubMed/NCBI | |
|
Xu X, Qiu Y, Chen S, Wang S, Yang R, Liu B, Li Y, Deng J, Su Y, Lin Z, et al: Different roles of the insulin-like growth factor (IGF) axis in non-small cell lung cancer. Curr Pharm Des. 28:2052–2064. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Remsing Rix LL, Sumi NJ, Hu Q, Desai B, Bryant AT, Li X, Welsh EA, Fang B, Kinose F, Kuenzi BM, et al: IGF-binding proteins secreted by cancer-associated fibroblasts induce context-dependent drug sensitization of lung cancer cells. Sci Signal. 15:eabj58792022. View Article : Google Scholar : PubMed/NCBI | |
|
Jiang S, Xu Z, Shi Y, Liang S, Jiang X, Xiao M, Wang K and Ding L: Circulating insulin-like growth factor-1 and risk of lung diseases: A Mendelian randomization analysis. Front Endocrinol (Lausanne). 14:11263972023. View Article : Google Scholar : PubMed/NCBI | |
|
Xu J, Bie F, Wang Y, Chen X, Yan T and Du J: Prognostic value of IGF-1R in lung cancer: A PRISMA-compliant meta-analysis. Medicine (Baltimore). 98:e154672019. View Article : Google Scholar : PubMed/NCBI | |
|
Wang Z, Li W, Guo Q, Wang Y, Ma L and Zhang X: Insulin-like growth factor-1 signaling in lung development and inflammatory lung diseases. Biomed Res Int. 2018:60575892018.PubMed/NCBI | |
|
Peng Y and Tan J: The relationship between IGF pathway and acquired resistance to tyrosine kinase inhibitors in cancer therapy. Front Biosci (Landmark Ed). 28:1632023. View Article : Google Scholar : PubMed/NCBI | |
|
Pal S, Yadav P, Sainis KB and Shankar BS: TNF-α and IGF-1 differentially modulate ionizing radiation responses of lung cancer cell lines. Cytokine. 101:89–98. 2018. View Article : Google Scholar : PubMed/NCBI | |
|
Sun L, Yuan W, Wen G, Yu B, Xu F, Gan X, Tang J, Zeng Q, Zhu L, Chen C and Zhang W: Parthenolide inhibits human lung cancer cell growth by modulating the IGF-1R/PI3K/Akt signaling pathway. Oncol Rep. 44:1184–1193. 2020. View Article : Google Scholar : PubMed/NCBI | |
|
Das D, Xie L and Hong J: Next-generation EGFR tyrosine kinase inhibitors to overcome C797S mutation in non-small cell lung cancer (2019–2024). RSC Med Chem. 15:3371–3394. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Das D, Wang J and Hong J: Next-generation kinase inhibitors targeting specific biomarkers in non-small cell lung cancer (NSCLC): A recent overview. ChemMedChem. 16:2459–2479. 2021. View Article : Google Scholar : PubMed/NCBI | |
|
Wang N, Zhang Y, Mi Y, Deng H, Chen G, Tang Z, Mao J, Cui S, Zhang Y and Wang L: Osimertinib for EGFR-mutant lung cancer with central nervous system metastases: A meta-analysis and systematic review. Ann Palliat Med. 9:3038–3047. 2020. View Article : Google Scholar : PubMed/NCBI | |
|
Solomon BJ, Besse B, Bauer TM, Felip E, Soo RA, Camidge DR, Chiari R, Bearz A, Lin CC, Gadgeel SM, et al: Lorlatinib in patients with ALK-positive non-small-cell lung cancer: Results from a global phase 2 study. Lancet Oncol. 19:1654–1667. 2018. View Article : Google Scholar : PubMed/NCBI | |
|
Soejima K, Yasuda H and Hirano T: Osimertinib for EGFR T790M mutation-positive non-small cell lung cancer. Expert Rev Clin Pharmacol. 10:31–38. 2017. View Article : Google Scholar : PubMed/NCBI | |
|
Yang JCH, Ahn MJ, Kim DW, Ramalingam SS, Sequist LV, Su WC, Kim SW, Kim JH, Planchard D, Felip E, et al: Osimertinib in pretreated T790M-positive advanced non-small-cell lung cancer: AURA study phase II extension component. J Clin Oncol. 35:1288–1296. 2017. View Article : Google Scholar : PubMed/NCBI | |
|
Ramalingam SS, Yang JCH, Lee CK, Kurata T, Kim DW, John T, Nogami N, Ohe Y, Mann H, Rukazenkov Y, et al: Osimertinib as first-line treatment of EGFR mutation-positive advanced non-small-cell lung cancer. J Clin Oncol. 36:841–849. 2018. View Article : Google Scholar : PubMed/NCBI | |
|
Araki T, Kanda S, Horinouchi H and Ohe Y: Current treatment strategies for EGFR-mutated non-small cell lung cancer: From first line to beyond osimertinib resistance. Jpn J Clin Oncol. 53:547–561. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Jänne PA, Planchard D, Kobayashi K, Cheng Y, Lee CK, Valdiviezo N, Laktionov K, Yang TY, Yu Y, Kato T, et al: CNS efficacy of osimertinib with or without chemotherapy in epidermal growth factor receptor-mutated advanced non-small-cell lung cancer. J Clin Oncol. 42:808–820. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Ye Z and Guo J: Acquired ALK G1202R-, ALK I1171N-, or EML4-ALK-mediated resistance to ensartinib in lung adenocarcinoma but responded to lorlatinib: A case report. Front Oncol. 13:10821152023. View Article : Google Scholar : PubMed/NCBI | |
|
Solomon BJ, Bauer TM, Mok TSK, Liu G, Mazieres J, de Marinis F, Goto Y, Kim DW, Wu YL, Jassem J, et al: Efficacy and safety of first-line lorlatinib versus crizotinib in patients with advanced, ALK-positive non-small-cell lung cancer: Updated analysis of data from the phase 3, randomised, open-label CROWN study. Lancet Respir Med. 11:354–366. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Bauer TM, Shaw AT, Johnson ML, Navarro A, Gainor JF, Thurm H, Pithavala YK, Abbattista A, Peltz G and Felip E: Brain penetration of lorlatinib: cumulative incidences of CNS and non-CNS progression with lorlatinib in patients with previously treated ALK-positive non-small-cell lung cancer. Target Oncol. 15:55–65. 2020. View Article : Google Scholar : PubMed/NCBI | |
|
Rybarczyk-Kasiuchnicz A, Ramlau R and Stencel K: Treatment of brain metastases of non-small cell lung carcinoma. Int J Mol Sci. 22:5932021. View Article : Google Scholar : PubMed/NCBI | |
|
Ernani V and Stinchcombe TE: Management of brain metastases in non-small-cell lung cancer. J Oncol Pract. 15:563–570. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Lin JJ, Choudhury NJ, Yoda S, Zhu VW, Johnson TW, Sakhtemani R, Dagogo-Jack I, Digumarthy SR, Lee C, Do A, et al: Spectrum of mechanisms of resistance to crizotinib and lorlatinib in ROS1 fusion-positive lung cancer. Clin Cancer Res. 27:2899–2909. 2021. View Article : Google Scholar : PubMed/NCBI | |
|
Corvaja C, Passaro A, Attili I, Aliaga PT, Spitaleri G, Signore ED and de Marinis F: Advancements in fourth-generation EGFR TKIs in EGFR-mutant NSCLC: Bridging biological insights and therapeutic development. Cancer Treat Rev. 130:1028242024. View Article : Google Scholar : PubMed/NCBI | |
|
Desai A and Peters S: Immunotherapy-based combinations in metastatic NSCLC. Cancer Treat Rev. 116:1025452023. View Article : Google Scholar : PubMed/NCBI | |
|
Passaro A, Jänne PA and Peters S: Antibody-drug conjugates in lung cancer: Recent advances and implementing strategies. J Clin Oncol. 41:3747–3761. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Desai A, Abdayem P, Adjei AA and Planchard D: Antibody-drug conjugates: A promising novel therapeutic approach in lung cancer. Lung Cancer. 163:96–106. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Merle G, Friedlaender A, Desai A and Addeo A: Antibody drug conjugates in lung cancer. Cancer J. 28:429–435. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Rosner S, Valdivia A, Hoe HJ, Murray JC, Levy B, Felip E and Solomon BJ: Antibody-drug conjugates for lung cancer: Payloads and progress. Am Soc Clin Oncol Educ Book. 43:e3899682023. View Article : Google Scholar : PubMed/NCBI | |
|
Marks S and Naidoo J: Antibody drug conjugates in non-small cell lung cancer: An emerging therapeutic approach. Lung Cancer. 163:59–68. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Tarantino P, Carmagnani Pestana R, Corti C, Modi S, Bardia A, Tolaney SM, Cortes J, Soria JC and Curigliano G: Antibody-drug conjugates: Smart chemotherapy delivery across tumor histologies. CA Cancer J Clin. 72:165–182. 2022.PubMed/NCBI | |
|
Weng W, Meng T, Zhao Q, Shen Y, Fu G, Shi J, Zhang Y, Wang Z, Wang M, Pan R, et al: Antibody-exatecan conjugates with a novel self-immolative moiety overcome resistance in colon and lung cancer. Cancer Discov. 13:950–973. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Verma S, Breadner D and Raphael J: ‘Targeting’ improved outcomes with antibody-drug conjugates in non-small cell lung cancer-an updated review. Curr Oncol. 30:4329–4350. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Parisi C, Mahjoubi L, Gazzah A and Barlesi F: TROP-2 directed antibody-drug conjugates (ADCs): The revolution of smart drug delivery in advanced non-small cell lung cancer (NSCLC). Cancer Treat Rev. 118:1025722023. View Article : Google Scholar : PubMed/NCBI | |
|
Peters S, Loi S, André F, Chandarlapaty S, Felip E, Finn SP, Jänne PA, Kerr KM, Munzone E, Passaro A, et al: Antibody-drug conjugates in lung and breast cancer: Current evidence and future directions-a position statement from the ETOP IBCSG partners foundation. Ann Oncol. 35:607–629. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Ricciuti B, Lamberti G, Andrini E, Genova C, De Giglio A, Bianconi V, Sahebkar A, Chiari R and Pirro M: Antibody-drug conjugates for lung cancer in the era of personalized oncology. Semin Cancer Biol. 69:268–278. 2021. View Article : Google Scholar : PubMed/NCBI | |
|
Pourjamal N, Yazdi N, Halme A, Joncour VL, Laakkonen P, Saharinen P, Joensuu H and Barok M: Comparison of trastuzumab emtansine, trastuzumab deruxtecan, and disitamab vedotin in a multiresistant HER2-positive breast cancer lung metastasis model. Clin Exp Metastasis. 41:91–102. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Fu Z, Gao C, Xie J, Zhang C, Li S, Gu M and Shi C: Incidence and risk of fatal adverse events in cancer patients treated with HER2-targeted antibody-drug conjugates: A systematic review and meta-analysis of randomized controlled trials. BMC Cancer. 23:9602023. View Article : Google Scholar : PubMed/NCBI | |
|
Larsen ME, Lyu H and Liu B: HER3-targeted therapeutic antibodies and antibody-drug conjugates in non-small cell lung cancer refractory to EGFR-tyrosine kinase inhibitors. Chin Med J Pulm Crit Care Med. 1:11–17. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Chen Q, Jia G, Zhang X and Ma W: Targeting HER3 to overcome EGFR TKI resistance in NSCLC. Front Immunol. 14:13320572024. View Article : Google Scholar : PubMed/NCBI | |
|
Belluomini L, Avancini A, Sposito M, Milella M, Rossi A and Pilotto S: Antibody-drug conjugates (ADCs) targeting TROP-2 in lung cancer. Expert Opin Biol Ther. 23:1077–1087. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Paz-Ares LG, Juan-Vidal O, Mountzios GS, Felip E, Reinmuth N, de Marinis F, Girard N, Patel VM, Takahama T, Owen SP, et al: Sacituzumab govitecan versus docetaxel for previously treated advanced or metastatic non-small cell lung cancer: The randomized, open-label phase III EVOKE-01 study. J Clin Oncol. 42:2860–2872. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Kim YJ, Li W, Zhelev DV, Mellors JW, Dimitrov DS and Baek DS: Chimeric antigen receptor-T cells are effective against CEACAM5 expressing non-small cell lung cancer cells resistant to antibody-drug conjugates. Front Oncol. 13:11240392023. View Article : Google Scholar : PubMed/NCBI | |
|
Zanchetta C, De Marchi L, Macerelli M, Pelizzari G, Costa J, Aprile G and Cortiula F: Antibody-drug conjugates in non-small cell lung cancer: state of the art and future perspectives. Int J Mol Sci. 26:2212024. View Article : Google Scholar : PubMed/NCBI | |
|
Belluomini L, Sposito M, Avancini A, Insolda J, Milella M, Rossi A and Pilotto S: Unlocking new horizons in small-cell lung cancer treatment: The onset of antibody-drug conjugates. Cancers (Basel). 15:53682023. View Article : Google Scholar : PubMed/NCBI | |
|
Blackhall F, Jao K, Greillier L, Cho BC, Penkov K, Reguart N, Majem M, Nackaerts K, Syrigos K, Hansen K, et al: Efficacy and safety of rovalpituzumab tesirine compared with topotecan as second-line therapy in DLL3-high SCLC: Results from the phase 3 TAHOE study. J Thorac Oncol. 16:1547–1558. 2021. View Article : Google Scholar : PubMed/NCBI | |
|
Owen DH, Giffin MJ, Bailis JM, Smit MAD, Carbone DP and He K: DLL3: An emerging target in small cell lung cancer. J Hematol Oncol. 12:612019. View Article : Google Scholar : PubMed/NCBI | |
|
Morgensztern D, Besse B, Greillier L, Santana-Davila R, Ready N, Hann CL, Glisson BS, Farago AF, Dowlati A, Rudin CM, et al: Efficacy and safety of rovalpituzumab tesirine in third-line and beyond patients with DLL3-expressing, relapsed/refractory small-cell lung cancer: Results from the phase II TRINITY study. Clin Cancer Res. 25:6958–6966. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Lashari BH, Vallatharasu Y, Kolandra L, Hamid M and Uprety D: Rovalpituzumab tesirine: A novel DLL3-targeting antibody-drug conjugate. Drugs R D. 18:255–258. 2018. View Article : Google Scholar : PubMed/NCBI | |
|
Zhao C, Zhang R, Yang H, Gao Y, Zou Y and Zhang X: Antibody-drug conjugates for non-small cell lung cancer: Advantages and challenges in clinical translation. Biochem Pharmacol. 226:1163782024. View Article : Google Scholar : PubMed/NCBI | |
|
Neupane N, Thapa S, Bhattarai A, Ahuja K, Schlam I, Mittal A, Tolaney SM and Tarantino P: Opportunities and challenges for a histology-agnostic utilization of trastuzumab deruxtecan. Curr Oncol Rep. 25:1467–1482. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Desai A, Subbiah V, Roy-Chowdhuri S, Sheshadri A, Deshmukh S and Peters S: Association of antibody-drug conjugate (ADC) target expression and interstitial lung disease (ILD) in non-small-cell lung cancer (NSCLC): Association or causation or neither? Cancers (Basel). 16:37532024. View Article : Google Scholar : PubMed/NCBI | |
|
Attili I, Passaro A, Pavan A, Conte P, De Marinis F and Bonanno L: Combination immunotherapy strategies in advanced non-small cell lung cancer (NSCLC): Does biological rationale meet clinical needs? Crit Rev Oncol Hematol. 119:30–39. 2017. View Article : Google Scholar : PubMed/NCBI | |
|
Tagliamento M, Genova C, Rossi G, Coco S, Rijavec E, Dal Bello MG, Boccardo S, Grossi F and Alama A: Microtubule-targeting agents in the treatment of non-small cell lung cancer: Insights on new combination strategies and investigational compounds. Expert Opin Investig Drugs. 28:513–523. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Girard N: New strategies and novel combinations in EGFR TKI-resistant non-small cell lung cancer. Curr Treat Options Oncol. 23:1626–1644. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Wu YL, Guarneri V, Voon PJ, Lim BK, Yang JJ, Wislez M, Huang C, Liam CK, Mazieres J, Tho LM, et al: Tepotinib plus osimertinib in patients with EGFR-mutated non-small-cell lung cancer with MET amplification following progression on first-line osimertinib (INSIGHT 2): A multicentre, open-label, phase 2 trial. Lancet Oncol. 25:989–1002. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Yoshida R, Saigi M, Tani T, Springer BF, Shibata H, Kitajima S, Mahadevan NR, Campisi M, Kim W, Kobayashi Y, et al: MET-induced CD73 restrains STING-mediated immunogenicity of EGFR-mutant lung cancer. Cancer Res. 82:4079–4092. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Zhao S, Ma Y, Liu L, Fang J, Ma H, Feng G, Xie B, Zeng S, Chang J, Ren J, et al: Ningetinib plus gefitinib in EGFR-mutant non-small-cell lung cancer with MET and AXL dysregulations: A phase 1b clinical trial and biomarker analysis. Lung Cancer. 188:1074682024. View Article : Google Scholar : PubMed/NCBI | |
|
Wang S, Liu C, Yang C, Jin Y, Cui Q, Wang D, Ge T, He G, Li W, Zhang G, et al: PI3K/AKT/mTOR and PD-1/CTLA-4/CD28 pathways as key targets of cancer immunotherapy (review). Oncol Lett. 28:5672024. View Article : Google Scholar : PubMed/NCBI | |
|
Fu ZY, Huang Y, Lian LS, Huang HT, Zhan SF, Cai Y, Li JX and Liu XH: Potential of semen coicis in enhancing the anti-tumor effects of PD-1 inhibitor on A549 cell lines by blocking the PI3K-AKT-mTOR pathway. Clin Transl Oncol. 26:2250–2261. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Li C, Tian C, Liu Y, Liang J, Zeng Y, Yang Q, Liu Y, Wu D, Wu J, Wang J, et al: Comprehensive profiling reveals distinct microenvironment and metabolism characterization of lung adenocarcinoma. Front Genet. 12:6198212021. View Article : Google Scholar : PubMed/NCBI | |
|
Li Y, Tuerxun H and Zhao Y, Liu X, Li X, Wen S and Zhao Y: The new era of lung cancer therapy: Combining immunotherapy with ferroptosis. Crit Rev Oncol Hematol. 198:1043592024. View Article : Google Scholar : PubMed/NCBI | |
|
Nair NU, Greninger P, Zhang X, Friedman AA, Amzallag A, Cortez E, Sahu AD, Lee JS, Dastur A, Egan RK, et al: A landscape of response to drug combinations in non-small cell lung cancer. Nat Commun. 14:38302023. View Article : Google Scholar : PubMed/NCBI | |
|
Zheng H, Zeltsman M, Zauderer MG, Eguchi T, Vaghjiani RG and Adusumilli PS: Chemotherapy-induced immunomodulation in non-small-cell lung cancer: A rationale for combination chemoimmunotherapy. Immunotherapy. 9:913–927. 2017. View Article : Google Scholar : PubMed/NCBI | |
|
Corke L and Sacher A: New strategies and combinations to improve outcomes in immunotherapy in metastatic non-small-cell lung cancer. Curr Oncol. 29:38–55. 2021. View Article : Google Scholar : PubMed/NCBI | |
|
Casagrande GMS, Silva MO, Reis RM and Leal LF: Liquid biopsy for lung cancer: Up-to-date and perspectives for screening programs. Int J Mol Sci. 24:25052023. View Article : Google Scholar : PubMed/NCBI | |
|
Pellini B and Chaudhuri AA: ctDNA monitoring for small cell lung cancer: Ready for prime time? Clin Cancer Res. 29:2176–2178. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Pan Y, Zhang JT, Gao X, Chen ZY, Yan B, Tan PX, Yang XR, Gao W, Gong Y, Tian Z, et al: Dynamic circulating tumor DNA during chemoradiotherapy predicts clinical outcomes for locally advanced non-small cell lung cancer patients. Cancer Cell. 41:1763–1773 .e4. 2023. | |
|
Sun X, Abrahamson P, Ballew N, Kalilani L, Phiri K, Bell KF, Slowley A, Zajac M, Hofstatter E, Stojadinovic A, et al: The utility of ctDNA in lung cancer clinical research and practice: A systematic review and meta-analysis of clinical studies. Cancer Invest. 41:571–592. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Ren F, Fei Q, Qiu K, Zhang Y, Zhang H and Sun L: Liquid biopsy techniques and lung cancer: Diagnosis, monitoring and evaluation. J Exp Clin Cancer Res. 43:962024. View Article : Google Scholar : PubMed/NCBI | |
|
Sands J, Li Q and Hornberger J: Urine circulating-tumor DNA (ctDNA) detection of acquired EGFR T790M mutation in non-small-cell lung cancer: An outcomes and total cost-of-care analysis. Lung Cancer. 110:19–25. 2017. View Article : Google Scholar : PubMed/NCBI | |
|
Chen K, Yang F, Shen H, Wang C, Li X, Chervova O, Wu S, Qiu F, Peng D, Zhu X, et al: Individualized tumor-informed circulating tumor DNA analysis for postoperative monitoring of non-small cell lung cancer. Cancer Cell. 41:1749–1762.e6. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Yan X and Liu C: Clinical application and prospect of MRD evaluation in lung cancer based on ctDNA level: A review. Tumori. 109:356–362. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Chae YK and Oh MS: Detection of minimal residual disease using ctDNA in lung cancer: Current evidence and future directions. J Thorac Oncol. 14:16–24. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Reina C, Šabanović B, Lazzari C, Gregorc V and Heeschen C: Unlocking the future of cancer diagnosis-promises and challenges of ctDNA-based liquid biopsies in non-small cell lung cancer. Transl Res. 272:41–53. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Medford AJ, Moy B, Spring LM, Hurvitz SA, Turner NC and Bardia A: Molecular residual disease in breast cancer: Detection and therapeutic interception. Clin Cancer Res. 29:4540–4548. 2023. View Article : Google Scholar : PubMed/NCBI | |
|
Lavacchi D, Gelmini S, Calabri A, Rossi G, Simi L, Caliman E, Mancini I, Salvianti F, Petroni G, Guidolin A, et al: Early changes in circulating tumor DNA (ctDNA) predict treatment response in metastatic KRAS-mutated colorectal cancer (mCRC) patients. Heliyon. 9:e218532023. View Article : Google Scholar : PubMed/NCBI | |
|
Pellini B and Chaudhuri AA: Circulating tumor DNA minimal residual disease detection of non-small-cell lung cancer treated with curative intent. J Clin Oncol. 40:567–575. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Dong S, Wang Z, Zhang JT, Yan B, Zhang C, Gao X, Sun H, Li YS, Yan HH, Tu HY, et al: Circulating tumor DNA-guided de-escalation targeted therapy for advanced non-small cell lung cancer: A nonrandomized controlled trial. JAMA Oncol. 10:932–940. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Yao H, Wen L, Li Z and Xia C: Analysis of diagnostic value of CTC and CTDNA in early lung cancer. Cell Mol Biol (Noisy-le-grand). 69:57–62. 2023. View Article : Google Scholar | |
|
Xie J, Hu B, Gong Y, He S, Lin J, Huang Q and Cheng J: A comparative study on ctDNA and tumor DNA mutations in lung cancer and benign cases with a high number of CTCs and CTECs. J Transl Med. 21:8732023. View Article : Google Scholar : PubMed/NCBI | |
|
Xiang Y, Liu X, Wang Y, Zheng D, Meng Q, Jiang L, Yang S, Zhang S, Zhang X, Liu Y and Wang B: Mechanisms of resistance to targeted therapy and immunotherapy in non-small cell lung cancer: Promising strategies to overcoming challenges. Front Immunol. 15:13662602024. View Article : Google Scholar : PubMed/NCBI | |
|
Zhang KR, Zhang YF, Lei HM, Tang YB, Ma CS, Lv QM, Wang SY, Lu LM, Shen Y, Chen HZ and Zhu L: Targeting AKR1B1 inhibits glutathione de novo synthesis to overcome acquired resistance to EGFR-targeted therapy in lung cancer. Sci Transl Med. 13:eabg64282021. View Article : Google Scholar : PubMed/NCBI | |
|
Roys A, Chang X, Liu Y, Xu X, Wu Y and Zuo D: Resistance mechanisms and potent-targeted therapies of ROS1-positive lung cancer. Cancer Chemother Pharmacol. 84:679–688. 2019. View Article : Google Scholar : PubMed/NCBI | |
|
Liu WJ, Du Y, Wen R, Yang M and Xu J: Drug resistance to targeted therapeutic strategies in non-small cell lung cancer. Pharmacol Ther. 206:1074382020. View Article : Google Scholar : PubMed/NCBI | |
|
Lim ZF and Ma PC: Emerging insights of tumor heterogeneity and drug resistance mechanisms in lung cancer targeted therapy. J Hematol Oncol. 12:1342019. View Article : Google Scholar : PubMed/NCBI | |
|
Meyer ML, Fitzgerald BG, Paz-Ares L, Cappuzzo F, Jänne PA, Peters S and Hirsch FR: New promises and challenges in the treatment of advanced non-small-cell lung cancer. Lancet. 404:803–822. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Koga T, Suda K and Mitsudomi T: Utility of the Ba/F3 cell system for exploring on-target mechanisms of resistance to targeted therapies for lung cancer. Cancer Sci. 113:815–827. 2022. View Article : Google Scholar : PubMed/NCBI | |
|
Makarem M and Jänne PA: Top advances of the year: Targeted therapy for lung cancer. Cancer. 130:3239–3250. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Li S, Wang A, Wu Y, He S, Shuai W, Zhao M, Zhu Y, Hu X, Luo Y and Wang G: Targeted therapy for non-small-cell lung cancer: New insights into regulated cell death combined with immunotherapy. Immunol Rev. 321:300–334. 2024. View Article : Google Scholar : PubMed/NCBI | |
|
Zullo L, Dall'Olio FG, Rossi G, Dellepiane C, Barletta G, Bennicelli E, Ingaliso M, Tagliamento M and Genova C: Molecular and genetic advances in small cell lung cancer landscape: From homogeneity to diversity. Int J Mol Sci. 25:2242023. View Article : Google Scholar : PubMed/NCBI |