Advances in molecular pathology and therapy of non-small cell lung cancer.

Journal: Signal transduction and targeted therapy
Published Date:

Abstract

Over the past two decades, non-small cell lung cancer (NSCLC) has witnessed encouraging advancements in basic and clinical research. However, substantial unmet needs remain for patients worldwide, as drug resistance persists as an inevitable reality. Meanwhile, the journey towards amplifying the breadth and depth of the therapeutic effect requires comprehending and integrating diverse and profound progress. In this review, therefore, we aim to comprehensively present such progress that spans the various aspects of molecular pathology, encompassing elucidations of metastatic mechanisms, identification of therapeutic targets, and dissection of spatial omics. Additionally, we also highlight the numerous small molecule and antibody drugs, encompassing their application alone or in combination, across later-line, frontline, neoadjuvant or adjuvant settings. Then, we elaborate on drug resistance mechanisms, mainly involving targeted therapies and immunotherapies, revealed by our proposed theoretical models to clarify interactions between cancer cells and a variety of non-malignant cells, as well as almost all the biological regulatory pathways. Finally, we outline mechanistic perspectives to pursue innovative treatments of NSCLC, through leveraging artificial intelligence to incorporate the latest insights into the design of finely-tuned, biomarker-driven combination strategies. This review not only provides an overview of the various strategies of how to reshape available armamentarium, but also illustrates an example of clinical translation of how to develop novel targeted drugs, to revolutionize therapeutic landscape for NSCLC.

Authors

  • Qing Huang
    Department of Environmental Health and Occupational Medicine,West China School of Public Health,Sichuan University,Chengdu 610041,China.
  • Yuanxiang Li
  • Yingdan Huang
    Department of Medical Oncology, Huazhong University of Science and Technology, Tongji Medical College, Hubei Cancer Hospital, Wuhan, 430079, Hubei, China.
  • Jingyi Wu
    Rehabilitation Hospital affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
  • Wendai Bao
    Center for Neurological Disease Research, Taihe Hospital, Hubei University of Medicine, Shiyan, 442000, Hubei, China.
  • Chang Xue
    Department of Medical Oncology, Huazhong University of Science and Technology, Tongji Medical College, Hubei Cancer Hospital, Wuhan, 430079, Hubei, China.
  • Xiaoyu Li
    Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, China.
  • Shuang Dong
    Department of Medical Oncology, Huazhong University of Science and Technology, Tongji Medical College, Hubei Cancer Hospital, Wuhan, 430079, Hubei, China.
  • Zhiqiang Dong
    Zhejiang Jianyang Polymer Technology Co., LTD, Jiaxing 314512, PR China.
  • Sheng Hu
    Department of Radiology, School of Medicine, The Fourth Affiliated Hospital of Zhejiang University, Yiwu, China.