Biologically targeted treatment in non‑small cell lung cancer or „do we always have mutations and PD-L1 examined?“ – case report

05/2021

MUDr. Gabriela Krákorová, Ph.D.

Klinika pneumologie a ftizeologie LF UK a FN Plzeň

SUMMARY

Metastatic or locally advanced non-small cell lung cancer (NSCLC) generally has a very poor prognosis. Five-year survival in stage IV is in the order of percentage units (less than 5%). Lung tumors with control mutations present are „different" tumors, with different behavior and prognosis. Treatment should always be initiated with knowledge of the mutation status and expression of programmed cell death-ligand 1 (PD-L1). PD-L1 expression should be reflexively determined in all NSCLC at the time of diagnosis by a pathologist and EGFR, ALK, ROS mutations reflexively in non-squamous NSCLC. The article presents a case report of a patient, where the omission of this examination may lead to the wrong choice of treatment scheme, but at least to a delay in the start of treatment. The article further discusses the possibilities of biologically targeted treatment for individual types of control mutations in lung cancer - EFGR, ALK, ROS, BRAF, KRAS, etc.

Key words

NSCLC, biological treatment, control mutations, EGFR, ALK