Advances in the Management of Lung Cancers

Abstract

Lung cancer is the first cause of death from cancer in the world. For 10 years, its prognosis has improved due to new therapeutic classes as the immunotherapy or targeted therapy drugs. The immunotherapy stimulates the immune system which induces an antitumor immune response. These drugs can be used in all patients with an advanced non-small cell lung cancer (NSCLC) and can lead to durable tumor responses longer than 24 months. However, only 20–50% of patients respond to these treatments. Targeted therapies are oral drugs used in advanced NSCLC with molecular aberrations as epithelial growth factor receptor (EGFR) mutations or anaplastic lymphoma kinase (ALK) rearrangements. These alterations are reported in 15% of patients with advanced NSCLC, mainly nonsmokers. This molecular diagnosis can be quickly performed and, sometimes, obtained by blood tests (liquid biopsy for EGFR mutations). Targeted drugs improve overall survival of patients with a median of 30 months. However, immunotherapy and targeted therapies involve specific toxicities which are common but often benign. Intensive care unit (ICU) admissions for patients with NSCLC increased over time. Due to prognosis improvement of these patients, ICU admissions should be discussed, avoiding unreasonable care.