Professor, Department of Pathology, Dalhousie University; Pulmonary Pathologist and Cyto-pathologist, QE II Health Sciences Centre; Senior Scientist, Beatrice Hunter Cancer Research Institute, 5788 University Ave, Halifax NS B3H 1V8, CanadaCanada
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Lung cancer is one of the most prevalent life-threatening diseases and remains the leading cause of cancer-related death worldwide.Although surgical resection of the tumor is considered as one of the most effective treatments, most lung cancer patients present with locally advanced or metastatic disease at the time of the diagnosis and are not candidates for surgical treatment.
PULMONARY RESEARCH AND RESPIRATORY MEDICINE ISSN 2377-1658 http://dx.doi.org/10.17140/PRRMOJ-2-119 Open Journal Short Significance of Molecular Genotyping for Communication Lung Cancer in Modern Oncology * *Corresponding author Zhaolin Xu, MD, FRCPC, FCAP * Professor Zhaolin Xu Department of Pathology Dalhousie University; Professor, Department of Pathology, Dalhousie University; Pulmonary Pathologist and Cyto- Pulmonary Pathologist and Cytopathologist pathologist, QE II Health Sciences Centre; Senior Scientist, Beatrice Hunter Cancer Research QE II Health Sciences Centre; Institute, 5788 University Ave, Halifax NS B3H 1V8, Canada Senior Scientist Beatrice Hunter Cancer Research Institute; 5788 University Ave Lung cancer is one of the most prevalent life-threatening diseases and remains the Halifax NS B3H 1V8, Canada leading cause of cancer-related death worldwide. Although surgical resection of the tumor is Tel. 902-473-7287 Fax: 902-473-3897 considered as one of the most effective treatments, most lung cancer patients present with E-mail: zxu3@dal.ca locally advanced or metastatic disease at the time of the diagnosis and are not candidates for surgical treatment. For these patients palliative chemotherapy and radiation therapy, alone or Volume 2 : Issue 3 in combination, become the main treatment of choice. The prognosis for lung cancer in general Article Ref. #: 1000PRRMOJ2119 is poor and an overall 5-year survival rate for all stages of lung cancer, regardless of subtypes, is about 18%, which has not been significantly improved in the past several decades. For those in an advanced stage of the disease the prognosis is even worse. About half of all lung cancer Article History nd patients have metastatic disease at the time of diagnosis with a 5-year survival rate of less than Received: October 2 , 2015 th 5%. There is no doubt that the conventional treatment of lung cancer would not significantly Accepted: October 19 , 2015 th change the outcome for lung cancer patients.
Published: October 19 , 2015 In order to conquer the deadly disease, it is important to understand the pathogenesis Citation of lung cancer that involves alteration and accumulation of molecular abnormalities over time. Xu Z. Significance of molecular geno- The abnormalities can occur in different levels including DNA sequence, gene transcripts, pro- typing for lung cancer in modern on- tein expression and cell signaling involved in cell proliferation, differentiation, apoptosis, and cology. Pulm Res Respir Med OpenJ.
2015; 2(3): 120-121. angiogenesis. These changes are related to alterations in normal genes due to gene mutations, doi: 10.17140/PRRMOJ-2-119 gene silencing, and gene amplification or deletion. Most of cancers are likely to be caused by or related to these driving genes that function as oncogene and make cancer cell develop and grow. Characterization of the gene mutations in lung cancer would provide valuable informa- tion for better understanding the clinical significance of the mutations and for developing ef- fective targeted treatment. Recent development in understanding of molecular pathogenesis in lung cancer has led to new strategies for early detection, molecular profiling, and personalized targeted therapy, which provide additional options for lung cancer treatment in modern oncol- ogy. Most of the driving genes identified in lung cancer patient such as KRAS, EFGR, ALK, BRAF, PIK3CA, ROS1, HER2, etc. are mainly in lung adenocarcinoma. These mutant genes are often mutually exclusive and identified collectively in about a half of the lung adenocar- cinomas. Tyrosine kinase inhibitors to treat lung cancer patients with EGFR gene mutations and ALK gene rearrangement are already in clinical practice and targeting these genes would achieve a better clinical outcome.
Although achievements have been made in molecular based targeted therapy to treat subsets of lung cancer cases, our knowledge in the understanding of pathogenesis for lung Copyright cancer is still limited. The driving genes have not been identified in approximatelly half of ©2015 Xu Z. This is an open ac- lung adenocarcinomas and little is known in other subtypes of lung cancer such as squamous cess article distributed under the cell carcinoma, large cell carcinoma, and neuroendocrine carcinomas including small cell car- Creative Commons Attribution 4.0 International License (CC BY 4.0), cinoma, etc. It is important to search new driving genes in lung cancer as tumor markers in or- which permits unrestricted use, der to further improve clinical outcome through molecular based targeted therapy. Analysis of distribution, and reproduction in various histologic types of lung cancer using high-throughput methods such as next generation any medium, provided the original sequcncing in cancer cell DNA sequence, gene transcription and protein expression levels has work is properly cited.
made it possible to identify new tumor biomarkers as potential targets to develop personalized PULMONARY RESEARCH AND RESPIRATORY MEDICINE ISSN 2377-1658 http://dx.doi.org/10.17140/PRRMOJ-2-119 Open Journal targeted therapy. Detailed analysis of lung cancer at the molecular level would provides the basis for a totally new direction of treat- ment which would result in much higher response rates, longer progression free survival and improved quality of life. Therefore, molecular genotyping of lung cancer is critical and the treatment options in modern oncology have included tumor marker based targeted therapy in addition to conventional methods that may bring the new hope for lung cancer patients if more driving genes can be identified in lung cancer.