What is new in SCLC?

A novel approach for targeting lung tumors with small-cell histology consists in the inhibition of transactivated transcription, as small-cell lung cancer (SCLC) has been found to be a transcription-addicted malignancy. Rudin et al. defined four molecular SCLC subtypes according to their differential expression of four key transcription regulators.

Specific treatment approaches in the EGFR-mutated setting

EGFR exon 20 insertion mutations are found in approximately 5 % to 12 % of EGFR-mutated NSCLC tumors, i.e., in 2 % of all NSCLC cases. They represent the third most common EGFR mutation after L858R and exon 19 deletion. However, EGFR TKIs cannot be used to treat lung cancer with exon 20 insertions as they are insensitive to these drugs due to steric hindrance at the TKI-binding site.

KRAS, HER2 & ALK: targeted options and sequencing issues

The KRAS p.G12C mutation is a key oncogenic driver occurring in approximately 13 % of lung adenocarcinomas and is associated with poor patient outcomes. The first-in-class, highly selective and irreversible KRASG12C inhibitor sotorasib has shown durable clinical benefit in a cohort of 59 heavily pretreated patients with NSCLC included in phase I of the CodeBreaK 100 study.

Pushing the bounds in early-stage lung cancer

Approximately 30 % of patients with non-small-cell lung cancer (NSCLC) present with resectable disease at diagnosis. Surgery with curative intent is the recommended treatment here, followed by adjuvant cisplatin-based chemotherapy in stage II/IIIA and select cases of stage IB disease. However, recurrence rates remain high across disease stages, regardless of postoperative chemotherapy use.

Preface

The 2020 World Conference of Lung Cancer (WCLC) originally scheduled for August 2020 in Singapore had to be postponed to January 2021 due to the COVID-19 pandemic and was finally held as a worldwide virtual conference from 28th to 31st January. WCLC, which is the leading gathering of international scientists, researchers and ­patient advocates in the field of lung cancer and thoracic malignancies, continues to provide a forum to connect, share knowledge and learn about the latest developments in the research and treatment of these diseases.

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