- ONCOLOGY Vol 27 No 9
- Volume 27
- Issue 9
Clinical Applications of The Cancer Genome Atlas Project (TCGA) for Squamous Cell Lung Carcinoma
We summarize here key findings from the comprehensive analysis of squamous cell lung cancer by The Cancer Genome Atlas group and discuss the clinical implications of these findings.
Very little progress has been made in the treatment of patients with metastatic squamous cell lung cancer over the past 2 decades. Identification of novel molecular alterations for targeted therapies is necessary to improve outcomes. Advances in genomic technology have now made it possible to analyze the genomic landscape of tumor tissues comprehensively. We summarize here key findings from the comprehensive analysis of squamous cell lung cancer by The Cancer Genome Atlas group and discuss the clinical implications of these findings.
Introduction
Lung cancer remains the major cause of cancer-related death in the United States.[1] Approximately 85% of lung cancer patients are diagnosed with non–small cell lung cancer (NSCLC).[2,3] Adenocarcinoma and squamous cell lung carcinoma (SqCC) are the most commonly diagnosed histologic subtypes of NSCLC, and 20% to 30% of patients with NSCLC have SqCC histology.[2] Recent advances in the field of cancer biology and therapeutics have led to the successful development and approval of targeted therapies that have demonstrated substantial efficacy in clinical trials.[4-7] The use of targeted agents in lung cancer patients harboring epidermal growth factor receptor (EGFR) gene mutations or anaplastic lymphoma receptor tyrosine kinase (ALK) and c-ros oncogene 1, receptor tyrosine kinase (ROS1) gene rearrangements has been associated with dramatic response rates and improved progression-free survival (PFS).[4,7-11] Unfortunately, improved outcomes with these agents have largely been confined to patients with adenocarcinoma. At presentation, most patients with NSCLC are diagnosed with metastatic disease which is associated with a dismal 5-year survival rate of 2%.[12] The current standard of care for patients with metastatic NSCLC negative for EGFR or ALK alterations is empiric therapy with platinum doublets.[13,14] The choice of therapy for patients with NSCLC is mostly independent of the histology, with the exception of pemetrexed and the monoclonal antibody against the vascular endothelial growth factor (VEGF), bevacizumab, which are not indicated in SqCC because of decreased efficacy and excessive toxicity, respectively.[15-17] Outcomes with existing chemotherapeutic regimens are far from optimal in SqCC, however, and there is an urgent need to develop novel agents for use in these patients.