Predictors of Biomarkers Guiding Targeted Therapeutic Strategies in Locally Advanced Lung Cancer

Lung cancer accounts for the majority of cancer-related deaths worldwide. We sought out to summarize the current state of molecular predictors for response and toxicity in locally advanced lung cancer. Several changes have been introduced in recent years in the standard-of-care treatment of advanced non-small cell lung cancer based on the identification of specific molecular alterations that determine response probability to certain therapies. Eligibility for these treatments is assessed by a biomarker test, evaluating if the molecular alteration is present or not in a patient's tumor. In particular, tissue testing for epidermal growth factor receptor and anaplastic lymphoma kinase alterations is currently recommended for certain patients with advanced non-small cell lung cancer, whereas excision repair cross-complementation group 1 and ribonucleotide reductase 1 as markers for outcome after platinum and gemcitabine therapy are promising but are currently not recommended outside a clinical trial. However, their application to the therapy of locally advanced disease is still mostly investigational. Moreover, additional candidate markers for response and toxicity for locally advanced lung cancer are under further investigation.