Abstract

Cancer originates from driver mutations that provide growth benefits to cells through inhibition of cell cycle checkpoints and exacerbated activation of signaling pathways involved in survival and proliferation. Lung cancer is the leading cause of cancer death in 89/185 countries, and precision medicine has now improved the diagnosis and treatment of this disease, considering the importance of the mutational profile of the tumor in the diagnosis. For example, tyrosine kinase inhibitors (TKIs) targeting driver mutations in EGFR, one of the most mutated gene in non-small cell lung cancer (NSCLC), have significantly decreased mortality and improved quality of life with more specific and less toxic drugs. The actionable genes in NSCLC are EGFR, ALK, ROS1, ERBB2, MET, MAP2K1, BRAF, KRAS, NTRK1/2/3, and RET, and combined they impact 64% of patients. However, unequal access to NGS and targeted drugs, along with the absence of actionable gene mutations and the development of therapy resistance mutations are global challenges. The incorporation of biomarkers such as PD-L1, the validation of circulating DNA in plasma instead of re-biopsy, the measurement of the mutational burden of the tumor, and the development of clinical trials with a combination of target therapies are some of the strategies in the current research in NSCLC. This review is focused providing Spanish-language readers with the current state of precision medicine in NSCLC in developed countries and Latin America.