Evolution of Lung Cancer Management

Abstract

Lung cancer is the malignant neoplasm with the highest incidence worldwide according to the 2022 Globocan [1]. Of all malignant neoplasms, in men, it ranks first with 15.2%; in women, second with 9.4%, thus becoming a public health problem. Unfortunately, most of the patients are diagnosed at advanced and metastatic stages. The traditional view divided it into two major groups: Non-Small Cell Lung Cancer and Small Cell Lung Cancer. The first included squamous type, adenocarcinoma, and large cells. In this context, the treatment was based on systemic chemotherapy with platinum salts around 1978, and then other drugs such as taxanes, Gemcitabine, and Vinorelbine were added. By the year 2000, the median survival had increased from 4 to 10 months, and the overall survival rate reached only 5% at 5 years [2]. Later, better understanding of molecular biology allowed the discovery of certain genetic anomalies at the cellular level of adenocarcinoma-type tumors, such as mutations, rearrangements, and amplifications, which conferred specific characteristics to their biological behavior and enabled the use of targeted therapies according to the alterations presented.