The Evolving Role of Biomarkers in Personalized Lung Cancer Therapy

Prior to the last decade, treatment for lung cancer was differentiated only by the main histological groups of small cell lung cancer (SCLC) and NSCLC. However, it is now known that differences in tumor histology affect response to chemotherapy and side effect profiles of certain agents. For example, during early clinical trials of the anti-VEGF monoclonal antibody (mAB) bevacizumab, a phase 2 study of carboplatin and paclitaxel plus or minus bevacizumab showed improved response rate, time to progression and overall survival (OS) with bevacizumab. However, the incidence of life-threatening pulmonary hemorrhage was 30% with squamous histology compared to 4% with adenocarcinoma [3] . Due to this unacceptable risk, further studies excluded squamous histology, and