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Certain genetic mutations are more common in lung cancer seen in non-smokers than in smokers. Biomarker tests may indicate targeted treatments for specific mutations.
Many people consider smoking to be a major risk factor for lung cancer. But people who don’t smoke can also get lung cancer.
In fact, lung cancer rates among non-smokers continue to rise, according to a 2017 retrospective study, despite the decline in overall lung cancer rates.
Experts divide lung cancer into two main categories: small cell lung cancer and non-small cell lung cancer (NSCLC). Small cell cancer occurs more often in people who smoke, and it tends to grow quickly.
By the time a person is diagnosed, it has often already spread to other parts of the body. Health care professionals often recommend chemotherapy and radiation therapy to shrink small cell lung cancer tumors.
The NSCLC includes:
- adenocarcinoma
- squamous carcinoma
- large cell carcinoma
It accounts for about 80 to 85% of lung cancers. Non-smokers diagnosed with lung cancer most likely have adenocarcinoma.
Many possible genetic changes can occur with NSCLC. Biomarker tests give experts a way to learn more about specific genetic mutations in cancer cells.
Depending on the genetic mutations present, a healthcare professional may recommend different targeted treatments. This means that they can choose from many different approaches for the treatment of NSCLC. No treatment will work for every individual situation.
Although healthcare professionals today rely on biomarker testing more often, they may not always perform the test. A person with NSCLC should ask their doctor for genetic testing if they have not already done so. Targeted therapies are generally more effective and have fewer side effects.
Experts consider a person to be a non-smoker if they have smoked less than 100 cigarettes in their lifetime. The data of a
The most common NSCLC genetic mutations in non-smokers include:
EGFR mutations are more common in non-smokers than in smokers.
However, experts still consider smoking to be a significant risk factor in the development of NSCLC. According to a
- exposure to second-hand smoke
- air pollution
- toxins in the workplace
Almost all cells in the human body contain genes. Genes tell a cell what to do. When a cell’s genetic material is damaged, it no longer acts as expected. It can start to grow atypically, which can lead to cancer.
When a person is diagnosed with NSCLC, the first step should always be testing for biomarkers. Biomarker tests look at the genetic material in the cells of the tumor tissue and give the doctor information about the most effective treatments.
Depending on the genetic mutation, a person may have targeted treatment options.
These treatments focus on the specific genetic mutation found in biomarker tests. This can help slow or stop the growth of cancer cells.
Experts recommend that anyone diagnosed with NSCLC receive biomarker testing.
This process will look for mutations in some or all of the following genes:
- EGFR
- ALK
- ROS1
- BRAF
- KRAS
- ENCOUNTER
- NTRK
- RIGHT
- PDL-1
Some of these mutations are more common than others. A 2017 study found that EGFR mutations occurred in 36% of people who never smoked, compared to 8% of smokers.
The same study also found a much higher incidence of mutation in the ALK uncomfortable. It occurred in 26% of non-smokers – a significantly higher percentage than the 4% of smokers who had a mutation in the ALK uncomfortable.
ROS1 gene fusions may occur less often, but are more likely to occur in people who do not smoke. This gene mutation occurs in about 1-2% of NSCLC cases, according to data from the 2017 study.
Even if a person has one of the less common genetic mutations, they will always benefit from knowing this information. Promising treatments may be in the works. A person can also find a clinical trial to participate in.
Although rare, some cases of lung cancer involve germline mutations – genetic changes that can pass through families. Most mutations in cancer cells are not inherited and cannot be passed from parents to children.
Some very rare changes in EGFR genes can make a person more likely to develop lung cancer, for example
The treatment plan depends on the genetic mutations seen by a healthcare professional during biomarker testing. Often times, they use a combination of treatments. Factors that influence the best treatment plan include:
- biomarkers
- the size and location of the tumor
- the health of the person
Inhibitor drugs are drugs that target specific genetic mutations. They focus on the specific genes that cause the cell to grow atypical. These drugs can slow down or stop cancer cells by cutting off genes causing abnormal growth.
A healthcare professional will choose the specific drug based on what the biomarker test reveals. A person can take more than one of these medications by mouth. Sometimes they can receive them by infusion.
Sometimes inhibitor therapy doesn’t work or it works for a while, but the cancer comes back. In these cases, experts recommend re-testing for biomarkers. A new mutation may require a different therapeutic approach.
A person can still receive chemotherapy for NSCLC. It depends on the size of the tumor and the stage of the lung cancer.
Biomarker testing can help a doctor decide if chemotherapy might help, according to a 2017 article. It can also help healthcare teams decide the best type of chemotherapy drugs to use.
A healthcare professional may also recommend surgery to remove part or all of a tumor as part of the treatment plan. This usually only happens in the early stages of lung cancer. NSCLC is more likely to be diagnosed at later stages.
Although overall rates of lung cancer have declined, rates among non-smokers continue to rise. Non-smokers who develop lung cancer most often have adenocarcinoma, a type of NSCLC.
Experts always recommend biomarker testing after a diagnosis of NSCLC. This can find one or more genetic mutations. For many of these mutations, a healthcare professional may recommend targeted therapy therapies.
Several possible biomarkers in NSCLC occur more often in non-smokers than in smokers. These mutations occur in the EGFR, ALK, and ROS1 Genoa.
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