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Paradigm shift in the management of metastatic Non-small Cell Lung Cancer
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  • Ruby Gupta,
  • Melanie Smalley,
  • Nwabundo Anusim,
  • Vishal Jindal,
  • Mandeep Singh Rahi,
  • Sorab Gupta,
  • Sachin Gupta,
  • Ishmael Jaiyesimi
Ruby Gupta
William Beaumont Hospital
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Melanie Smalley
William Beaumont Hospital - Royal Oak
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Nwabundo Anusim
William Beaumont Hospital - Royal Oak
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Vishal Jindal
William Beaumont Hospitals Corp
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Mandeep Singh Rahi
Bridgeport Hospital
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Sorab Gupta
Bronx-Lebanon Health Care System
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Sachin Gupta
Reading Hospital
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Ishmael Jaiyesimi
William Beaumont Hospital - Royal Oak
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Background: Lung cancer is one of the leading causes of cancer mortality in the US. The use of precision medicine in the past 10 years has significantly changed the therapeutic landscape of lung cancer. Management of advanced non-small cell lung cancer (NSCLC) has transitioned from a chemotherapeutic approach to targeted treatments and immunotherapeutic agents. Several tyrosine kinase inhibitors (TKIs) have been approved for patients with targeted mutations while patients who do not have driver mutations; immunotherapy has been recently approved as frontline therapy, which has resulted in marked improvement in overall survival and added a new tool in our armamentarium. Aims: The purpose of this review is to highlight recent advancements in diagnostic approach and management strategies in patients with metastatic NSCLC. Materials and methods: Published studies included in Medline (via PubMed) and National Comprehensive Cancer Network Guidelines were reviewed for data gathering. Conclusion: The use of next generation sequencing has significantly changed our understanding of molecular oncogenic mechanisms of lung cancer. These advancements have created a paradigm shift in the treatment strategies of metastatic lung cancer from primarily chemotherapeutic approach to increasing use of targeted therapies and immune check point inhibitors (ICI) leading to better survival rates and lesser toxicity.

Peer review status:ACCEPTED

08 Nov 2020Submitted to International Journal of Clinical Practice
15 Feb 2021Submission Checks Completed
15 Feb 2021Assigned to Editor
17 Feb 2021Reviewer(s) Assigned
09 Apr 2021Review(s) Completed, Editorial Evaluation Pending
16 May 20211st Revision Received
31 May 2021Submission Checks Completed
31 May 2021Assigned to Editor
31 May 2021Review(s) Completed, Editorial Evaluation Pending
06 Jun 2021Editorial Decision: Accept