Review Article  Open Access


Hanyang Med Rev. 2014 Feb;34(1):4-9. Korean.
Published online February 25, 2014.  https://doi.org/10.7599/hmr.2014.34.1.4
© 2014 Hanyang University College of Medicine
Molecular Biology of Non-small-cell Lung Cancer
Jung Hye Choi
Department of Internal Medicine, Hanyang University College of Medicine, Guri, Korea.

Correspondence to: Jung Hye Choi. Department of Internal Medicine, Hanyang University Guri Hospital, 153 Gyeongchun-ro, Guri 471-701, Korea. Tel: +82-31-560-2236, Fax: +82-31-553-7369, Email: jhcmd@hanyang.ac.kr
Received November 24, 2013; Revised January 20, 2014; Accepted January 24, 2014.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.




Abstract

In the past decades, substantial developments in the understanding of molecular biology in non-small-cell lung cancer (NSCLC) have improved diagnosis and treatment of NSCLC based on the genotype of each patient's tumor. For example, gain-of function mutations of epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) rearrangement are sensitive biomarkers in predicting tumor response and survival to EGFR tyrosine kinase inhibitor and ALK inhibitor, respectively. However, since NSCLC is one of the most complex and heterogenous cancers and the leading cause of cancer-related death in the world, there are still many challenges for prevention, diagnosis, and treatment of NSCLC. This review summarizes the molecular biology of NSCLC including activation of oncogenes, suppression of tumor suppressor genes, angiogenesis, epigenetic alteration, microRNA, telomerase, cancer stem cell, and cancer genomics using next generation sequencing methods.

Keywords: Carcinoma, Non-Small-Cell Lung; Molecular Biology; High-Throughput Nucleotide Sequencing

References
1. Mok TS, Wu YL, Thongprasert S, Yang CH, Chu DT, Saijo N, et al. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med 2009;361:947–957.
2. Kwak EL, Bang YJ, Camidge DR, Shaw AT, Solomon B, Maki RG, et al. Anaplastic lymphoma kinase inhibition in non-small-cell lung cancer. N Engl J Med 2010;363:1693–1703.
3. Larsen JE, Minna JD. Molecular biology of lung cancer: clinical implications. Clin Chest Med 2011;32:703–740.
4. Sun S, Schiller JH, Gazdar AF. Lung cancer in never smokers--a different disease. Nat Rev Cancer 2007;7:778–790.
5. Sharma SV, Bell DW, Settleman J, Haber DA. Epidermal growth factor receptor mutations in lung cancer. Nat Rev Cancer 2007;7:169–181.
6. Lynch TJ, Bell DW, Sordella R, Gurubhagavatula S, Okimoto RA, Brannigan BW, et al. Activating mutations in the epidermal growth factor receptor underlying responsiveness of non-small-cell lung cancer to gefitinib. N Engl J Med 2004;350:2129–2139.
7. Shaw AT, Engelman JA. ALK in lung cancer: past, present, and future. J Clin Oncol 2013;31:1105–1111.
8. Solomon B, Varella-Garcia M, Camidge DR. ALK gene rearrangements: a new therapeutic target in a molecularly defined subset of non-small cell lung cancer. J Thorac Oncol 2009;4:1450–1454.
9. Soda M, Choi YL, Enomoto M, Takada S, Yamashita Y, Ishikawa S, et al. Identification of the transforming EML4-ALK fusion gene in non-small-cell lung cancer. Nature 2007;448:561–566.
10. Downward J. Targeting RAS signalling pathways in cancer therapy. Nat Rev Cancer 2003;3:11–22.
11. Linardou H, Dahabreh IJ, Kanaloupiti D, Siannis F, Bafaloukos D, Kosmidis P, et al. Assessment of somatic k-RAS mutations as a mechanism associated with resistance to EGFR-targeted agents: a systematic review and meta-analysis of studies in advanced non-small-cell lung cancer and metastatic colorectal cancer. Lancet Oncol 2008;9:962–972.
12. Vivanco I, Sawyers CL. The phosphatidylinositol 3-Kinase AKT pathway in human cancer. Nat Rev Cancer 2002;2:489–501.
13. Courtney KD, Corcoran RB, Engelman JA. The PI3K pathway as drug target in human cancer. J Clin Oncol 2010;28:1075–1083.
14. Chin LP, Soo RA, Soong R, Ou SH. Targeting ROS1 with anaplastic lymphoma kinase inhibitors: a promising therapeutic strategy for a newly defined molecular subset of non-small-cell lung cancer. J Thorac Oncol 2012;7:1625–1630.
15. Bergethon K, Shaw AT, Ou SH, Katayama R, Lovly CM, McDonald NT, et al. ROS1 rearrangements define a unique molecular class of lung cancers. J Clin Oncol 2012;30:863–870.
16. Takeuchi K, Soda M, Togashi Y, Suzuki R, Sakata S, Hatano S, et al. RET, ROS1 and ALK fusions in lung cancer. Nat Med 2012;18:378–381.
17. Sadiq AA, Salgia R. MET as a possible target for non-small-cell lung cancer. J Clin Oncol 2013;31:1089–1096.
18. Engelman JA, Zejnullahu K, Mitsudomi T, Song Y, Hyland C, Park JO, et al. MET amplification leads to gefitinib resistance in lung cancer by activating ERBB3 signaling. Science 2007;316:1039–1043.
19. Wells SA Jr, Santoro M. Targeting the RET pathway in thyroid cancer. Clin Cancer Res 2009;15:7119–7123.
20. Kohno T, Ichikawa H, Totoki Y, Yasuda K, Hiramoto M, Nammo T, et al. KIF5B-RET fusions in lung adenocarcinoma. Nat Med 2012;18:375–377.
21. Kim HR, Kim DJ, Kang DR, Lee JG, Lim SM, Lee CY, et al. Fibroblast growth factor receptor 1 gene amplification is associated with poor survival and cigarette smoking dosage in patients with resected squamous cell lung cancer. J Clin Oncol 2013;31:731–737.
22. Tran TN, Selinger CI, Kohonen-Corish MR, McCaughan BC, Kennedy CW, O'Toole SA, et al. Fibroblast growth factor receptor 1 (FGFR1) copy number is an independent prognostic factor in non-small cell lung cancer. Lung Cancer 2013;81:462–467.
23. Vogelstein B, Lane D, Levine AJ. Surfing the p53 network. Nature 2000;408:307–310.
24. Lee EB, Jin G, Lee SY, Park JY, Kim MJ, Choi JE, et al. TP53 mutations in Korean patients with non-small cell lung cancer. J Korean Med Sci 2010;25:698–705.
25. Chau BN, Wang JY. Coordinated regulation of life and death by RB. Nat Rev Cancer 2003;3:130–138.
26. Cooper WA, Lam DC, O'Toole SA, Minna JD. Molecular biology of lung cancer. J Thorac Dis 2013;5:S479–S490.
27. Gill RK, Yang SH, Meerzaman D, Mechanic LE, Bowman ED, Jeon HS, et al. Frequent homozygous deletion of the LKB1/STK11 gene in non-small cell lung cancer. Oncogene 2011;30:3784–3791.
28. Ellis LM, Hicklin DJ. VEGF-targeted therapy: mechanisms of anti-tumour activity. Nat Rev Cancer 2008;8:579–591.
29. Baylin SB, Ohm JE. Epigenetic gene silencing in cancer - a mechanism for early oncogenic pathway addiction? Nat Rev Cancer 2006;6:107–116.
30. Takamizawa J, Konishi H, Yanagisawa K, Tomida S, Osada H, Endoh H, et al. Reduced expression of the let-7 microRNAs in human lung cancers in association with shortened postoperative survival. Cancer Res 2004;64:3753–3756.
31. Lin PY, Yu SL, Yang PC. MicroRNA in lung cancer. Br J Cancer 2010;103:1144–1148.
32. Hiyama K, Hiyama E, Ishioka S, Yamakido M, Inai K, Gazdar AF, et al. Telomerase activity in small-cell and non-small-cell lung cancers. J Natl Cancer Inst 1995;87:895–902.
33. Reya T, Morrison SJ, Clarke MF, Weissman IL. Stem cells, cancer, and cancer stem cells. Nature 2001;414:105–111.
34. Li T, Kung HJ, Mack PC, Gandara DR. Genotyping and genomic profiling of non-small-cell lung cancer: implications for current and future therapies. J Clin Oncol 2013;31:1039–1049.
35. Meyerson M, Gabriel S, Getz G. Advances in understanding cancer genomes through second-generation sequencing. Nat Rev Genet 2010;11:685–696.
36. Metzker ML. Sequencing technologies - the next generation. Nat Rev Genet 2010;11:31–46.
37. Gerlinger M, Rowan AJ, Horswell S, Larkin J, Endesfelder D, Gronroos E, et al. Intratumor heterogeneity and branched evolution revealed by multiregion sequencing. N Engl J Med 2012;366:883–892.
38. Yates LR, Campbell PJ. Evolution of the cancer genome. Nat Rev Genet 2012;13:795–806.
39. Forment JV, Kaidi A, Jackson SP. Chromothripsis and cancer: causes and consequences of chromosome shattering. Nat Rev Cancer 2012;12:663–670.