Future individualized therapy for lung cancer in post-genomic era

Since lung cancer is often diagnosed at advanced stages, patients usually require systemic therapy, such as chemotherapy or targeted agents, to control their disease. In the past, patients are treated in a trial-and-error fashion. Now with the advances in genomic sequencing, the application of mutation screening particularly in epidermal growth factor receptor (EGFR) and K-ras to predict the response to targeted agents has gradually become a routine practice. In addition, multiple biomarkers have been identified to correlate not only the response but also the side effects of cancer treatment. However, translating the new information into the care of lung cancer has yet been fully realized. To accomplish the goal of individualized therapy, we need a comprehensive approach to integrate current individual genomic information into our clinical practice in the post-genomic era. In this chapter, we review current development in the integration of pharmacogenomics, pharmacokinetics and new biomarkers and hope to depict the future of individualized therapy for lung cancer. The integration might allow us to optimize the efficacy of chemotherapy and targeted agents with minimized toxicity, so patients with lung cancer will receive the right agents with the right dose at the right time in the modern post-genomic era.