Cancer and Precision Medicine –

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By: Dr. Luis E. Raez MD FACP. Es Presidente de la Florida Society of Clinical Oncology (FLASCO) and trabaja como Director Médico del Memorial Cancer Institute, which is part of Memorial Health Care System in Miami Florida, does not have the Profesor de la Florida International University. The tumors were originally classified as tumors of solid organs or tumors of the tornado tumor and were associated with the creation of the specialties of Oncology and Clinical Hematology, respectively.

However, the tumors are classified depending on the organ of donation originating, considering that the origin of the tumor or the uvacation may guide the biological behavior of the tumor and that this classification should extend to its mechanism of creation, extension. In addition to this approach in specific cases such as pulmonary cancer, sobriety is only 15% and palliative chemotherapy only for 5% of patients with metastasis.

In the last few years, some genetic alterations responsible for the oncogenic process have been described and described in a variety of tumors, while some marketers are “affordable” and can be the object of medication that works as direct therapy therapy. Thanks to this, the treatment of cancer has evolved from empirical palliative chemotherapy, with a high probability of recovery and no total response in the case of the case, to direct therapy, which in some studies shows promising results, not only aumentando tasas de respuesta general y sobre- vida globale, sino también mejorando la qualidad de vida. This is a major impact on cancer treatment.

In this article we will review some of the genetic aberrations in those that can be extremely effective in finding effective treatments for lung cancer such as: ROS-1, RET, NTRK in BRAFv600.

The ROS-1 genetic alterations are produced by the genetic interchange of two genes, as well as the translocation or fusion pathogens present in 1% of patients with pulmonary cancer. In general, patients are not smokers and have the right to discover medicines: crizotinib and entrectinib are approved by the FDA and are used for these patients with a response of 70% and a sobering of various years. There is also the drug known as ceritinib which is approved for ALK mergers that also works in this type of cancer and includes protecting the central nervous system.

Another type of translocation or merger is called RET, these mergers are another example of the precision of the medicine of precision. Hasta la fecha han tenido results results in cancer of pulmonary and thyroid. All medicines called selpercatinib and praseltinib are approved. The first was associated with a significant activity in cancer pulmonary cancer for RET mergers, showing an objective response rate of 68%, these duration responses and effective grade 1 and 2 effects, with a drug abandonment rate of 1.7% . When it comes to medication, the response and sobriety are similar and are now approved for pulmonary cancer and it is hoped that it will be approved for thyroid cancer soon.

Genetic aberration is the mutation of the BRA- Fv600 gene, which is also involved in the process of oncogenesis. These are reported in 7-15% of all cancer types, being melanoma the most common. Other types of tumors with a high prevalence of BRAF V600 include multiple myeloma, pelvic cell leukemia, thyroid cancer, Erdheim-Chester disease, Langerhans cell histiocytosis, cancerous ovarian cancer. Tumors with this type of mutation are associated with a more aggressive form of cancer, with a free progressive progression and global minor sovereignty, compared to tumors that are not present. Medicines that have BRAF as white as are currently available; dabrafenib, vemurafenib, encorafenib and some of the pathway inhibitors of the MEK pathway. In patients with pulmonary cancer with BRAFV600 mutations, the treatment with the combination of dabrafenib and the inhibitor of MEK, trametinib, was approved. The general response rate was 62%, with the result that dabrafenib monotherapy in 78 patients showed a general response rate of 27% and the addition of the MEK trametinib inhibitor needed to increase a mayor’s response.

The ultimate genetic aberration that we mention are the fusion proteins NTRK1, NTRK2 and NTRK3. The genes of NTRK are found in the origin and development of the central nervous system in uterus, sensations of pain, prophylaxis and postnatal appetite in normal circulation. Therefore, gene gene alterations in adult adulthood are present in solid tumors due to genetic translocations or fusion of proteins responsible for abnormal cellular proliferation. These oncogenic fusions are associated with both cases of global sobriety in patients with pulmonary cancer and other types of cancer. These NTRK fusions are common in smallpox cancers, such as infantile fibrosarcoma, and are less common in most common cancers such as gliomas, melanoma, thyroid and mama. Although other oncogenes such as ALK, BRAF and ROS, the NTRK fusions were found in 17 different types of tumors. For the treatment of this type of cancer, the entrectinib and larotrectinib drugs are approved, the top ten profiles have acceptable adverse effects, all are effective in all types of cancer and fusion types of NTRK. Let us clarify that, although NTRK mergers are responsible for less than 1% of the frequency of some cancers, this group is very important and has benefited from agnostic therapy. These patients can respond more than two years before developing resistance to the therapy. Thanks to all these descriptions we can tell if we need a personalized medicine and the therapies for the cancer are not empirical.

These are other interesting articles, accompanied by reporters; special interviews and collaborations with the most connected specialists at the national and international level; you can find in our Special Edition Multimedia of the Revista “Advances and Innovation in Pulmonary Cancer 2020”, International edition with presence in Ibero Latinoamericana. Free form consultation in