Post-chemotherapy and targeted therapy imaging of the chest in lung cancer

• Published in: Clinical radiology 2022-01, Vol.77 (1), p.e1-e10
• Main Authors: Carter, B.W., Altan, M., Shroff, G.S., Truong, M.T., Vlahos, I.
• Format: Article
• Language: English
• Subjects: Carcinoma, Non-Small-Cell Lung - diagnostic imaging; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - therapy; Humans; Immunotherapy - methods; Lung - diagnostic imaging; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - drug therapy; Lung Neoplasms - therapy; Tomography, X-Ray Computed - methods
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2021.08.001

Non-small-cell lung cancer (NSCLC) is frequently diagnosed when it is not amenable to local therapies; therefore, systemic agents are the mainstay of therapy for many patients. In recent years, treatment of advanced NSCLC has evolved from a general approach primarily involving chemotherapy to a more personalised strategy in which biomarkers such as the presence of genomic tumour aberrations and the expression of immune proteins such as programmed death-ligand 1 (PD-L1), in combination with other elements of clinical information such as histology and clinical stage, guide management. For instance, pathways resulting in uncontrolled growth and proliferation of tumour cells due to epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangements may be targeted by tyrosine kinase inhibitors (TKIs). In this article, we review the current state of medical oncology, imaging characteristics of mutations, pitfalls in response assessments and the imaging of complications.