Pharmacogenomic research and serum DNA analysis in the treatment of non-small cell lung cancer

Various genetic alterations have been identified as crucial to both carcinogenesis and prognosis, including several mutational patterns, loss of heterozygosity, and gene overexpression. These alterations have been shown to correlate with mechanisms of resistance to certain cytotoxic agents used in the treatment of non-small-cell lung cancer. This article reviews various aspects of taxane resistance and the relative importance of p53 and ras mutations. Paclitaxel resistance is related to β-tubulin mutations. Genetic alterations can be detected in plasma or serum DNA of patients. Finally, the article discusses the genetic objectives of a european protocol for neoadjuvant and adjuvant chemotherapy in lung cancer.