Drug Development in Non-Oncogene-Addicted Non-Small Cell Lung Cancer

Non-oncogene-addicted non-small cell lung cancer therapy has seen major advances in recent years. New molecular targets and biomarkers have enabled the development of drugs as diverse as immunotherapies and antibody-drug conjugates, among others. With a pharmacological armamentarium so precise, phase I trials have also evolved from exclusively toxicological studies into early efficacy signal-seeking trials. Nonetheless, difficulties remain, with the frequent failure of new drugs when progressing to a phase III setting. Challenges are seen in the setting of later lines therapy (testing against docetaxel), of which there are several examples. These are being tackled with promising new drugs being developed, based on innovative biological rationales. We review the current state of the art of drug development in non-oncogene-addicted non-small cell lung cancer, including advances, new drugs and targets, challenges, and opportunities in drug development.