Carcinoma de pulmón de célula no pequeña

Abstract

Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancer cases. The main risk factor is tobacco, followed by radon. The main histological subtypes are adenocarcinoma and squamous cell carcinoma. In most cases, patients are diagnosed with NSCLC in advanced stages (III-IV), usually after the onset of respiratory and/or constitutional symptoms. The first diagnostic test is usually a chest X-ray in which a pulmonary nodule is observed, after which staging should be completed with a thoracic-abdominal-pelvic computed tomography (CT) scan (and a positron emission tomography (PET-CT) scan in case of localized or locally advanced disease) and a cranial CT scan. The histological diagnosis should be confirmed by performing a biopsy. Enough tissue should be obtained not only for cytomorphological diagnosis (histological subtype), but also for the biomarker study (molecular diagnosis and PD-L1). In the last decade, significant advances have been made in the treatment of patients with NSCLC with the emergence of targeted therapies and immunotherapy, which have achieved a significant improvement in survival. The treatment of choice will depend on the patient's characteristics (general condition, previous diseases, etc.) and preferences as well as on the tumor characteristics, the histological subtype, and whether targeted therapies exist or not (depending on the biomarker results).