Abstract
ln this review, the author describes the different characteristics of lung cancer in smokers and non-smokers. The differences are mainly related to a subset of nonsquamous carcinomas, which can be divided into those with and without mutation ("wild type"). Systemic treatment approaches differ substantially between these groups of tumours - for tumours with mutation, first-line targeted therapy is optirnal, with systemic chemotherapy being another option. For "wild type" tumours, immuno-oncology and/or systemic chemotherapy are increasingly used. Nowadays, there are many drugs targeting nine different types of driver mutations in mutated tumours.
Approaches to primary treatment and relapsed disease therapy in mutated tumours are described and the need for rebiopsy or testing of circulating tumour DNA to make decisions about treatment of relapses in this type of tumours is emphasized. lmmuno-oncological therapy is less effective in NSCLC with mutations than in wild-type tumours. More recently, adjuvant treatment of EGFR mutation-driven cancers with the third-generation EGFR inhibitor osimertinib following surgery has been shown to be beneficial.