Abstract
Selective inactivation of tumour genes and immunogenic activation of host anti-tumor surveillance as curement modalities are becoming more common in lung cancer due to genomics-driven comprehensive molecular profiling's identification of advanced chemically and immunologically noticeable vulnerabilities. However, recurrence occurs as a result of persistent disease states that are resistant to these specified therapies after an initially dramatic response. Although various mechanisms and conceptual frameworks for therapeutic resistance have been put forth, it has proven difficult to account for and forecast resistance trajectories in advance. In this review, we cover the present state of genomics-guided individualized therapy against both oncogenic changes and post-therapy resistance pathways in both NSCLC and SCLC. We include the most prominent oncogenic changes found in NSCLC. We list a variety of innovative and developing precision medicine strategies for SCLC, which is currently very resistant to specified therapy. In addition, we review a number of immunotherapy strategies that are being studied clinically for lung cancer, either individually or in combination. This review not only analyses tumour heterogeneity as a source of residual disease and emphasizes common molecular themes underlying many classes of resistance but also highlights potential solutions to these obstacles. We underline how a thorough understanding of these themes helps forecast and enhance therapeutic approaches, including poly-therapy approaches, to prevent tumour growth in the first place.