Grzegorz Kurec

Background: Precision oncology has significantly transformed the management of non-small cell lung cancer (NSCLC) through the integration of molecular diagnostics, targeted therapies, and biomarker-driven treatment selection. Advances in next-generation sequencing (NGS) and liquid biopsy have improved the identification of actionable molecular alterations and enabled dynamic monitoring of tumor evolution. Objective: To provide a structured narrative review of current evidence regarding actionable molecular biomarkers, diagnostic methodologies, targeted therapies, and future directions in NSCLC precision oncology, with a specific focus on conceptualizing acquired resistance mechanisms. Methods: A structured narrative literature review was conducted by searching PubMed and Google Scholar for English-language studies published between 2015 and 2026. Eligible publications included clinical trials, cohort studies, translational research, reviews, and clinical guidelines addressing molecular profiling, targeted treatments, diagnostic approaches, and resistance mechanisms in NSCLC. Results: A total of 99 foundational studies and clinical documents were analyzed. Key actionable biomarkers included EGFR (Epidermal Growth Factor Receptor), ALK (Anaplastic Lymphoma Kinase), ROS1 (ROS Proto-Oncogene 1, Receptor Tyrosine Kinase), KRAS (Kirsten Rat Sarcoma Viral Oncogene Homolog), RET (Rearranged during Transfection), MET (Mesenchymal–Epithelial Transition Factor), HER2 (Human Epidermal Growth Factor Receptor 2) and NTRK (Neurotrophic Tyrosine Receptor Kinase) alterations, along with emerging targets such as NRG1 (Neuregulin 1) fusions. NGS emerged as the cornerstone of comprehensive molecular profiling, while liquid biopsy enabled longitudinal monitoring of tumor dynamics and resistance development. To organize the biological complexity of treatment failure, acquired resistance mechanisms were categorized into a three-tiered conceptual framework: target-centric genetic evolution (Tier 1), cellular plasticity and intratumoral heterogeneity (Tier 2), and non-genetic/microenvironmental adaptation (Tier 3). Targeted therapies significantly improved clinical outcomes compared with conventional chemotherapy; however, acquired resistance remained a major challenge across all tiers. Conclusions: Precision oncology in NSCLC is evolving from a biomarker-focused approach toward a dynamic framework integrating molecular diagnostics, targeted therapies, and continuous resistance monitoring. The proposed three-tiered resistance framework provides a structured basis for understanding treatment failure, guiding molecular reassessment at progression, and informing future adaptive therapeutic strategies to improve long-term patient outcomes.

Background/Objectives: Non-small cell lung cancer (NSCLC) remains associated with high mortality, frequent late-stage diagnosis, biological heterogeneity, and recurrence after treatment. Although molecular and immunohistochemical biomarkers have transformed treatment selection, there remains a need for accessible, repeatable, and clinically practical circulating biomarkers that may support prognosis and post-treatment monitoring. This review discusses prolactin (PRL) as a candidate supplementary biomarker in NSCLC, with particular emphasis on its biological rationale, potential prognostic relevance, and possible role in personalized risk stratification after systemic therapy. Methods: This narrative review summarizes current evidence on established biomarkers in NSCLC, the physiology and regulation of PRL, PRL/PRLR signaling in cancer biology, mechanisms of PRL dysregulation in lung cancer, and available clinical observations concerning PRL alterations in NSCLC. Particular attention is given to the distinction between prognostic and predictive biomarkers, longitudinal monitoring, pituitary involvement, immune checkpoint inhibitor-related endocrine effects, and biological, pharmacological, and analytical confounders affecting PRL interpretation. Results: Current evidence suggests that PRL may be biologically relevant in NSCLC through its involvement in pathways related to cell proliferation, survival, angiogenesis, invasion, epithelial–mesenchymal transition, immune modulation, and possible therapy resistance. Clinical observations indicate that altered PRL levels may occur in advanced disease, pituitary involvement, systemic inflammation, stress, or during anticancer and supportive treatment. However, PRL lacks cancer specificity and is influenced by multiple confounders, including circadian rhythm, stress, endocrine disorders, macroprolactin, cachexia, medications, and assay variability. Available clinical data remain limited and are largely derived from small studies or case-based evidence. Conclusions: PRL should not currently be considered a standalone diagnostic, predictive, or treatment-selective biomarker in NSCLC. Its most realistic potential role is as a supplementary circulating marker within multimarker prognostic and monitoring models. Prospective validation with standardized sampling, assay procedures, and confounder adjustment is required before clinical implementation.

Wstęp: Anoreksja nervosa (AN) to poważne zaburzenie psychiczne charakteryzujące się przewlekłym ograniczaniem spożycia kalorii, zniekształconym obrazem własnego ciała i wysoką śmiertelnością. Pomimo dostępnych metod leczenia długoterminowe sukcesy są ograniczone, a nawroty choroby częste. Dowody wskazują, że czynniki związane z traumą odgrywają kluczową rolę w rozwoju i utrzymywaniu się AN, co podkreśla potrzebę stosowania innowacyjnych terapii. W niniejszym przeglądzie oceniono terapię EMDR (Eye Movement Desensitisation and Reprocessing) jako środek wspomagający w leczeniu AN, zwłaszcza u pacjentów z traumatyczną przeszłością, oraz podsumowano aktualne badania dotyczące jej skuteczności. Materiał i metody: Przegląd literatury z lat 2020–2025 przeprowadzono przy użyciu baz PubMed, Google Scholar i Scopus. Wybrane badania obejmują badania empiryczne, przeglądy systematyczne i metaanalizy dotyczące roli EMDR w leczeniu AN i traumy. Oceniono jakość metodologiczną i trafność badań. Dyskusja: Pierwotnie stosowana w leczeniu zespołu stresu pourazowego (PTSD), terapia EMDR okazuje się obiecująca jako podejście uzupełniające w leczeniu jadłowstrętu psychicznego, szczególnie u osób z traumatyczną przeszłością. Włączenie terapii EMDR do standardowych metod leczenia (np. CBT-E) poprawia wskaźnik BMI, zmniejsza objawy dysocjacyjne i psychopatologiczne oraz pomaga w przetwarzaniu negatywnych przekonań i problemów związanych z obrazem własnego ciała. Terapia EMDR skupia się na nieprzetworzonych traumatycznych wspomnieniach, poprawiając regulację emocjonalną i postrzeganie własnej osoby, a także może zmniejszyć objawy związane z traumą, zwłaszcza w złożonych przypadkach związanych z maltretowaniem w dzieciństwie. Wnioski: EMDR stanowi cenne uzupełnienie multidyscyplinarnego leczenia AN, wspomagając przetwarzanie traumy i redukcję objawów. Konieczne są dalsze badania na dużą skalę w celu ustalenia standardowych protokołów i strategii integracji w ramach kompleksowej opieki.

Introduction: Anorexia nervosa (AN) is a serious eating disorder. Globally, eating disorders affect 25% of the population over the course of a lifetime and occur significantly more often in women than in men. AN is associated with high mortality, complications. The comorbidity of AN and depression highlights the need for a holistic therapeutic approach. Material and methods: This literature review was conducted on the basis of scientific articles published from 2013 to 2025. As sources were used:PubMed, Scopus, Google Scholar using the following keywords: norexia nervosa, phytotherap, cannabinoids, Angelica archangelica, Artemisia absinthium. Results: Phytotherapy may support recovery and improve quality of life in patients with AN, which remains a therapeutic challenge despite the growing treatment options. This article explores phytotherapy as an adjunct to conventional therapy, offering clinicians guidance on natural supplements. Cannabinoids can stimulate appetite and mood, Angelica archangelica may help manage anemia and cognitive impairment, while Artemisia absinthium alleviates anorexia-related symptoms caused by zinc deficiency. These approaches highlight phytotherapy’s potential role in enhancing treatment effectiveness and supporting patient outcomes. Conclusions: Phytotherapy including cannabinoids, A. archangelica, and A. absinthium offers promising support in the treatment of AN. Cannabinoids may improve appetite and mood, A. archangelica supports the treatment of anemia and cognitive impairment, while A. absinthium helps alleviate symptoms of anorexia resulting from zinc deficiency.