Int J Med Sci 2013; 10(3):320-330. doi:10.7150/ijms.4609
EGFR-Targeted Therapy for Non-Small Cell Lung Cancer: Focus on EGFR Oncogenic Mutation
1. Thoracic Surgery and Lung Transplantation Unit, Foundation IRCCS (Scientific Institute for Research Hospitalization and Health Care) “Ca' Granda” General Hospital, University of Milan, Milan, Italy.
2. Thoracic Surgery EOC Unit - San Giovanni Hospital, Bellinzona, Switzerland.
3. Pediatric Oncology Unit, Foundation IRCCS National Cancer Institute (NCI), Milan, Italy.
4. Department of Preclinical Science LITA Vialba, Luigi Sacco Hospital, University of Milan, Milan, Italy.
5. General Thoracic Surgery Unit, Saronno Regional Hospital, Saronno, Italy.
6. Institute of Anestesiology and Intensive Care Medicine, Catholic University of Sacred Heart, Rome, Italy.
7. Deputy Scientific Director, IRCCS San Raffaele Group, Rome, Italy.
8. Division of Thoracic Surgery, Catholic University of Sacred Heart, Rome, Italy.
9. Laboratory of Systems Approaches and Non Communicable Diseases, IRCCS “San Raffaele Pisana”, Rome, Italy.
10. CFO - Florence Cancer Center, Sesto Fiorentino, Italy.
The two essential requirements for pathologic specimens in the era of personalized therapies for non-small cell lung carcinoma (NSCLC) are accurate subtyping as adenocarcinoma (ADC) versus squamous cell carcinoma (SqCC) and suitability for EGFR molecular testing, as well as for testing of other oncogenes such as EML4-ALK and KRAS. Actually, the value of EGFR expressed in patients with NSCLC in predicting a benefit in terms of survival from treatment with an epidermal growth factor receptor targeted therapy is still in debate, while there is a convincing evidence on the predictive role of the EGFR mutational status with regard to the response to tyrosine kinase inhibitors (TKIs).
This is a literature overview on the state-of-the-art of EGFR oncogenic mutation in NSCLC. It is designed to highlight the preclinical rationale driving the molecular footprint assessment, the progressive development of a specific pharmacological treatment and the best method to identify those NSCLC who would most likely benefit from treatment with EGFR-targeted therapy. This is supported by the belief that a rationale for the prioritization of specific regimens based on patient-tailored therapy could be closer than commonly expected.
Keywords: EGFR targeted therapy, NSCLC, advanced, mutation, TKIs, resistance.
Antonicelli A, Cafarotti S, Indini A, Galli A, Russo A, Cesario A, Lococo FM, Russo P, Mainini AF, Bonifati LG, Nosotti M, Santambrogio L, Margaritora S, Granone PM, Dutly AE. EGFR-Targeted Therapy for Non-Small Cell Lung Cancer: Focus on EGFR Oncogenic Mutation. Int J Med Sci 2013; 10(3):320-330. doi:10.7150/ijms.4609. Available from http://www.medsci.org/v10p0320.htm