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. 2013 Dec;2(6):445-8.
doi: 10.3978/j.issn.2218-6751.2013.10.14.

EGFR mutation heterogeneity and mixed response to EGFR tyrosine kinase inhibitors of non small cell lung cancer: a clue to overcoming resistance

Jordi Remon  1 , Margarita Majem  2
Affiliations

EGFR mutation heterogeneity and mixed response to EGFR tyrosine kinase inhibitors of non small cell lung cancer: a clue to overcoming resistance

Jordi Remon et al. Transl Lung Cancer Res. 2013 Dec.

Abstract

The presence of an EGFR activating mutation is predictive of benefit from reversible and irreversible EGFR tyrosine kinase inhibitor (EGFR-TKI) allowing personalized medicine in lung cancer. However, intratumoral heterogeneity in EGFR mutation status has recently been described and ranged from 13.9% to 27% in some studies. Intratumor heterogeneity may have important consequences for personalized-medicine approaches that commonly rely on a single tumor-biopsy to portray tumor mutational landscape. EGFR mutation heterogeneity could also explain the mixed responses phenomenon and act as a mechanism of acquired resistance to EGFR-TKI. In order to a better tailored treatment in advanced non-small cell lung cancer (NSCLC), it is extremely important to elucidate the relevance and degree of heterogeneous distribution of the targeted biomarker regarding the metastasis localisation, previous systemic treatments and interval between primary tumor and metastasis. Additionally, these findings would also help us to design new strategies for patients with lung cancer harboring heterogeneous EGFR mutations.

Keywords: EGFR mutation; heterogeneity; lung cancer; mixed responses.

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References

    1. Mitsudomi T, Morita S, Yatabe Y, et al. Gefitinib versus cisplatin plus docetaxel in patients with non-small-cell lung cancer harbouring mutations of the epidermal growth factor receptor (WJTOG3405): an open label, randomised phase 3 trial. Lancet Oncol 2010;11:121-8. - PubMed
    1. Zhou C, Wu YL, Chen G, et al. Erlotinib versus chemotherapy as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer (OPTIMAL, CTONG-0802): a multicentre, open-label, randomised, phase 3 study. Lancet Oncol 2011;12:735-42. - PubMed
    1. Rosell R, Carcereny E, Gervais R, et al. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol 2012;13:239-46. - PubMed
    1. Inoue A, Kobayashi K, Maemondo M, et al. Updated overall survival results from a randomized phase III trial comparing gefitinib with carboplatin-paclitaxel for chemo-naïve non-small cell lung cancer with sensitive EGFR gene mutations (NEJ002). Ann Oncol 2013;24:54-9. - PubMed
    1. Sequist LV, Yang JC, Yamamoto N, et al. Phase III Study of Afatinib or Cisplatin Plus Pemetrexed in Patients With Metastatic Lung Adenocarcinoma With EGFR Mutations. J Clin Oncol 2013;31:3327-34. - PubMed