TY - JOUR
T1 - Predictive molecular markers for EGFR-TKI in non-small cell lung cancer patients
T2 - New insights and critical aspects
AU - Ulivi, Paola
AU - Calistri, Daniele
AU - Zoli, Wainer
AU - Amadori, Dino
PY - 2010
Y1 - 2010
N2 - In recent years, a number of novel agents have been investigated that target specific molecular pathways in non-small cell lung cancer (NSCLC). A great deal of effort has been focused on identifying specific markers that predict treatment response, given that a tailored approach would maximize both the therapeutic index and the cost-effectiveness. The epidermal growth factor receptor (EGFR) pathway has emerged as a key regulator of cancer cell proliferation and invasion, and several specific EGFR inhibitors have been examined. Gefitinib and erlotinib are selective EGFR tyrosine kinase inhibitors (EGFR-TKIs), demonstrating good results in selected cases both in terms of objective response rate and of overall survival. At present, EGFR gene mutations are the best positive predictive factors for TKI therapy, and a number of other potential biomarkers are being investigated as additional positive or negative predictors of response. The correct selection of patients that could benefit from these innovative therapies, based on an accurate molecular characterization, is mandatory to provide the best clinical management. Currently, the main factor limiting the characterization of metastatic NSCLC patients is the small quantity of tumor cells available for molecular analysis. In this paper we provide an overview of the most important molecular predictive markers for EGFR-TKIs therapy in NSCLC patients, and focus attention on biological samples suitable for analysis and alternative sampling approaches such as plasma- or serum-derived DNA.
AB - In recent years, a number of novel agents have been investigated that target specific molecular pathways in non-small cell lung cancer (NSCLC). A great deal of effort has been focused on identifying specific markers that predict treatment response, given that a tailored approach would maximize both the therapeutic index and the cost-effectiveness. The epidermal growth factor receptor (EGFR) pathway has emerged as a key regulator of cancer cell proliferation and invasion, and several specific EGFR inhibitors have been examined. Gefitinib and erlotinib are selective EGFR tyrosine kinase inhibitors (EGFR-TKIs), demonstrating good results in selected cases both in terms of objective response rate and of overall survival. At present, EGFR gene mutations are the best positive predictive factors for TKI therapy, and a number of other potential biomarkers are being investigated as additional positive or negative predictors of response. The correct selection of patients that could benefit from these innovative therapies, based on an accurate molecular characterization, is mandatory to provide the best clinical management. Currently, the main factor limiting the characterization of metastatic NSCLC patients is the small quantity of tumor cells available for molecular analysis. In this paper we provide an overview of the most important molecular predictive markers for EGFR-TKIs therapy in NSCLC patients, and focus attention on biological samples suitable for analysis and alternative sampling approaches such as plasma- or serum-derived DNA.
KW - Epidermal growth factor receptor- tyrosine kinase inhibitors
KW - Non-small cell lung cancer
KW - Plasma/serum
KW - Predictive markers
UR - http://www.scopus.com/inward/record.url?scp=78649919343&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78649919343&partnerID=8YFLogxK
U2 - 10.4081/jnai.2010.e10
DO - 10.4081/jnai.2010.e10
M3 - Article
AN - SCOPUS:78649919343
VL - 1
SP - 47
EP - 54
JO - Journal of Nucleic Acids Investigation
JF - Journal of Nucleic Acids Investigation
SN - 2036-7996
IS - 1
ER -