Treatment of advanced non-small-cell lung cancer with epidermal growth factor receptor (EGFR) mutation or ALK gene rearrangement: Results of an International expert panel meeting of the Italian association of thoracic oncology

Cesare Gridelli, Filippo De Marinis, Federico Cappuzzo, Massimo Di Maio, Fred R. Hirsch, Tony Mok, Floriana Morgillo, Rafael Rosell, David R. Spigel, James Chih Hsin Yang, Fortunato Ciardiello

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

The availability of targeted drugs has made the assessment of the EGFR mutation and ALK rearrangement critical in choosing the optimal treatment for patients with advanced non-small-cell lung cancer (NSCLC). In May 2013, the Italian Association of Thoracic Oncology (AIOT) organized an International Experts Panel Meeting to review strengths and limitations of the available evidence for the diagnosis and treatment of advanced NSCLC with EGFR or anaplastic lymphoma kinase (ALK) alterations and to discuss implications for clinical practice and future clinical research. All patients with advanced NSCLC, with the exclusion of pure squamous cell carcinoma in former or current smokers, should be tested for EGFR mutations and ALK rearrangements before decisions are made on first-line treatment. First-line treatment of EGFR-mutated cases should be with an EGFR tyrosine kinase inhibitor (TKI). Any available agent (gefitinib, erlotinib, or afatinib) can be used, until further data from comparative studies may better guide TKI selection. As general rule, and when clinically feasible, results of EGFR mutational status should be awaited before starting first-line treatment. Panelists agreed that the use of crizotinib is justified in any line of treatment. Although solid evidence supporting the continuation of EGFR TKIs or crizotinib beyond progression is lacking, in some cases (minimal, asymptomatic progression, or oligoprogression manageable by local therapy), treatment continuation beyond progression could be justified. Experimental strategies to target tumor heterogeneity and to treat patients after failure of EGFR TKIs or crizotinib are considered high-priority areas of research. A number of relevant research priorities were identified to optimize available treatment options.

Original languageEnglish
Pages (from-to)173-181
Number of pages9
JournalClinical Lung Cancer
Volume15
Issue number3
DOIs
Publication statusPublished - 2014

Fingerprint

Gene Rearrangement
Epidermal Growth Factor Receptor
Non-Small Cell Lung Carcinoma
Thorax
Mutation
Therapeutics
Protein-Tyrosine Kinases
Research
anaplastic lymphoma kinase
Squamous Cell Carcinoma

Keywords

  • ALK rearrangement
  • Epidermal growth factor receptor mutation
  • Non-small-cell lung cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Pulmonary and Respiratory Medicine
  • Medicine(all)

Cite this

Treatment of advanced non-small-cell lung cancer with epidermal growth factor receptor (EGFR) mutation or ALK gene rearrangement : Results of an International expert panel meeting of the Italian association of thoracic oncology. / Gridelli, Cesare; De Marinis, Filippo; Cappuzzo, Federico; Di Maio, Massimo; Hirsch, Fred R.; Mok, Tony; Morgillo, Floriana; Rosell, Rafael; Spigel, David R.; Yang, James Chih Hsin; Ciardiello, Fortunato.

In: Clinical Lung Cancer, Vol. 15, No. 3, 2014, p. 173-181.

Research output: Contribution to journalArticle

Gridelli, Cesare ; De Marinis, Filippo ; Cappuzzo, Federico ; Di Maio, Massimo ; Hirsch, Fred R. ; Mok, Tony ; Morgillo, Floriana ; Rosell, Rafael ; Spigel, David R. ; Yang, James Chih Hsin ; Ciardiello, Fortunato. / Treatment of advanced non-small-cell lung cancer with epidermal growth factor receptor (EGFR) mutation or ALK gene rearrangement : Results of an International expert panel meeting of the Italian association of thoracic oncology. In: Clinical Lung Cancer. 2014 ; Vol. 15, No. 3. pp. 173-181.
@article{7bd968de9b3c4f678141516fc16b8a75,
title = "Treatment of advanced non-small-cell lung cancer with epidermal growth factor receptor (EGFR) mutation or ALK gene rearrangement: Results of an International expert panel meeting of the Italian association of thoracic oncology",
abstract = "The availability of targeted drugs has made the assessment of the EGFR mutation and ALK rearrangement critical in choosing the optimal treatment for patients with advanced non-small-cell lung cancer (NSCLC). In May 2013, the Italian Association of Thoracic Oncology (AIOT) organized an International Experts Panel Meeting to review strengths and limitations of the available evidence for the diagnosis and treatment of advanced NSCLC with EGFR or anaplastic lymphoma kinase (ALK) alterations and to discuss implications for clinical practice and future clinical research. All patients with advanced NSCLC, with the exclusion of pure squamous cell carcinoma in former or current smokers, should be tested for EGFR mutations and ALK rearrangements before decisions are made on first-line treatment. First-line treatment of EGFR-mutated cases should be with an EGFR tyrosine kinase inhibitor (TKI). Any available agent (gefitinib, erlotinib, or afatinib) can be used, until further data from comparative studies may better guide TKI selection. As general rule, and when clinically feasible, results of EGFR mutational status should be awaited before starting first-line treatment. Panelists agreed that the use of crizotinib is justified in any line of treatment. Although solid evidence supporting the continuation of EGFR TKIs or crizotinib beyond progression is lacking, in some cases (minimal, asymptomatic progression, or oligoprogression manageable by local therapy), treatment continuation beyond progression could be justified. Experimental strategies to target tumor heterogeneity and to treat patients after failure of EGFR TKIs or crizotinib are considered high-priority areas of research. A number of relevant research priorities were identified to optimize available treatment options.",
keywords = "ALK rearrangement, Epidermal growth factor receptor mutation, Non-small-cell lung cancer",
author = "Cesare Gridelli and {De Marinis}, Filippo and Federico Cappuzzo and {Di Maio}, Massimo and Hirsch, {Fred R.} and Tony Mok and Floriana Morgillo and Rafael Rosell and Spigel, {David R.} and Yang, {James Chih Hsin} and Fortunato Ciardiello",
year = "2014",
doi = "10.1016/j.cllc.2013.12.002",
language = "English",
volume = "15",
pages = "173--181",
journal = "Clinical Lung Cancer",
issn = "1525-7304",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Treatment of advanced non-small-cell lung cancer with epidermal growth factor receptor (EGFR) mutation or ALK gene rearrangement

T2 - Results of an International expert panel meeting of the Italian association of thoracic oncology

AU - Gridelli, Cesare

AU - De Marinis, Filippo

AU - Cappuzzo, Federico

AU - Di Maio, Massimo

AU - Hirsch, Fred R.

AU - Mok, Tony

AU - Morgillo, Floriana

AU - Rosell, Rafael

AU - Spigel, David R.

AU - Yang, James Chih Hsin

AU - Ciardiello, Fortunato

PY - 2014

Y1 - 2014

N2 - The availability of targeted drugs has made the assessment of the EGFR mutation and ALK rearrangement critical in choosing the optimal treatment for patients with advanced non-small-cell lung cancer (NSCLC). In May 2013, the Italian Association of Thoracic Oncology (AIOT) organized an International Experts Panel Meeting to review strengths and limitations of the available evidence for the diagnosis and treatment of advanced NSCLC with EGFR or anaplastic lymphoma kinase (ALK) alterations and to discuss implications for clinical practice and future clinical research. All patients with advanced NSCLC, with the exclusion of pure squamous cell carcinoma in former or current smokers, should be tested for EGFR mutations and ALK rearrangements before decisions are made on first-line treatment. First-line treatment of EGFR-mutated cases should be with an EGFR tyrosine kinase inhibitor (TKI). Any available agent (gefitinib, erlotinib, or afatinib) can be used, until further data from comparative studies may better guide TKI selection. As general rule, and when clinically feasible, results of EGFR mutational status should be awaited before starting first-line treatment. Panelists agreed that the use of crizotinib is justified in any line of treatment. Although solid evidence supporting the continuation of EGFR TKIs or crizotinib beyond progression is lacking, in some cases (minimal, asymptomatic progression, or oligoprogression manageable by local therapy), treatment continuation beyond progression could be justified. Experimental strategies to target tumor heterogeneity and to treat patients after failure of EGFR TKIs or crizotinib are considered high-priority areas of research. A number of relevant research priorities were identified to optimize available treatment options.

AB - The availability of targeted drugs has made the assessment of the EGFR mutation and ALK rearrangement critical in choosing the optimal treatment for patients with advanced non-small-cell lung cancer (NSCLC). In May 2013, the Italian Association of Thoracic Oncology (AIOT) organized an International Experts Panel Meeting to review strengths and limitations of the available evidence for the diagnosis and treatment of advanced NSCLC with EGFR or anaplastic lymphoma kinase (ALK) alterations and to discuss implications for clinical practice and future clinical research. All patients with advanced NSCLC, with the exclusion of pure squamous cell carcinoma in former or current smokers, should be tested for EGFR mutations and ALK rearrangements before decisions are made on first-line treatment. First-line treatment of EGFR-mutated cases should be with an EGFR tyrosine kinase inhibitor (TKI). Any available agent (gefitinib, erlotinib, or afatinib) can be used, until further data from comparative studies may better guide TKI selection. As general rule, and when clinically feasible, results of EGFR mutational status should be awaited before starting first-line treatment. Panelists agreed that the use of crizotinib is justified in any line of treatment. Although solid evidence supporting the continuation of EGFR TKIs or crizotinib beyond progression is lacking, in some cases (minimal, asymptomatic progression, or oligoprogression manageable by local therapy), treatment continuation beyond progression could be justified. Experimental strategies to target tumor heterogeneity and to treat patients after failure of EGFR TKIs or crizotinib are considered high-priority areas of research. A number of relevant research priorities were identified to optimize available treatment options.

KW - ALK rearrangement

KW - Epidermal growth factor receptor mutation

KW - Non-small-cell lung cancer

UR - http://www.scopus.com/inward/record.url?scp=84898001764&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84898001764&partnerID=8YFLogxK

U2 - 10.1016/j.cllc.2013.12.002

DO - 10.1016/j.cllc.2013.12.002

M3 - Article

C2 - 24486058

AN - SCOPUS:84898001764

VL - 15

SP - 173

EP - 181

JO - Clinical Lung Cancer

JF - Clinical Lung Cancer

SN - 1525-7304

IS - 3

ER -