title: Pharmacogenetics of EGFR in lung cancer: perspectives and clinical applications.
abstract: Lung cancer is a lethal disease, and most cases have already disseminated at the time of diagnosis. Driver mutations in the EGFR tyrosine kinase domain (mainly deletions in exon 19 and L858R mutation in exon 21) have been identified in lung adenocarcinomas, mostly in never smokers, at frequencies of 20-60%. The EGFR tyrosine kinase inhibitors (TKIs) gefitinib or erlotinib attain a response rate of 70% and progression-free survival of 9-13 months, although there are subgroups of patients with long-lasting remissions. No significant correlation between EGFR overexpression and response to treatment has been found, while controversial results have been reported regarding EGFR gene amplification. The pretreatment presence of the T790M mutation, initially identified as an acquired resistance mutation to treatment with EGFR TKIs, has also been reported and may indicate a genetically distinct disease. Finally, other genetic factors, such as mRNA expression of BRCA1 and components of the NF-κB pathway, can modulate response to EGFR TKIs in EGFR-mutated patients.
authors.affiliation: Pangaea Biotech, Laboratory of Oncology, USP Dexeus University Institute, Sabino Arana, 5-19, 08028 Barcelona, Spain.
authors.forename: Clara
authors.initials: C
authors.lastname: Mayo
authors.forename: Jordi
authors.initials: J
authors.lastname: Bertran-Alamillo
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Molina-Vila
authors.forename: Ana
authors.initials: A
authors.lastname: Giménez-Capitán
authors.forename: Carlota
authors.initials: C
authors.lastname: Costa
authors.forename: Rafael
authors.initials: R
authors.lastname: Rosell
mesh_terms: D054316:Biomarkers, Pharmacological; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000235:genetics; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000235:genetics; D000069347:Erlotinib Hydrochloride; D000077156:Gefitinib; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000235:genetics; D010597:Pharmacogenetics; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011799:Quinazolines / Q000627:therapeutic use
chemical_list: D054316:Biomarkers, Pharmacological; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; C512478:EGFR protein, human; D066246:ErbB Receptors; D000077156:Gefitinib