title: [Biological diagnosis of resistance to erlotinib in a malignant pleural effusion].
abstract: BACKGROUND
  The characterization of genetic abnormalities in non-small cell lung cancer (NSCLC) constitutes a theranostic revolution which is leading to rapid progress in the personalized management of this condition.
  
  
  METHODS
  We present the case of a patient with NSCLC harboring an activating mutation of the Epidermal Growth Factor Receptor (EGFR). After two years of treatment with a tyrosine kinase inhibitor (TKI), the development of a pleural effusion demonstrated that the NSCLC had progressed. The T790M mutation was identified in tumour cells from the pleural aspirate. This anomaly had not been observed in the initial lung biopsy sample.
  
  
  CONCLUSIONS
  The genetic study of tumour cells contained in a biological fluid could be used to initiate molecular monitoring of the NSCLC tumour, without requiring repeated tissue biopsies and to customize the treatment in some patients with NSCLC.
authors.affiliation: LUNAM université, 49000 Angers, France; Pôle thorax-vaisseaux, université d'Angers, CHU d'Angers, 4, rue Larrey, 49933 Angers, France.
authors.forename: C
authors.initials: C
authors.lastname: Rieux
authors.forename: M
authors.initials: M
authors.lastname: Boisdron-Celle
authors.forename: A
authors.initials: A
authors.lastname: Morel
authors.forename: L
authors.initials: L
authors.lastname: Fey
authors.forename: T
authors.initials: T
authors.lastname: Urban
authors.forename: J
authors.initials: J
authors.lastname: Hureaux
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000235:genetics*; D004252:DNA Mutational Analysis; D019008:Drug Resistance, Neoplasm / Q000235:genetics*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000235:genetics*; D000069347:Erlotinib Hydrochloride; D018773:Genes, erbB-1; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000235:genetics*; D008297:Male; D009154:Mutation; D016066:Pleural Effusion, Malignant / Q000235:genetics* / Q000473:pathology; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011799:Quinazolines / Q000627:therapeutic use*
chemical_list: D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors
keywords: Cancer bronchique non à petites cellules; Drug resistance neoplasm; Epidermal growth factor receptor (EGFR); Inhibiteur tyrosine kinase; Malignant pleural effusion; Non-small cell lung cancer; Pleurésie métastatique; Récepteur du facteur de croissance épidermique (EGFR); Résistance aux anticancéreux; Tyrosine kinase inhibitor