title: Systemic treatment in EGFR-ALK NSCLC patients: second line therapy and beyond.
abstract: Over a short period of time, translational research has described a new clinically relevant molecular subset of non-small-cell lung cancer (NSCLC) that is defined by EGFR mutations or EML4-ALK fusions. Today, patients with metastatic disease can achieve survival rates at least double that of patients with wild-type tumors. Through the rational dissection of the mechanisms of drug sensitivity and resistance, promising strategies have been defined to further improve the outcomes of patients with NCSLC. This review adds to a growing body of knowledge into mechanisms of resistance that can be interrogated in NSCLC patients with EGFR mutations or EML4-ALK fusions, as well as strategies to overcome resistance to TKIs.
authors.affiliation: Instituto Oncológico Dr Rosell, Quirón-Dexeus Hospital Universitario, Barcelona, Spain.
authors.forename: Niki
authors.initials: N
authors.lastname: Karachaliou
authors.forename: Rafael
authors.initials: R
authors.lastname: Rosell
authors.forename: Daniela
authors.initials: D
authors.lastname: Morales-Espinosa
authors.forename: Santiago
authors.initials: S
authors.lastname: Viteri
mesh_terms: D000077716:Afatinib; D000818:Animals; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D019008:Drug Resistance, Neoplasm / Q000235:genetics*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000235:genetics*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D058990:Molecular Targeted Therapy; D009154:Mutation; D015514:Oncogene Proteins, Fusion / Q000235:genetics* / Q000378:metabolism; D047428:Protein Kinase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D011799:Quinazolines / Q000494:pharmacology / Q000627:therapeutic use; D052999:Quinazolinones / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: C522504:EML4-ALK fusion protein, human; D015514:Oncogene Proteins, Fusion; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D052999:Quinazolinones; D000077716:Afatinib; C525726:dacomitinib; C512478:EGFR protein, human; D066246:ErbB Receptors
keywords: EGFR; EML4–ALK; TKI resistance; lung cancer; tyrosine kinase inhibitors