title: The International Association for the Study of Lung Cancer Consensus Statement on Optimizing Management of EGFR Mutation-Positive Non-Small Cell Lung Cancer: Status in 2016.
abstract: Mutations in the epidermal growth factor receptor gene (EGFR) represent one of the most frequent "actionable" alterations in non-small cell lung cancer (NSCLC). Typified by high response rates to targeted therapies, EGFR tyrosine kinase inhibitors (TKIs) are now established first-line treatment options and have transformed the treatment paradigm for NSCLC. With the recent breakthrough designation and approval of the third-generation EGFR TKI osimertinib, available systemic and local treatment options have expanded, requiring new clinical algorithms that take into account individual patient molecular and clinical profiles. In this International Association for the Study of Lung Cancer commissioned consensus statement, key pathologic, diagnostic, and therapeutic considerations, such as optimal choice of EGFR TKI and management of brain metastasis, are discussed. In addition, recommendations are made for clinical guidelines and research priorities, such as the role of repeat biopsies and use of circulating free DNA for molecular studies. With the rapid pace of progress in treating EGFR-mutant NSCLC, this statement provides a state-of-the-art review of the contemporary issues in managing this unique subgroup of patients.
authors.affiliation: National Cancer Centre Singapore and Genome Institute of Singapore, Singapore.
authors.forename: Daniel S W
authors.initials: DS
authors.lastname: Tan
authors.affiliation: Department of Radiation Oncology, University of California, San Francisco, California.
authors.forename: Sue S
authors.initials: SS
authors.lastname: Yom
authors.affiliation: Departments of Pathology, University Health Network, Princess Margaret Cancer Centre, and the University of Toronto, Toronto, Ontario, Canada.
authors.forename: Ming S
authors.initials: MS
authors.lastname: Tsao
authors.affiliation: Department of Cardiothoracic Surgery, New York University Langone Medical Center, New York, New York.
authors.forename: Harvey I
authors.initials: HI
authors.lastname: Pass
authors.affiliation: University of California Davis Comprehensive Cancer Center, Sacramento, California.
authors.forename: Karen
authors.initials: K
authors.lastname: Kelly
authors.affiliation: The Thoracic Cancer Unit, Davidoff Cancer Center, Tel Aviv University, Tel-Aviv, Israel.
authors.forename: Nir
authors.initials: N
authors.lastname: Peled
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Greater Baltimore Medical Center, Baltimore, Maryland.
authors.forename: Rex C
authors.initials: RC
authors.lastname: Yung
authors.affiliation: Department of Translational Molecular Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas.
authors.forename: Ignacio I
authors.initials: II
authors.lastname: Wistuba
authors.affiliation: Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yatabe
authors.affiliation: Sidney Kimmel Medical College and Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: Michael
authors.initials: M
authors.lastname: Unger
authors.affiliation: University of California Davis Comprehensive Cancer Center, Sacramento, California.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Mack
authors.affiliation: International Association for the Study of Lung Cancer, Aurora, Colorado.
authors.forename: Murry W
authors.initials: MW
authors.lastname: Wynes
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mitsudomi
authors.affiliation: Division of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Walter
authors.initials: W
authors.lastname: Weder
authors.affiliation: Department of Radiology, Mount Sinai School of Medicine, New York, New York.
authors.forename: David
authors.initials: D
authors.lastname: Yankelevitz
authors.affiliation: Yale Cancer Center, New Haven, Connecticut.
authors.forename: Roy S
authors.initials: RS
authors.lastname: Herbst
authors.affiliation: University of California Davis Comprehensive Cancer Center, Sacramento, California.
authors.forename: David R
authors.initials: DR
authors.lastname: Gandara
authors.affiliation: Division of Medical Oncology, The Ohio State University, Columbus, Ohio.
authors.forename: David P
authors.initials: DP
authors.lastname: Carbone
authors.affiliation: Division of Medical Oncology, University of Colorado Cancer Center, Aurora, Colorado.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Bunn
authors.affiliation: State Key Laboratory of Southern China, Hong Kong Cancer Institute, Department of Clinical Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, People's Republic of China. Electronic address: tony@clo.cuhk.edu.hk.
authors.forename: Tony S K
authors.initials: TS
authors.lastname: Mok
authors.affiliation: Division of Medical Oncology, University of Colorado Cancer Center, Aurora, Colorado.
authors.forename: Fred R
authors.initials: FR
authors.lastname: Hirsch
mesh_terms: D001932:Brain Neoplasms / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D032921:Consensus; D019008:Drug Resistance, Neoplasm; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000235:genetics*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D009154:Mutation; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use
chemical_list: D047428:Protein Kinase Inhibitors; C512478:EGFR protein, human; D066246:ErbB Receptors
keywords: Brain metastases; EGFR mutation; Non–small cell lung cancer; Resistance; Therapy; Tyrosine kinase inhibitor