Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Introduction
  • Published:

The role of genetic testing in the prediction of response to EGFR inhibitors in NSCLC

Oncogene volume 28, pages S1–S3 (2009)Cite this article

Abstract

Lung cancer is the leading cause of cancer deaths worldwide. Non-small-cell lung cancer (NSCLC) is the largest subgroup of the disease and accounts for ∼80% of lung cancers. Most patients with NSCLC are diagnosed with locally advanced or metastatic disease. The current treatment options for such patients are associated with substantial limitations in efficacy and safety. Targeted therapies have provided some improvement in clinical outcomes. Recent efforts have focused on identifying specific markers that are predictive of response to treatment. A pretreatment detection of such markers could facilitate a more personalized and specific approach to therapy, whereby the most appropriate and efficacious treatment is selected for a specific subset of patients. Such a tailored approach would maximize both the therapeutic index and cost-effectiveness of treatments. In addition, several novel agents are under development, which may have the potential for overcoming acquired resistance to existing treatments. This supplement will review the current and emerging treatments for patients with advanced NSCLC and the molecular predictors of response that may facilitate the future clinical application of personalized medicine.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  • American Cancer Society (2008). Non-Small Cell Lung Cancer Detailed Guide, 2008. Available at: http://www.cancer.org/docroot/CRI/content/CRI_2_4_1x_What_Are_the_Key_Statistics_About_Lung_Cancer_15.asp. Last update: 24 October 2008. Accessed 29 April 2009.

  • Astra Zeneca Pharmaceuticals, LP (2008). AstraZeneca files marketing application in Europe for EGFR inhibitor gefitinib (IRESSA) in locally advanced pre-treated non-small cell lung cancer. Last update: 2 May 2008. Available at: http://www.astrazeneca.com/pressrelease/5390.aspx. Last update: 2008. Accessed 29 April 2009.

  • Breathnach OS, Freidlin B, Conley B, Green MR, Johnson DH, Gandara DR et al. (2001). Twenty-two years of phase III trials for patients with advanced non-small-cell lung cancer: sobering results. J Clin Oncol 19: 1734–1742.

    Article  CAS  Google Scholar 

  • Carney DN . (2002). Lung cancer—time to move on from chemotherapy. N Engl J Med 346: 126–128.

    Article  Google Scholar 

  • Fukuoka M, Yano S, Giaccone G, Tamura T, Nakagawa K, Douillard JY et al. (2003). Multi-institutional randomized phase II trial of gefitinib for previously treated patients with advanced non-small-cell lung cancer (the IDEAL 1 trial). J Clin Oncol 21: 2237–2246.

    Article  CAS  Google Scholar 

  • Johnson DH, Fehrenbacher L, Novotny WF, Herbst RS, Nemunaitis JJ, Jablons DM et al. (2004). Randomized phase II trial comparing bevacizumab plus carboplatin and paclitaxel alone in previously untreated locally advanced or metastatic non-small-cell lung cancer. J Clin Oncol 22: 2184–2191.

    Article  CAS  Google Scholar 

  • Kris MG, Natale RB, Herbst RS, Lynch Jr TJ, Prager D, Belani CP et al. (2003). Efficacy of gefitinib, an inhibitor of the epidermal growth factor receptor tyrosine kinase, in symptomatic patients with non-small cell lung cancer: a randomized trial. JAMA 290: 2149–2158.

    Article  CAS  Google Scholar 

  • Lee D, Kim S, Park K, Kim J, Lee J, Shin S et al. (2008). A randomized open-label study of gefitinib versus docetaxel in patients with advanced/metastatic non-small cell lung cancer (NSCLC) who have previously received platinum-based chemotherapy (abstract no. 8025). J Clin Oncol 26 (15S part I): 430s.

    Google Scholar 

  • Mok TS, Wu Y-L, Thongprasert S, Yang C-H, Chu D-T, Saijo N et al. (2009). Initial treatment of pulmonary adenocarcinoma with gefitinib or carboplatin/paclitaxel. N Engl J Med (in press).

  • National Comprehensive Cancer Network (NCCN) (2008). Clinical Practice Guidelines: Non-small Cell Lung Cancer v.2, 2008. Available at: http://www.nccn.org/professionals/physician_gls/PDF/nscl.pdf. Last update: 2008. Accessed 29 April 2009.

  • Pirker R, Pereira JR, Szczesna A, von Pawel J, Krzakowski M, Ramlau R et al. (2009). Cetriximab plus chemotherapy in patients with advanced non-small cell lung cancer (FLEX): an open-label randomized phase III trial. Lancet 373: 1525–1531.

    Article  CAS  Google Scholar 

  • Ries LAG, Melbert D, Krapcho M, Stinchcomb DG, Howlader N, Horner MJ et al. (2008). SEER Cancer Statistics Review, 1975–2005, National Cancer Institute. Bethesda, MD, based on November 2007 SEER data submission, posted to the SEER web site, 2008. Available at: http://seer.cancer.gov/csr/1975_2005/. Last update: 2008. Accessed 29 April 2009.

  • Sandler A, Gray R, Perry MC, Brahmer J, Schiller JH, Dowlati A et al. (2006). Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med 355: 2542–2550.

    Article  CAS  Google Scholar 

  • Shepherd F, Tsao MS . (2006). Unraveling the mystery of prognostic and predictive factors in epidermal growth factor receptor therapy. J Clin Oncol 24: 1219–1220.

    Article  Google Scholar 

  • Shepherd FA, Rodrigues Pereira J, Ciuleanu T, Tan EH, Hirsh V, Thongprasert S et al. (2005). Erlotinib in previously treated non-small-cell lung cancer. N Engl J Med 353: 123–132.

    Article  CAS  Google Scholar 

  • Spigel DR, Lin M, O’Neill V, Hainsworth JD . (2008). Final survival and safety results from a multicenter, open-label, phase 3b trial of erlotinib in patients with advanced non–small cell lung cancer. Cancer 112: 2749–2755.

    Article  CAS  Google Scholar 

  • Thatcher N, Chang A, Parikh P, Pereira JR, Ciuleanu T, von Pawel J et al. (2005). Gefitinib plus best supportive care in previously treated patients with refractory advanced non-small-cell lung cancer: results from a randomized, placebo-controlled, multi-centre study (Iressa survival evaluation in lung cancer). Lancet 366: 1527–1537.

    Article  CAS  Google Scholar 

  • Wingo PA, Cardinez CJ, Landis SH, Greenlee RT, Ries LA, Anderson RN et al. (2003). Long-term trends in cancer mortality in the United States, 1930–1998. Cancer 97: 3133–3275.

    Article  Google Scholar 

  • World Health Organization (WHO) (2008). Fact Sheet No. 310, March 2007. Available at: http://www.who.int/mediacentre/factsheets/fs310/en/index.html. Last update: October 2008. Accessed 29 April 2009.

Download references

Author information

Authors and Affiliations

  1. Department of Medical Oncology, University of Colorado Cancer Center, Aurora, CO, USA

    F R Hirsch

Authors
  1. F R Hirsch
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to F R Hirsch.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hirsch, F. The role of genetic testing in the prediction of response to EGFR inhibitors in NSCLC. Oncogene 28 (Suppl 1), S1–S3 (2009). https://doi.org/10.1038/onc.2009.195

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/onc.2009.195

Keywords

Search

Advanced search

Quick links