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Abstract
Non-small cell lung cancer (NSCLC) therapeutic approach has been a priority in recent years, since conventional treatments seem to have reached a plateau in survival improvement. Epidermal Growth Factor Receptor (EGFR), a transmembrane receptor with tyrosine kinase activity, was identified as a promising target for NSCLC molecular therapy given its preponderant role in development and progression of some lung tumors. Unfortunately, the Tyrosine Kinase Inhibitors (TKI) that target the EGFR pathway, like Gefitinib or Erlotinib, are active only in a minority of patients. The aim is now to accurately identify patient’s clinical and biological characteristics that will allow prediction of response or resistance to these agents, therefore contributing to a comprehensive patient screening and also for important economical saving.
The most common clinicopathologic predictors of response to TKI are neversmoking history, female sex, Asian ethnicity and adenocarcinoma histology. At the molecular level, EGFR gene mutations and increased gene copy number are the most critical predictors of response, although with conflicting results with regard to survival. Several mutations involving not only the EGFR gene but also KRAS or HER2 have been consistently associated with resistance to those agents.
This article intends to systematize the current knowledge on therapeutic targeting of EGFR in NSCLC, which provides an important and useful tool for the clinical management of a subset of lung cancer patients.
