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Stella GM, Valizia C, Zorzetto M, et al. Unexpected responses to EGFR inhibition in NSCLC. Respir Med Case Rep. 2015;16:32-4doi: 10.1016/j.rmcr.2015.06.006.
Stella, G. M., Valizia, C., Zorzetto, M., Inghilleri, S., Valentini, A., Dore, R., Colombo, S., Valentino, F., Orlandoni, G., & Morbini, P. (2015). Unexpected responses to EGFR inhibition in NSCLC. Respiratory medicine case reports, 1632-4. https://doi.org/10.1016/j.rmcr.2015.06.006
Stella, Giulia M, et al. "Unexpected responses to EGFR inhibition in NSCLC." Respiratory medicine case reports vol. 16 (2015): 32-4. doi: https://doi.org/10.1016/j.rmcr.2015.06.006
Stella GM, Valizia C, Zorzetto M, Inghilleri S, Valentini A, Dore R, Colombo S, Valentino F, Orlandoni G, Morbini P. Unexpected responses to EGFR inhibition in NSCLC. Respir Med Case Rep. 2015 Jun 25;16:32-4. doi: 10.1016/j.rmcr.2015.06.006. eCollection 2015. PMID: 26744648; PMCID: PMC4681892.
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Respir Med Case Rep. 2015 Jun 25;16:32-4. doi: 10.1016/j.rmcr.2015.06.006. eCollection 2015.

Unexpected responses to EGFR inhibition in NSCLC.

Respiratory medicine case reports

Giulia M Stella, Claudio Valizia, Michele Zorzetto, Simona Inghilleri, Adele Valentini, Roberto Dore, Sara Colombo, Francesco Valentino, Giulio Orlandoni, Patrizia Morbini

Affiliations

  1. Department of Molecular Medicine, Laboratory of Biochemistry and Genetics, Pneumology Unit, University and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  2. Institute of Radiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  3. Department of Hemato-oncology, Radiation Therapy, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  4. Department of Hemato-oncology, Medical Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  5. Cardiothoracic Surgery Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  6. Department of Molecular Medicine, Section of Pathology, University of Pavia and Foundation IRCCS Policlinico S. Matteo, Pavia, Italy.

PMID: 26744648 PMCID: PMC4681892 DOI: 10.1016/j.rmcr.2015.06.006

Abstract

The presence of activating mutations of the epidermal growth factor receptor (EGFR)-gene identifies a distinct and clinically relevant molecular subset of non-small-cell lung cancer. It is now well demonstrated that EGFR tyrosine kinase inhibitors (TKIs) gefitinib and erlotinib are superior to standard chemotherapy in this subset of tumors. Nevertheless, in many cases, responses are not durable and last for 6-12 months due to the occurrence of secondary or acquired resistance. Here we present three cases of EGFR-mutant lung adenocarcinomas (ADC), that showed an unexpected response to anti-EGFR small molecules. The first patient presented a continued 89 month-long response to erlotinib in a tumor recurred after surgery and conventional chemotherapy. In the other cases, subclinically persistent tumor in the lung tissue was documented histologically in lung resections performed after partial response to TKI treatment. The persistence of interstitial and endolymphatic tumor cells after TKI treatment might explain the common observation of tumor relapse after TKI discontinuation, and sustain the decision to continue treatment in responsive patients as in our first case.

Keywords: Actionable markers; Cancer genetics; Targeted therapy

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