Abstract
In the decade since the first report that a mutation in EGFR correlated with response to gefitinib, 1 Paez JG Janne PA Lee JC et al. EGFR mutations in lung cancer: correlation with clinical response to gefitinib therapy. Science. 2004; 304: 1497-1500 Crossref PubMed Scopus (8399) Google Scholar new treatment regimens for patients with advanced stage non-small-cell lung cancer have slowly emerged. Molecular analysis of tumour specimens is recommended to guide treatment decisions for these patients by both the American Society of Clinical Oncology 2 Keedy VL Temin S Somerfield MR et al. American Society of Medical Oncology Provisional Opinion: epidermal growth factor receptor mutation testing for patients with advanced non-small cell lung cancer considering first line EGFR tyrosine kinase inhibitor therapy. J Clin Onc. 2011; 29: 2121-2127 Crossref PubMed Scopus (447) Google Scholar and the European Society of Medical Oncology. 3 Peters S Adjei AA Gridelli C et al. Metastatic Non-small cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2012; 23: vii56-vii64 Summary Full Text Full Text PDF PubMed Scopus (398) Google Scholar Patients with tumours with an activating EGFR mutation should receive an EGFR tyrosine-kinase inhibitor as initial treatment. Patients whose tumours have no activating EGFR mutation or other actionable mutations (eg, ALK, ROS) are better treated with chemotherapy. Treatment after progression on chemotherapy is not as clearly defined for patients with wild-type EGFR or for those with insufficient tissue for molecular testing. In this setting a simple, blood-based tumour marker that could guide treatment decisions would be an important advance. Predictive value of a proteomic signature in patients with non-small-cell lung cancer treated with second-line erlotinib or chemotherapy (PROSE): a biomarker-stratified, randomised phase 3 trialOur findings indicate that serum protein test status is predictive of differential benefit in overall survival for erlotinib versus chemotherapy in the second-line setting. Patients classified as likely to have a poor outcome have better outcomes on chemotherapy than on erlotinib. Full-Text PDF
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