Pharmacogenomics of EGFR-targeted therapies in non-small cell lung cancer:EGFR and beyond

Commonly observed aberrations in epidermal growth factor receptor(EGFR) signaling have led to the development of EGFR-targeted therapies for various cancers,including non-small cell lung cancer(NSCLC).EGFR mutations and overexpression have further been shown to modulate sensitivity to these EGFR-targeted therapies in NSCLC and several other types of cancers.However,it is clear that mutations and/or genetic variations in EGFR alone cannot explain all of the variability in the responses of patients with NSCLC to EGFR-targeted therapies.For instance,in addition to EGFR genotype,genetic variations in other members of the signaling pathway downstream of EGFR or variations in parallel receptor tyrosine kinase(RTK) pathways are now recognized to have a significant impact on the efficacy of certain EGFR-targeted therapies.In this review,we highlight the mutations and genetic variations in such genes downstream of EGFR and in parallel RTK pathways.Specifically,the directional effects of these pharmacogenetic factors are discussed with a focus on two commonly prescribed EGFR inhibitors:cetuximab and erlotinib.The results of this comprehensive review can be used to optimize the treatment of NSCLC with EGFR inhibitors.Furthermore,they may provide the rationale for the design of subsequent combination therapies that involve the inhibition of EGFR.

肺癌的下一代测序技术

肺癌在生物学上具有侵袭性,并且是癌症相关死亡的主要原因。根据临床特征、预后、对治疗的反应和耐受性,每一例肺癌患者的进展均是独特的。传统上基于毛细管的单基因测序的第一代技术(如Sanger测序法)已被允许大量平行测序且成本更低、通量更高的下一代测序技术(next-generation sequencing,NGS)所替代。与传统方法相比,NGS技术取得显著进步。我们希望这些方法可全面地解释癌症全球图谱,并提供更多信息以满足个体化用药的需求。本综述包括对不同NGS技术的简要说明,NGS在肺癌研究进展中的应用和重要发现的总结,包括对已知靶基因(EGFR、ALK和KRAS)的进一步探索、其它肺癌突变的鉴定和癌症基因组研究的全局协调。