Epidermal growth factor receptor tyrosine kinase inhibitor-resistant disease

Kadoaki Ohashi1, Yosef E Maruvka, Franziska Michor

  • 1University School of Medicine, Nashville,TN, USA.

Abstract

Insights

Epidermal growth factor receptor (EGFR) mutations have transformed non-small-cell lung cancer (NSCLC) treatment, significantly improving patient survival. Current research focuses on managing EGFR-mutant lung cancer as a chronic condition.

Area of Science:

  • Oncology
  • Genetics
  • Internal Medicine

Background:

  • Epidermal growth factor receptor (EGFR) mutations define a distinct subtype of non-small-cell lung cancer (NSCLC).
  • The identification of EGFR mutations has revolutionized NSCLC treatment paradigms since 2004.

Purpose of the Study:

  • To provide an updated review of controversies and conclusions regarding EGFR-mutant lung cancer.
  • To discuss the clinical implications of EGFR mutations in NSCLC, particularly focusing on tyrosine kinase inhibitor resistance.

Main Methods:

  • Literature review focusing on clinical implications of EGFR mutations in lung cancer.
  • Analysis of treatment strategies and outcomes related to EGFR mutations and resistance.

Main Results:

  • EGFR mutations have significantly improved survival rates for patients with metastatic NSCLC, more than doubling previous outcomes.
  • Patients with EGFR-mutant tumors now have an expected survival exceeding 2 years.

Conclusions:

  • EGFR mutation status is crucial for guiding NSCLC treatment decisions.
  • Future efforts aim to manage EGFR-mutant lung cancer as a chronic illness, shifting from a fatal diagnosis to a manageable condition.

Related Concept Videos

Mitogens and the Cell Cycle02:38

Mitogens and the Cell Cycle

Mitogens and their receptors play a crucial role in controlling the progression of the cell cycle. However, the loss of mitogenic control over cell division leads to tumor formation. Therefore, mitogens and mitogen receptors play an important role in cancer research. For instance, the epidermal growth factor (EGF) - a type of mitogen and its transmembrane receptor (EGFR), decides the fate of the cell's proliferation. When EGF binds to EGFR, a member of the ErbB family of tyrosine kinase...
Treatment Resistant Cancers02:56

Treatment Resistant Cancers

Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
Receptor Tyrosine Kinases01:26

Receptor Tyrosine Kinases

Receptor tyrosine kinases or RTKs are membrane-bound receptors that phosphorylate specific tyrosine on protein substrates. RTKs regulate cellular growth, differentiation, survival, and migration. They contain an extracellular ligand binding domain, a transmembrane domain, and a cytosolic tail with intrinsic kinase activity. Several extracellular signaling molecules activate RTKs in one or more ways and relay the signal downstream. Ligands such as platelet-derived growth factor (PDGF) or...
Targeted Cancer Therapies02:57

Targeted Cancer Therapies

The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...
Transducer Mechanism: Enzyme-Linked Receptors01:27

Transducer Mechanism: Enzyme-Linked Receptors

Enzyme-linked receptors are cell-surface receptors acting as an enzyme or associating with an enzyme intracellularly. They make excellent drug targets. Drugs can bind to the extracellular ligand-binding domain or directly affect their enzymatic domain and alter their activity.
Major types that are helpful drug targets include:
mTOR Signaling and Cancer Progression03:03

mTOR Signaling and Cancer Progression

The mammalian target of rapamycin or mTOR protein was discovered in 1994 due to its direct interaction with rapamycin. The protein gets its name from a yeast homolog called TOR. The mTOR protein complex in mammalian cells plays a major role in balancing anabolic processes such as the synthesis of proteins, lipids, and nucleotides and catabolic processes, such as autophagy in response to environmental cues, such as availability of nutrients and growth factors.
The mTOR pathway or the...