Genotyping lung adenocarcinoma : from bench to bedside.
Genotipificación del carcinoma de pulmón : del laboratorio al paciente.
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Lung cancer harboring mutations in the epidermal growth factor receptor (EGFR) respond to tyrosine kinase inhibitors, but drug resistance invariably emerges. Almost all drug-resistant tumors retained their original activating EGFR mutations, and some acquired known mechanisms of resistance including the EGFR T790M mutation or MET gene amplification. Some resistant cancers showed unexpected genetic changes including EGFR amplification and mutations in the PI3KCA gene, where as others underwent a pronounced epithelial-to-mesenchymal transition. Currently we do not know which is the best treatment for this population so several authors reported the use of EGFR inhibitors plus chemotherapy, chemotherapy alone, radiotherapy or surgery. Some have seen responses with a rechallenge of gefitinib/erlotinib in patients previously responding to these compounds. Here, we report a case that benefited from both these approaches.
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