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The evolving scenario of EGFR+ NSCLC patients

Old bedrocks and new horizons


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Mutations of the Epidermal Growth Factor Receptor (EGFR) in Non Small Cell Lung Cancer (NSCLC) patients represent one of the best examples of oncogene-addiction in solid tumor. Discovered almost 20 years ago, these alterations are detectable in ≈20% of Caucasian patients with non-squamous lung carcinoma, increasing until 60% in the Asian population. ldentification of EGFR aberrations is, nowadays, a cornerstone of NSCLC patients' journey. Treating them with specific small inhibitors (tyrosine kinase inhibitors, TKls) has been demonstrating paradigmatic improvements in terms of quantity and quality of life, both at early and advanced disease stage. Preclinical and clinica! researchers are working to further refine diagnostic algorithms and treatment scenarios. More recent sequencing platforms gave insights on rare EGFR mutations, that should be properly targeted, and mechanisms of resistance emerging along treatments. Undoubtedly, EGFR+ patients will witness other forthcoming milestones in their clinica! management, such as more effective combinatoria! strategies, TKI administration to locally-advanced patients and new molecules for "orphan" uncommon alterations. These and other relevant aspects are discussed in this book with a focus on "state of the art" algorithms and key open questions, both from a biologica! and clinica! perspective.


Molecular pathology: strategies to characterize EGFR mutated tumors

Angela Listì, Fabio Turco, Antonio Ungaro, Umberto Malapelle

Early-stage and locally advanced disease: widen therapeutic options

Emanuela Olmetto, Elena Parlagreco, Francesca Jacobs, Marcello Tiseo

Improving treatment strategies in the advanced setting

Valentina Bertaglia, Marco D. Delcuratolo, Edoardo Garbo, Silvia Novello

Targeting less frequent alterations: exon 20 and other rare mutations

Elisa Roca, Cristina Cecchi, Benedetta Del Rio, Paolo Bironzo

Hard-to-treat cancer sites

Annapaola Mariniello, Alessandro Audisio, Lavinia Di Prima, Sara Ramella

Intrinsic and acquired resistance mechanisms and clinical strategies to overcome them

Daniele Pignataro, Maristella Bungaro, Irene Persano, Francesco Passiglia

“Drug tolerant persister cancer cells” biology: understand and overcome this phenomenon

Fabrizio Tabbò, Chiara Pisano, Massimiliano Cani, Riccardo Taulli

Side effects of being diagnosed and treated for EGFR+ lung cancer

Maria Vittoria Pacchiana, Marco Audisio, Giorgia Ferrari, Maria Lucia Reale

Pharmacological aspects of targeting oncogene-addicted patients

Cinzia Nada, Marco De Filippis, Valeria Cetoretta, Marzia Del Re

Clinical management of EGFR+ patients

Tiziana Vavalà, Chiara Paratore, Davide Garino, Enrica Capelletto

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