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Importance of the fieldNon-small-cell lung cancer (NSCLC) is a disseminated disease in 50% of cases, with a gloomy prognosis and median survivals of < 1 year.Areas covered in this reviewBased on substantial advances, cancer biology insights and novel biotechnology tools, customized treatment provides hints that cisplatin-based treatment can be optimized in favorable subgroups of patients according to gene expression DNA repair profiles. In 2004, it was discovered that 10-15% of NSCLC can harbor a new class of EGFR mutation conferring specific sensitivity to EGFR tyrosine kinase inhibitors.What the reader will gainThe homologous recombination pathway provides information for customizing cisplatin-based chemotherapy. BRCA1 plays a central role in this pathway that can be used in tailoring chemotherapy. Patient subgroups can obtain significant increases in progression-free survival. For EGFR lung-addicted cancers, treatment with EGFR tyrosine kinase inhibitors like erlotinib provide impressive improvement in progression-free survival--up to 14 months with significant enhanced survival.Take home messageCustomized chemotherapy based on BRCA1 models can contribute to demonstrating this approach's clinical relevance, and the implementation of EGFR mutation assessment is warranted to identify EGFR-addicted lung cancers with a different prognosis that could benefit from a specifically targeted therapy approach.

Original publication

DOI

10.1517/14656566.2010.482101

Type

Journal article

Journal

Expert opinion on pharmacotherapy

Publication Date

07/2010

Volume

11

Pages

1683 - 1693

Addresses

Hospital Germans Trias i Pujol, Catalan Institute of Oncology, Medical Oncology Service, Ctra Canyet, s/n 08916 Badalona, Barcelona, Spain. rrosell@ico.scs.es

Keywords

Humans, Carcinoma, Non-Small-Cell Lung, Lung Neoplasms, Neoplasm Metastasis, Quinazolines, Carrier Proteins, DNA-Binding Proteins, BRCA1 Protein, Nuclear Proteins, RNA, Messenger, Neoplasm Staging, Mutation, Clinical Trials, Phase II as Topic, Histone Chaperones, ErbB Receptors, Erlotinib Hydrochloride