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Transl Lung Cancer Res. 2015 Feb;4(1):67-81. doi: 10.3978/j.issn.2218-6751.2014.11.06.

Known and putative mechanisms of resistance to EGFR targeted therapies in NSCLC patients with EGFR mutations-a review.

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1 Princess Margaret Cancer Centre, University Health Network, 2 Department of Medical Biophysics, 3 Department of Laboratory Medicine and Pathobiology, 4 Department of Medicine, University of Toronto, Toronto, Ontario, Canada.


Lung cancer is the leading cause of cancer related deaths in Canada with non-small cell lung cancer (NSCLC) being the predominant form of the disease. Tumor characterization can identify cancer-driving mutations as treatment targets. One of the most successful examples of cancer targeted therapy is inhibition of mutated epidermal growth factor receptor (EGFR), which occurs in ~10-30% of NSCLC patients. While this treatment has benefited many patients with activating EGFR mutations, almost all who initially benefited will eventually acquire resistance. Approximately 50% of cases of acquired resistance (AR) are due to a secondary T790M mutation in exon 20 of the EGFR gene; however, many of the remaining mechanisms of resistance are still unknown. Much work has been done to elucidate the remaining mechanisms of resistance. This review aims to highlight both the mechanisms of resistance that have already been identified in patients and potential novel mechanisms identified in preclinical models which have yet to be validated in the patient settings.


Epidermal growth factor receptor (EGFR); antineoplastic; drug resistance; molecular targeted therapy

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