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J Thorac Oncol. 2016 Jul;11(7):946-63. doi: 10.1016/j.jtho.2016.05.008. Epub 2016 May 23.

The International Association for the Study of Lung Cancer Consensus Statement on Optimizing Management of EGFR Mutation-Positive Non-Small Cell Lung Cancer: Status in 2016.

Author information

1
National Cancer Centre Singapore and Genome Institute of Singapore, Singapore.
2
Department of Radiation Oncology, University of California, San Francisco, California.
3
Departments of Pathology, University Health Network, Princess Margaret Cancer Centre, and the University of Toronto, Toronto, Ontario, Canada.
4
Department of Cardiothoracic Surgery, New York University Langone Medical Center, New York, New York.
5
University of California Davis Comprehensive Cancer Center, Sacramento, California.
6
The Thoracic Cancer Unit, Davidoff Cancer Center, Tel Aviv University, Tel-Aviv, Israel.
7
Department of Pulmonary and Critical Care Medicine, Greater Baltimore Medical Center, Baltimore, Maryland.
8
Department of Translational Molecular Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas.
9
Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan.
10
Sidney Kimmel Medical College and Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania.
11
International Association for the Study of Lung Cancer, Aurora, Colorado.
12
Division of Thoracic Surgery, Department of Surgery, Kinki University Faculty of Medicine, Osaka-Sayama, Japan.
13
Division of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland.
14
Department of Radiology, Mount Sinai School of Medicine, New York, New York.
15
Yale Cancer Center, New Haven, Connecticut.
16
Division of Medical Oncology, The Ohio State University, Columbus, Ohio.
17
Division of Medical Oncology, University of Colorado Cancer Center, Aurora, Colorado.
18
State Key Laboratory of Southern China, Hong Kong Cancer Institute, Department of Clinical Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, People's Republic of China. Electronic address: tony@clo.cuhk.edu.hk.

Abstract

Mutations in the epidermal growth factor receptor gene (EGFR) represent one of the most frequent "actionable" alterations in non-small cell lung cancer (NSCLC). Typified by high response rates to targeted therapies, EGFR tyrosine kinase inhibitors (TKIs) are now established first-line treatment options and have transformed the treatment paradigm for NSCLC. With the recent breakthrough designation and approval of the third-generation EGFR TKI osimertinib, available systemic and local treatment options have expanded, requiring new clinical algorithms that take into account individual patient molecular and clinical profiles. In this International Association for the Study of Lung Cancer commissioned consensus statement, key pathologic, diagnostic, and therapeutic considerations, such as optimal choice of EGFR TKI and management of brain metastasis, are discussed. In addition, recommendations are made for clinical guidelines and research priorities, such as the role of repeat biopsies and use of circulating free DNA for molecular studies. With the rapid pace of progress in treating EGFR-mutant NSCLC, this statement provides a state-of-the-art review of the contemporary issues in managing this unique subgroup of patients.

KEYWORDS:

Brain metastases; EGFR mutation; Non–small cell lung cancer; Resistance; Therapy; Tyrosine kinase inhibitor

PMID:
27229180
DOI:
10.1016/j.jtho.2016.05.008
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