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Lung Adenocarcinoma Accordingly To Epidermal Growth Factor Receptor Status: A New Comprehension of Disease Characteristics and Treatment Approaches

April-June 2011, Volume 06, Number 2
Ioannis P. Boukovinas and Paris Kosmidis
Theagenion Cancer Hospital, Thessaloniki, Greece

Lung adenocarcinoma is the major subtype of non-small cell lung cancer, accounting for more than 50% of cases, followed by squamous carcinoma. All cases of lung adenocarcinoma associate preferentially with epidermal growth factor receptor mutations (90% locate at exons 19 and 21) and respond with different rates to epidermal growth factor receptor-targeted therapy. While not recognized to confer significant survival benefit in first-line treatment in combination with chemotherapy of unselected non-small cell lung cancer patients, epidermal growth factor receptor inhibitors are reported to produce survival benefits in second-line treatment in patients with lung adenocarcinoma. Current accumulating knowledge of epidermal growth factor receptor biology, gene profiling, distribution and epidermal growth factor receptor-mediated intracellular cascades in non-small cell lung cancer patients, when coupled with data on the clinical profile of epidermal growth factor receptor-targeted therapy responders, non-responders, and patients with acquired resistance, may document a case for the further discrimination of non-small cell lung cancer/lung adenocarcinoma. The perception of lung adenocarcinoma as more than a single malicious disease with ubiquitous characteristics could facilitate the better understanding of current knowledge and future clinical results that would eventually lead to a more refined, rationalized description of disease progression and treatment outcomes. In the present comprehensive review we present all relevant current knowledge that potentially supports the further discrimination of non-small cell lung cancer/lung adenocarcinoma based on epidermal growth factor receptor response traits.

Key words:
Lung adenocarcinoma. EGFR. Disease characteristics. Treatment.
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