Dealing with NSCLC EGFR mutation testing and treatment: A comprehensive review with an Italian real-world perspective. (April 2021)

• Record Type: Journal Article
• Authors: Malapelle, Umberto; Pilotto, Sara; Passiglia, Francesco; Pepe, Francesco; Pisapia, Pasquale; Righi, Luisella; Listì, Angela; Bironzo, Paolo; Belluomini, Lorenzo; Tabbò, Fabrizio; Reale, Maria Lucia; Russo, Gianluca; De Luca, Caterina; Novello, Silvia; Troncone, Giancarlo
• Is Part Of: Critical reviews in oncology/hematology. Volume 160(2021)
• Publication Date: 2021-04
• Subjects: EGFR -- Common mutations -- Uncommon mutations -- Molecular testing -- Tyrosine kinase inhibitors -- Non-small cell lung cancer; Oncology -- Periodicals; Hematology -- Periodicals; 616.994
• DOI: 10.1016/j.critrevonc.2021.103300
• Languages: English
• ISSNs: 1040-8428

Abstract

Graphical abstract: Highlights: EGFR mutations play a pivotal role as predictive biomarkers in NSCLC. EGFR mutational assessment is critical for adequate management of NSCLC patients. Around 20 % of Italian institutions adopt NGS platforms for EGFR mutation testing. Definition and treatment of uncommon EGFR mutations are quite heterogenous. Implementation of molecular tumor board is critical to support the treatment selection process. Abstract: Since their discovery, relevant efforts have been made to optimize the detection approaches to EGFR mutations as well as the clinical management of EGFR -mutated NSCLC. The recent shift from single gene testing to novel comprehensive detection platforms along with the development of new generation tyrosine kinase inhibitors, targeting both common and uncommon EGFR -mutations, is leading to a progressive increase in the number of patients who may benefit from targeted approaches, with subsequent impact on their long-term survival and quality of life. However, a prompt and adequate implementation of the most recent diagnostic and treatment advances in the routine practice often remains critical to be specifically addressed. In this review we provide a complete and updated overview of the different detection platforms and therapeutic options currently available for the clinical management of advanced EGFR -positive NSCLC, summarizing scientific evidence and describing molecular testing as well as treatment practice in the real-word scenario.