Genotipificación del carcinoma de pulmón : del laboratorio al paciente.

Cardona, Andrés Felipe; Carranza, Hernán; García Herreros, Luis Gerardo; Granada, Julio César; Vargas, Carlos; Otero, Jorge Miguel; Serrano, Silvia; Rodríguez, July Katherine; Torres, Diana; Reguart, Noemí

doi:10.51643/22562915.301

Titulo:

Genotipificación del carcinoma de pulmón : del laboratorio al paciente.
.

Sumario:

El cáncer de pulmón que presenta mutaciones en el receptor para el factor de crecimiento epidérmico (EGFR) responde a inhibidores de tirosina quinasa; no obstante, siempre se documenta resistencia a estos medicamentos. Casi todos los tumores que exhiben tolerancia a los inhibidores blanco dirigidos conservan sus mutaciones activadoras originales, y algunos presentan mecanismos adquiridos, incluyendo la mutación T790M o la amplificación del gen MET. Algunos tumores resistentes demuestran inesperados cambios genéticos, entre ellos la amplificación del EGFR y mutaciones en el PI3KCA, mientras que otros progresan a través de la transición epitelio-mesenquimal. En la actualidad, desconocemos cuál es el mejor tratamiento para esta población, aunq... Ver más

Guardado en:

Revista:

Revista Colombiana de Hematología y Oncología

ISSN:

2256-2877

EISSN:

2256-2915

Autores:

Cardona, Andrés Felipe

Carranza, Hernán

García Herreros, Luis Gerardo

Rodríguez, July Katherine

Torres, Diana

Reguart, Noemí

Editor:

ASOCIACION COLOMBIANA DE HEMATOLOGIA Y ONCOLOGIA

DOI:

10.51643/22562915.301

Volumen:

Año de publicación:

2012-07-01

Pagina inicial:

Pagina final:

Pais:

Colombia

Palabras claves:

cáncer de pulmón de célula no pequeña

Licencia:

Andrés Felipe Cardona - 2012

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.

info:eu-repo/semantics/openAccess

http://purl.org/coar/access_right/c_abf2

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spelling	Genotipificación del carcinoma de pulmón : del laboratorio al paciente. Genotyping lung adenocarcinoma : from bench to bedside. El cáncer de pulmón que presenta mutaciones en el receptor para el factor de crecimiento epidérmico (EGFR) responde a inhibidores de tirosina quinasa; no obstante, siempre se documenta resistencia a estos medicamentos. Casi todos los tumores que exhiben tolerancia a los inhibidores blanco dirigidos conservan sus mutaciones activadoras originales, y algunos presentan mecanismos adquiridos, incluyendo la mutación T790M o la amplificación del gen MET. Algunos tumores resistentes demuestran inesperados cambios genéticos, entre ellos la amplificación del EGFR y mutaciones en el PI3KCA, mientras que otros progresan a través de la transición epitelio-mesenquimal. En la actualidad, desconocemos cuál es el mejor tratamiento para esta población, aunque varios autores han reportado el uso de los inhibidores reversibles más quimioterapia, quimioterapia sola, radioterapia o cirugía. Otros han observado respuestas tras la reexposición al gefitinib/erlotinib en pacientes previamente respondedores a estos compuestos. A continuación, se reporta el caso de un paciente que se benefició de estos dos enfoques. Lung cancer harboring mutations in the epidermal growth factor receptor (EGFR) respond to tyrosine kinase inhibitors, but drug resistance invariably emerges. Almost all drug-resistant tumors retained their original activating EGFR mutations, and some acquired known mechanisms of resistance including the EGFR T790M mutation or MET gene amplification. Some resistant cancers showed unexpected genetic changes including EGFR amplification and mutations in the PI3KCA gene, where as others underwent a pronounced epithelial-to-mesenchymal transition. Currently we do not know which is the best treatment for this population so several authors reported the use of EGFR inhibitors plus chemotherapy, chemotherapy alone, radiotherapy or surgery. Some have seen responses with a rechallenge of gefitinib/erlotinib in patients previously responding to these compounds. Here, we report a case that benefited from both these approaches. Cardona, Andrés Felipe Carranza, Hernán García Herreros, Luis Gerardo Granada, Julio César Vargas, Carlos Otero, Jorge Miguel Serrano, Silvia Rodríguez, July Katherine Torres, Diana Reguart, Noemí cáncer de pulmón de célula no pequeña mutación en el EGFR resistencia erlotinib gefitinib non-small cell lung cancer EGFR mutation resistance erlotinib gefitinib 1 2 Núm. 2 , Año 2012 : Julio Artículo de revista Journal article 2012-07-01T00:00:00Z 2012-07-01T00:00:00Z 2012-07-01 application/pdf Asociación Colombiana de Hematología y Oncología (ACHO) Revista Colombiana de Hematología y Oncología 2256-2877 2256-2915 https://revista.acho.info/index.php/acho/article/view/301 10.51643/22562915.301 https://doi.org/10.51643/22562915.301 spa https://creativecommons.org/licenses/by-nc-sa/4.0 Andrés Felipe Cardona - 2012 Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0. 66 71 Behera D. Managing lung cancer in developing countries: difficulties and solutions. Indian J Chest Dis Allied Sci. 2006;48(4):243-4. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74-108. Pal SK, Mittal B. Fight against cancer in countries with limited resources: the post-genomic era scenario. Asian Pac J Cancer Prev 2004;5(3):328-33. Travis WD. Pathology of lung cancer. Clin Chest Med. 2011;32(4):669-92. Arrieta O, Cardona AF, Federico Bramuglia G, Gallo A, CamposParra AD, Serrano S, et al. Genotyping non-small cell lung cancer (NSCLC) in Latin America. J Thorac Oncol. 2011;6(11):1955-9. Bria E, Milella M, Cuppone F, Novello S, Ceribelli A, Vaccaro V, et al. Outcome of advanced NSCLC patients harboring sensitizing EGFR mutations randomized to EGFR tyrosine kinase inhibitors or chemotherapy as first-line treatment: a meta-analysis. Ann Oncol. 2011;22(10):2277-85. Goldberg SB. Chemotherapy with erlotinib or chemotherapy alone in advanced NSCLC with acquired resistance to EGFR tyrosine kinase inhibitors (TKI). J Clin Oncol. 2012;30 (suppl; abstr 7524). Cardona AF, Moran T, Reguart N, Porta R, Queralt C, Cardenal E, et al. Characteristics and outcomes of non-small cell lung cancer (NSCLC) patients (pts) carrying epidermal growth factor receptor (EGFR) mutations who progress after initial erlotinib (E) response. J Clin Oncol. 2009;27:15s (suppl; abstr 8064). Enchev S. Bronchoalveolar cancer or pulmonary adenomatosis (Jaagsiekte) of sheep. Neoplasma. 1970;17(4):415-25. Travis WD, Brambilla E, Noguchi M, Nicholson AG, Geisinger KR, Yatabe Y, et al. International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 2011;6(2):244-85. Livneh O, Hod I, Yegana Y, Mashiah A, Ben-Menahem N, Ron A, et al. Sheep bronchoalveolar carcinoma: tissue associated protein complex (TAPC) in normal lung tissue and in the tumor differed quantitatively. Cancer Detect Prev. 1988;11(3-6):287-96. Meyers FJ, Madewell BR, Gumerlock PH, DeMartini JC. ras p21 expression in ovine pulmonary carcinoma. Vet Immunol Immunopathol. 1989;23(3-4):279-91. Humann-Ziehank E, Wolf P, Renko K, Schomburg L, Ludwig Bruegmann M, Andreae A, et al. Ovine pulmonary adenocarcinoma as an animal model of progressive lung cancer and the impact of nutritional selenium supply. J Trace Elem Med Biol. 2011;25 Suppl 1:S30-4. Kitamura H, Okudela K. Bronchioloalveolar neoplasia. Int J Clin Exp Pathol 2010;4(1):97-9. Mok TS, Wu YL, Thongprasert S, Yang CH, Chu DT, Saijo N, et al. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med. 2009;361(10):947-57. Rosell R, Moran T, Queralt C, Porta R, Cardenal F, Camps C, et al. Screening for epidermal growth factor receptor mutations in lung cancer. N Engl J Med. 2009;361(10):958-67. Rosell R, Molina MA, Costa C, Simonetti S, Gimenez-Capitan A, Bertran-Alamillo J, et al. Pretreatment EGFR T790M mutation and BRCA1 mRNA expression in erlotinib-treated advanced non-small-cell lung cancer patients with EGFR mutations. Clin Cancer Res. 2011;17(5):1160-8. Sequist LV, Waltman BA, Dias-Santagata D, Digumarthy S, Turke AB, Fidias P, et al. Genotypic and histological evolution of lung cancers acquiring resistance to EGFR inhibitors. Sci Transl Med. 2011;3(75):75ra26. Smit EF, Burgers SA, Biesma B, Smit HJ, Eppinga P, Dingemans AM, et al. Randomized phase II and pharmacogenetic study of pemetrexed compared with pemetrexed plus carboplatin in pretreated patients with advanced non-small-cell lung cancer. J Clin Oncol. 2009;27(12):2038-45. Georgoulias V, Agelidou A, Syrigos K, Rapti A, Agelidou M, Nikolakopoulos J, et al. Second-line treatment with irinotecan plus cisplatin vs cisplatin of patients with advanced nonsmall-cell lung cancer pretreated with taxanes and gemcitabine: a multicenter randomised phase II study. Br J Cancer. 2005;93(7):763-9. Yamamoto N, Nakagawa K, Nishimura Y, Tsujino K, Satouchi M, Kudo S, et al. Phase III study comparing second- and thirdgeneration regimens with concurrent thoracic radiotherapy in patients with unresectable stage III non-small-cell lung cancer: West Japan Thoracic Oncology Group WJTOG0105. J Clin Oncol. 2010;28(23):3739-45. Ohe Y, Ohashi Y, Kubota K, Tamura T, Nakagawa K, Negoro S, et al. Randomized phase III study of cisplatin plus irinotecan versus carboplatin plus paclitaxel, cisplatin plus gemcitabine, and cisplatin plus vinorelbine for advanced non-small-cell lung cancer: Four-Arm Cooperative Study in Japan. Ann Oncol. 2007;18(2):317-23. Han JY, Lim HS, Shin ES, Yoo YK, Park YH, Lee JE, et al. Comprehensive analysis of UGT1A polymorphisms predictive for pharmacokinetics and treatment outcome in patients with nonsmall-cell lung cancer treated with irinotecan and cisplatin. J Clin Oncol. 2006;24(15):2237-44. Cho BC, Im CK, Park MS, Kim SK, Chang J, Park JP, et al. Phase II study of erlotinib in advanced non-small-cell lung cancer after failure of gefitinib. J Clin Oncol. 2007;25(18):2528-33. Yokouchi H, Yamazaki K, Kinoshita I, Konishi J, Asahina H, Sukoh N, et al. Clinical benefit of readministration of gefitinib for initial gefitinib-responders with non-small cell lung cancer. BMC Cancer. 2007;7:51. Wong AS, Seto KY, Chin TM, Soo RA. Lung cancer response to gefitinib, then erlotinib, then gefitinib again. J Thorac Oncol. 2008;3(9):1077-8. Heon S, Nishino M, Goldberg SB, Porter J, Sequist LV, Jackman DM, et al. Response to EGFR tyrosine kinase inhibitor (TKI) retreatment after a drug-free interval in EGFR-mutant advanced non-small cell lung cancer (NSCLC) with acquired resistance. J Clin Oncol. 2012;30 (suppl; abstr 7525). Weickhardt AJ, Scheier B, Burke JM, Gan G, Doebele RC, Bunn PA, et al. Continuation of EGFR/ALK inhibition after local therapy of oligoprogressive disease in EGFR mutant (Mt) and ALK+ non-small cell lung cancer (NSCLC). J Clin Oncol. 2012;30 (suppl; abstr 7526). Yu HA, Sima CS, Cruz AED, Varghese AM, Pietanza MC, Azzoli CG, et al. Local therapy as a treatment strategy in EGFR-mutant advanced lung cancers that have developed acquired resistance to EGFR tyrosine kinase inhibitors. J Clin Oncol. 2012;30 (suppl; abstr 7527). Janjigian YY, Groen HJ, Horn L, Smit EF, Fu Y, Wang F, et al. Activity and tolerability of afatinib (BIBW 2992) and cetuximab in NSCLC patients with acquired resistance to erlotinib or gefitinib. J Clin Oncol. 2011;29 (suppl; abstr 7525). https://revista.acho.info/index.php/acho/article/download/301/271 info:eu-repo/semantics/article http://purl.org/coar/resource_type/c_6501 info:eu-repo/semantics/publishedVersion http://purl.org/coar/version/c_970fb48d4fbd8a85 info:eu-repo/semantics/openAccess http://purl.org/coar/access_right/c_abf2 Text Publication
institution	ASOCIACION COLOMBIANA DE HEMATOLOGIA Y ONCOLOGIA
thumbnail	https://nuevo.metarevistas.org/ASOCIACIONCOLOMBIANADEHEMATOLOGIAYONCOLOGIA/logo.png
country_str	Colombia
collection	Revista Colombiana de Hematología y Oncología
title	Genotipificación del carcinoma de pulmón : del laboratorio al paciente.
spellingShingle	Genotipificación del carcinoma de pulmón : del laboratorio al paciente. Cardona, Andrés Felipe Carranza, Hernán García Herreros, Luis Gerardo Granada, Julio César Vargas, Carlos Otero, Jorge Miguel Serrano, Silvia Rodríguez, July Katherine Torres, Diana Reguart, Noemí cáncer de pulmón de célula no pequeña mutación en el EGFR resistencia erlotinib gefitinib non-small cell lung cancer EGFR mutation resistance erlotinib gefitinib
title_short	Genotipificación del carcinoma de pulmón : del laboratorio al paciente.
title_full	Genotipificación del carcinoma de pulmón : del laboratorio al paciente.
title_fullStr	Genotipificación del carcinoma de pulmón : del laboratorio al paciente.
title_full_unstemmed	Genotipificación del carcinoma de pulmón : del laboratorio al paciente.
title_sort	genotipificación del carcinoma de pulmón : del laboratorio al paciente.
title_eng	Genotyping lung adenocarcinoma : from bench to bedside.
description	El cáncer de pulmón que presenta mutaciones en el receptor para el factor de crecimiento epidérmico (EGFR) responde a inhibidores de tirosina quinasa; no obstante, siempre se documenta resistencia a estos medicamentos. Casi todos los tumores que exhiben tolerancia a los inhibidores blanco dirigidos conservan sus mutaciones activadoras originales, y algunos presentan mecanismos adquiridos, incluyendo la mutación T790M o la amplificación del gen MET. Algunos tumores resistentes demuestran inesperados cambios genéticos, entre ellos la amplificación del EGFR y mutaciones en el PI3KCA, mientras que otros progresan a través de la transición epitelio-mesenquimal. En la actualidad, desconocemos cuál es el mejor tratamiento para esta población, aunque varios autores han reportado el uso de los inhibidores reversibles más quimioterapia, quimioterapia sola, radioterapia o cirugía. Otros han observado respuestas tras la reexposición al gefitinib/erlotinib en pacientes previamente respondedores a estos compuestos. A continuación, se reporta el caso de un paciente que se benefició de estos dos enfoques.
description_eng	Lung cancer harboring mutations in the epidermal growth factor receptor (EGFR) respond to tyrosine kinase inhibitors, but drug resistance invariably emerges. Almost all drug-resistant tumors retained their original activating EGFR mutations, and some acquired known mechanisms of resistance including the EGFR T790M mutation or MET gene amplification. Some resistant cancers showed unexpected genetic changes including EGFR amplification and mutations in the PI3KCA gene, where as others underwent a pronounced epithelial-to-mesenchymal transition. Currently we do not know which is the best treatment for this population so several authors reported the use of EGFR inhibitors plus chemotherapy, chemotherapy alone, radiotherapy or surgery. Some have seen responses with a rechallenge of gefitinib/erlotinib in patients previously responding to these compounds. Here, we report a case that benefited from both these approaches.
author	Cardona, Andrés Felipe Carranza, Hernán García Herreros, Luis Gerardo Granada, Julio César Vargas, Carlos Otero, Jorge Miguel Serrano, Silvia Rodríguez, July Katherine Torres, Diana Reguart, Noemí
author_facet	Cardona, Andrés Felipe Carranza, Hernán García Herreros, Luis Gerardo Granada, Julio César Vargas, Carlos Otero, Jorge Miguel Serrano, Silvia Rodríguez, July Katherine Torres, Diana Reguart, Noemí
topicspa_str_mv	cáncer de pulmón de célula no pequeña mutación en el EGFR resistencia erlotinib gefitinib
topic	cáncer de pulmón de célula no pequeña mutación en el EGFR resistencia erlotinib gefitinib non-small cell lung cancer EGFR mutation resistance erlotinib gefitinib
topic_facet	cáncer de pulmón de célula no pequeña mutación en el EGFR resistencia erlotinib gefitinib non-small cell lung cancer EGFR mutation resistance erlotinib gefitinib
citationvolume	1
citationissue	2
citationedition	Núm. 2 , Año 2012 : Julio
publisher	Asociación Colombiana de Hematología y Oncología (ACHO)
ispartofjournal	Revista Colombiana de Hematología y Oncología
source	https://revista.acho.info/index.php/acho/article/view/301
language	spa
format	Article
rights	https://creativecommons.org/licenses/by-nc-sa/4.0 Andrés Felipe Cardona - 2012 Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0. info:eu-repo/semantics/openAccess http://purl.org/coar/access_right/c_abf2
references	Behera D. Managing lung cancer in developing countries: difficulties and solutions. Indian J Chest Dis Allied Sci. 2006;48(4):243-4. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55(2):74-108. Pal SK, Mittal B. Fight against cancer in countries with limited resources: the post-genomic era scenario. Asian Pac J Cancer Prev 2004;5(3):328-33. Travis WD. Pathology of lung cancer. Clin Chest Med. 2011;32(4):669-92. Arrieta O, Cardona AF, Federico Bramuglia G, Gallo A, CamposParra AD, Serrano S, et al. Genotyping non-small cell lung cancer (NSCLC) in Latin America. J Thorac Oncol. 2011;6(11):1955-9. Bria E, Milella M, Cuppone F, Novello S, Ceribelli A, Vaccaro V, et al. Outcome of advanced NSCLC patients harboring sensitizing EGFR mutations randomized to EGFR tyrosine kinase inhibitors or chemotherapy as first-line treatment: a meta-analysis. Ann Oncol. 2011;22(10):2277-85. Goldberg SB. Chemotherapy with erlotinib or chemotherapy alone in advanced NSCLC with acquired resistance to EGFR tyrosine kinase inhibitors (TKI). J Clin Oncol. 2012;30 (suppl; abstr 7524). Cardona AF, Moran T, Reguart N, Porta R, Queralt C, Cardenal E, et al. Characteristics and outcomes of non-small cell lung cancer (NSCLC) patients (pts) carrying epidermal growth factor receptor (EGFR) mutations who progress after initial erlotinib (E) response. J Clin Oncol. 2009;27:15s (suppl; abstr 8064). Enchev S. Bronchoalveolar cancer or pulmonary adenomatosis (Jaagsiekte) of sheep. Neoplasma. 1970;17(4):415-25. Travis WD, Brambilla E, Noguchi M, Nicholson AG, Geisinger KR, Yatabe Y, et al. International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 2011;6(2):244-85. Livneh O, Hod I, Yegana Y, Mashiah A, Ben-Menahem N, Ron A, et al. Sheep bronchoalveolar carcinoma: tissue associated protein complex (TAPC) in normal lung tissue and in the tumor differed quantitatively. Cancer Detect Prev. 1988;11(3-6):287-96. Meyers FJ, Madewell BR, Gumerlock PH, DeMartini JC. ras p21 expression in ovine pulmonary carcinoma. Vet Immunol Immunopathol. 1989;23(3-4):279-91. Humann-Ziehank E, Wolf P, Renko K, Schomburg L, Ludwig Bruegmann M, Andreae A, et al. Ovine pulmonary adenocarcinoma as an animal model of progressive lung cancer and the impact of nutritional selenium supply. J Trace Elem Med Biol. 2011;25 Suppl 1:S30-4. Kitamura H, Okudela K. Bronchioloalveolar neoplasia. Int J Clin Exp Pathol 2010;4(1):97-9. Mok TS, Wu YL, Thongprasert S, Yang CH, Chu DT, Saijo N, et al. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med. 2009;361(10):947-57. Rosell R, Moran T, Queralt C, Porta R, Cardenal F, Camps C, et al. Screening for epidermal growth factor receptor mutations in lung cancer. N Engl J Med. 2009;361(10):958-67. Rosell R, Molina MA, Costa C, Simonetti S, Gimenez-Capitan A, Bertran-Alamillo J, et al. Pretreatment EGFR T790M mutation and BRCA1 mRNA expression in erlotinib-treated advanced non-small-cell lung cancer patients with EGFR mutations. Clin Cancer Res. 2011;17(5):1160-8. Sequist LV, Waltman BA, Dias-Santagata D, Digumarthy S, Turke AB, Fidias P, et al. Genotypic and histological evolution of lung cancers acquiring resistance to EGFR inhibitors. Sci Transl Med. 2011;3(75):75ra26. Smit EF, Burgers SA, Biesma B, Smit HJ, Eppinga P, Dingemans AM, et al. Randomized phase II and pharmacogenetic study of pemetrexed compared with pemetrexed plus carboplatin in pretreated patients with advanced non-small-cell lung cancer. J Clin Oncol. 2009;27(12):2038-45. Georgoulias V, Agelidou A, Syrigos K, Rapti A, Agelidou M, Nikolakopoulos J, et al. Second-line treatment with irinotecan plus cisplatin vs cisplatin of patients with advanced nonsmall-cell lung cancer pretreated with taxanes and gemcitabine: a multicenter randomised phase II study. Br J Cancer. 2005;93(7):763-9. Yamamoto N, Nakagawa K, Nishimura Y, Tsujino K, Satouchi M, Kudo S, et al. Phase III study comparing second- and thirdgeneration regimens with concurrent thoracic radiotherapy in patients with unresectable stage III non-small-cell lung cancer: West Japan Thoracic Oncology Group WJTOG0105. J Clin Oncol. 2010;28(23):3739-45. Ohe Y, Ohashi Y, Kubota K, Tamura T, Nakagawa K, Negoro S, et al. Randomized phase III study of cisplatin plus irinotecan versus carboplatin plus paclitaxel, cisplatin plus gemcitabine, and cisplatin plus vinorelbine for advanced non-small-cell lung cancer: Four-Arm Cooperative Study in Japan. Ann Oncol. 2007;18(2):317-23. Han JY, Lim HS, Shin ES, Yoo YK, Park YH, Lee JE, et al. Comprehensive analysis of UGT1A polymorphisms predictive for pharmacokinetics and treatment outcome in patients with nonsmall-cell lung cancer treated with irinotecan and cisplatin. J Clin Oncol. 2006;24(15):2237-44. Cho BC, Im CK, Park MS, Kim SK, Chang J, Park JP, et al. Phase II study of erlotinib in advanced non-small-cell lung cancer after failure of gefitinib. J Clin Oncol. 2007;25(18):2528-33. Yokouchi H, Yamazaki K, Kinoshita I, Konishi J, Asahina H, Sukoh N, et al. Clinical benefit of readministration of gefitinib for initial gefitinib-responders with non-small cell lung cancer. BMC Cancer. 2007;7:51. Wong AS, Seto KY, Chin TM, Soo RA. Lung cancer response to gefitinib, then erlotinib, then gefitinib again. J Thorac Oncol. 2008;3(9):1077-8. Heon S, Nishino M, Goldberg SB, Porter J, Sequist LV, Jackman DM, et al. Response to EGFR tyrosine kinase inhibitor (TKI) retreatment after a drug-free interval in EGFR-mutant advanced non-small cell lung cancer (NSCLC) with acquired resistance. J Clin Oncol. 2012;30 (suppl; abstr 7525). Weickhardt AJ, Scheier B, Burke JM, Gan G, Doebele RC, Bunn PA, et al. Continuation of EGFR/ALK inhibition after local therapy of oligoprogressive disease in EGFR mutant (Mt) and ALK+ non-small cell lung cancer (NSCLC). J Clin Oncol. 2012;30 (suppl; abstr 7526). Yu HA, Sima CS, Cruz AED, Varghese AM, Pietanza MC, Azzoli CG, et al. Local therapy as a treatment strategy in EGFR-mutant advanced lung cancers that have developed acquired resistance to EGFR tyrosine kinase inhibitors. J Clin Oncol. 2012;30 (suppl; abstr 7527). Janjigian YY, Groen HJ, Horn L, Smit EF, Fu Y, Wang F, et al. Activity and tolerability of afatinib (BIBW 2992) and cetuximab in NSCLC patients with acquired resistance to erlotinib or gefitinib. J Clin Oncol. 2011;29 (suppl; abstr 7525).
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Genotipificación del carcinoma de pulmón : del laboratorio al paciente.
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