Concomitance of EGFR mutations and ALK rearrangement in patients with Lung Cancer
Concomitance of EGFR mutations and ALK rearrangement in patients with Lung Cancer
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DOI：
10.1016/j.genrep.2018.03.018
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发表时间：
2018-06-01
期刊：
影响因子：
1.3
通讯作者：
Nadifi, Sellama
中科院分区：
文献类型：
--
作者：
Berradi, Hind;Kaanane, Houda;Nadifi, Sellama
靶向治疗是治疗肺癌最常用的治疗方法。它通常与几个基因的相互作用有关，主要是上皮生长因子受体(EGFR)、柯尔斯滕大鼠肉瘤病毒(K-RAS)和间变性淋巴瘤激酶(ALK)融合基因。在非小细胞肺癌(NSCLC)中，EGFR突变和EML4(棘皮微管相关蛋白样蛋白4)-ALK融合被认为是相互排斥的，但不同的研究报道了一些病例同时存在EGFR突变和ALK重排影响对治疗的敏感性。在这里，我们回顾了自2008年首次发现这种共同改变并描述患者对治疗的反应以来报告这种共同改变的病例。我们发现，Crizotinib和EGFR-TKIs的组合可以通过抑制EGFR和ALK途径来克服对TKIs的耐药性。这篇综述证明了对EGFR和ALK改变进行基因分型的必要性，以指导临床医生针对每个患者进行个性化治疗。
Targeted therapy is the most popular treatment used against lung cancer. It is usually associated with the mutual status of several genes, mainly epithelial growth factor receptor (EGFR), Kirsten rat sarcoma viral (K-Ras) and anaplastic lymphoma kinase (ALK) fusion gene. The EGFR mutations and EML4 (Echinoderm Microtubule Associated Protein Like 4) -ALK fusion are considered mutually exclusive in non-small cell lung cancers (NSCLCs), but different studies have reported cases harboring a concomitance of EGFR mutations and ALK rearrangement affecting the sensibility to treatments in some cases. Herein, we reviewed the cases reporting this co-alteration since its first discovery in 2008 and describing the patients' response to therapy. We found that a combination of crizotinib and EGFR-TKIs is preferred to overcome the resistance to TKIs by inhibiting both EGFR and ALK pathways. This review demonstrated the necessity of genotyping both EGFR and ALK alterations to guide the clinicians to a personalized therapy for each patient.