Authors' recommendations: Lung cancer is the leading cause of cancer-related death in the United States. Lung cancer occurs primarily in the elderly, with a median age at diagnosis of 72 years; the 5-year relative survival rate for all stages of lung cancer combined is only 15.6%. Cigarette smoking remains the most significant risk factor for developing lung cancer, although radon exposure is now considered the second major cause in the United States. The two main types of lung cancer are small cell lung cancer and non-small cell lung cancer (NSCLC). NSCLC accounts for 85% of all lung cancers. Overexpression of the epidermal growth factor receptor (EGFR) transmembrane protein in NSCLC has been associated with advanced stage, poor prognosis, and/or resistance to therapy. Because of the overexpression of EGFR in 40% to 80% of NSCLC tumors, small molecule EGFR tyrosine kinase inhibitors (TKIs) have been developed. Gefitinib (Iressa®; AstraZeneca Pharmaceuticals LP) and erlotinib (Tarceva®; Genentech Inc. and Astellas Pharma US) are the two EGFR TKIs that have been approved in the United States or internationally for treatment of NSCLC. Following the introduction of these agents, clinical and experimental evidence developed to suggest that the benefit was limited to just 10% to 20% of NSCLC patients in the United States, and biomarkers were sought to identify which patients respond to treatment with EGFR TKIs. It has become widely accepted that response to treatment with EGFR TKIs is higher in patients with activating variants in the EGFR gene. Furthermore, it has also been suggested that patients with v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) gene sequence variants do not respond to treatment with EGFR TKIs. KRAS is a signal transducer in the EGFR signaling pathway. KRAS variants occur in 15% to 20% of patients with NSCLC. This report examines the evidence that supports the use of genetic testing for KRAS sequence variants in predicting response to treatment with EGFR TKIs.

Project Status: Completed

Year Published: 2012

URL for published report: The report may be purchased from:http://www.hayesinc.com/hayes/crd/?crd=13791

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: HAYES, Inc.

Contact Address: 157 S. Broad Street, Suite 200, Lansdale, PA 19446, USA. Tel: 215 855 0615; Fax: 215 855 5218

Contact Name: saleinfo@hayesinc.com

Contact Email: saleinfo@hayesinc.com

Copyright: 2012 Winifred S. Hayes, Inc