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Lung cancer is still a major cause of death globally, but the development of personalized, precision medicine has had a marked effect on treatment management and improved clinical outcomes, particularly for those with advanced stage non-small-cell lung cancer (NSCLC). EGFR mutations are the third most common mutation found in patients with advanced stage NSCLC. First-line treatment with a traditional epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) is indicated for most patients, but not for patients with EGFR exon 20 insertion mutations (ex20ins). Instead, recent approvals of an EGFR ex20ins-specific TKI (mobocertinib) and a bispecific antibody (amivantamab) targeting both EGFR and mesenchymalepithelial transition factor (MET) offer the potential for improved outcomes in this patient population. Furthermore, new approaches to treatment continue to be developed and trials for new agents with greater activity against ex20ins mutations are ongoing.

This text is a concise and up-to-date review, which discusses the background, development and mechanisms of resistance, testing methods and technology, current and emerging therapies and resources that clinicians can provide to their patients. Busy healthcare professionals who want a quick review of treatment resistance in lung cancer as well as a summary of current therapies will benefit from this succinct guide.

Guide to Targeted Therapies: EGFR Mutations in NSCLC is a speedy and up-to-date review, which discusses EGFR mutations, testing methods and technology, current and emerging therapies, and resources that clinicians can provide to their patients. Busy healthcare professionals who want a quick review of EGFR gene mutations as well as a summary of current therapies will benefit from this succinct guide.

The last 15 years have brought an understanding of growth and differentiation at the molecular level, expanding our knowledge of the origin and progression of cancer. Early breakthroughs defining growth control pathways came via studies of oncogenes, mutated signaling molecules that have lost the capacity to tum off their proliferative signal. Oncogenes with diverse growth-promoting activities have been discovered, covering the gamut from cell surface to nuclear signaling. Sequencing of these oncogenes revealed that they were mutated forms of captured cellular genes and displayed tyrosine kinase activity. The epidermal growth factor (EGF) receptor was the first of 40-50 transmembrane tyrosine kinase receptors to be cloned and sequenced. Beyond cell proliferation, activation of EGF receptor by its specific ligands controls important physiological processes, such as cell differentiation, apoptosis, cell migration, and cell shape. Activation of autocrine growth loops, consisting in solid human tumors of upregulated expression of EGFR together with increased production of ligands suggested its crucial role in autonomous tumor growth.

Les thérapies ciblées occupent aujourd'hui en cancérologie une place importante, en raison des résultats exceptionnels que cet ensemble d'approches innovantes a permis d'obtenir dans plusieurs pathologies malignes. L'ouvrage est consacré à une cible particulièrement importante en cancérologie, qui a été validée par la découverte et la mise sur le marché de plusieurs médicaments : les récepteurs de facteurs de croissance de la famille de l'EGF. Il est divisé en trois parties : Une partie fondamentale, indispensable à la compréhension de ce que sont ces récepteurs et de leur rôle dans l'oncogenèse. Une partie pharmacologique montrant comment les cibles ont été identifiées, comment les molécules ont été imaginées, comment leur développement a été assuré. Une partie clinique, reprenant la description des essais cliniques qui ont abouti à faire de ces molécules des médicaments actifs. Chaque chapitre a été rédigé par un clinicien de renom ayant participé personnellement à l'extraordinaire aventure du ciblage des récepteurs des facteurs de croissance de la famille de l'EGF. L'ouvrage est coordonné par un binôme efficace, composé d'un fondamentaliste spécialiste de la biologie structurale des récepteurs à activité tyrosine kinase, le Dr Pierre Hubert (Institut de Biologie structurale, Marseille), et d'une clinicienne rompue à l'utilisation pratique des nouvelles molécules ciblant ces récepteurs, le Pr Sandrine Faivre ( Hôpital Beaujon, Paris).