%0 Journal Article
%T Italian multicenter survey to evaluate the opinion of patients and their reference clinicians on the ¡°tolerance¡± to targeted therapies already available for non-small cell lung cancer treatment in daily clinical practice
%A Antonio Rossi
%A Clelia Casartelli
%A Diego Cortinovis
%A Domenico Galetta
%A Enrica Capelletto
%A Giuseppe Valmadre
%A Marcello Tiseo
%A Silvia Novello
%A Simonetta Grazia Rapetti
%J SCIE-indexed Journal
%D 2014
%X The knowledge of molecular mechanisms of cancer pathogenesis has led to the discovery of pathways directly involved in cell transformation. In patients¡¯ subgroups, malignancies can result from genetic alterations in a single gene. The cancer becomes dependent upon, or ¡°addicted¡± to, signaling from a specific transcribed protein which often is a tyrosine kinase receptor. In advanced non-small cell lung cancer (NSCLC), the epidermal growth factor receptor (EGFR) and the anaplastic lymphoma kinase (ALK) are proteins for which specific inhibitors are currently available in the clinical practice. About 10-15% of Caucasians are affected by advanced NSCLC ¡°addicted¡± to activating mutations of EGFR and receive greater benefit from first-line EGFR-tyrosine kinase inhibitors (TKIs) such as gefitinib, erlotinib and afatinib (1). Erlotinib is currently licensed also for unselected pretreated NSCLC patients on the basis of survival benefit reported compared with placebo in the BR.21 trial (2). In another 2-5% of patients, NSCLC is ¡°addicted¡± to ALK-translocations and crizotinib, an ALK-TKI, is currently the standard second-line therapy for this subset of patients (3) (at least in Italy). All these TKIs are small molecules administered orally daily and are used according to the ¡°personalized medicine¡± model, for which every single tumor might potentially benefit from a specific individual treatment, reaching unprecedented impressive outcomes in NSCLC (1,3). Among the many anti-angiogenic compounds that have been tested in advanced NSCLC, only bevacizumab has been approved in first line treatment in association with carboplatin-paclitaxel or cisplatin-gemcitabine. To date, no specific target has been identified to select the population receiving greater benefits from this treatment, as in fact the choice is currently based on clinical, radiologic and histological characteristics
%U http://tlcr.amegroups.com/article/view/2731/3283