Genetic and Chemical Modifiers of EGFR Dependence in Non-Small Cell Lung Cancer

Abstract

The term `oncogene addiction' has been used to describe the phenomenon whereby tumor cells exhibit singular reliance on an oncogene or oncogenic pathway for their survival, despite the accumulation of multiple genetic lesions. In non-small cell lung cancer (NSCLC), this principle is perhaps best exemplified with the finding that epidermal growth factor receptor (EGFR) mutations predict response to EGFR-targeted therapies and thus represent a dependency in the subset of tumors harboring these alterations. Yet while EGFR-mutant tumors often respond dramatically to EGFR inhibition, nearly 30% of cases are refractory to therapy at the outset, and all responsive patients ultimately develop resistance to therapy. A deeper understanding of the genetic underpinnings of EGFR dependence, and of the mechanisms by which EGFR-mutant cells can overcome addiction to EGFR, may improve clinical outcomes.