Lung cancer : journal of the International Association for the Study of Lung Cancer
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Functional genomics has emerged over the past 10 years as a novel technology to study genetic alterations. Gene expression arrays are one genomic technique employed to discover changes in the DNA expression that occur in neoplastic transformation. Microarrays have been applied to investigating lung cancer. ⋯ Microarrays can also be applied to improve diagnosis, staging and discover prognostic markers. The eventual goal of this technology is to discover new markers for therapy and to customize therapy based on an individual tumor genetic composition. In this review, we present the current state of gene expression array technology in its application to lung cancer.
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The epidermal growth factor receptor (EGFR) has been implicated in the pathophysiology of various cancers, including non-small cell lung cancer (NSCLC). Inhibitors targeting the tyrosine kinase domain of this receptor have been seen to elicit favourable responses in a subset of NSCLC patients. Mutational analysis of the EGFR has revealed that the response to reversible tyrosine kinase inhibitors (TKIs) is a result of the presence of activating mutations present between exons 18 and 21, most frequently the exon 19 deletion and the L858R mutations. ⋯ In addition to the predominant mutations in the EGFR gene, alternative genetic changes between exons 18 and 21 have been observed. Experimental models have demonstrated that TKIs exhibit differential efficacy depending on which mutations are present. Such information may result in the design of highly specific agents that target specific mutations, which could result in more efficacious treatments.