Epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) is a clinically important driver alteration affecting approximately one-third of lung cancer patients. Treatments for EGFR-exon 19 deletion and exon 21 L858R NSCLC have evolved over the last decade from first-generation reversible tyrosine kinase inhibitors (TKI) to third-generation irreversible TKIs, of which osimertinib has been the widely accepted as first-line therapy. Despite survival improvement seen with osimertinib and its efficacy against acquired T790M mutation, resistance through on-target and off-target pathways eventually develop. This Element describes the structural biology and pathophysiology of EGFR-mutant NSCLC and discusses past, current, and future treatment options in the metastatic, neoadjuvant, and adjuvant settings. It describes the biology and recently approved treatment for EGFR-exon 20 insertion mutation and the treatment for the uncommon exon 18 (G719X), 20 (S768I), and 21 (L861Q) mutations. It also outlines the promising clinical applications of circulating tumor DNA (ctDNA).
Wisdom of the Martians of Science refers to five scientists whose brilliance contributed to shaping the modern world. John von Neumann was a pioneer of the modern computer; Theodore von Kármán was the scientist behind the US Air Force; Leo Szilard initiated the development of nuclear weapons; the Nobel laureate Eugene P Wigner was the world's first nuclear engineer; and Edward Teller was the father of the hydrogen bomb. They were born and raised in Budapest, were forced out of Hungary and then from Germany, they became Americans, and devoted themselves to the defense of the United States and the Free World.They contributed significant discoveries to fundamental science ranging from the properties of materials to the application of the symmetry principle in physics, to creating information theory, to game theory. The areas in which we can learn about their wisdom include applications of science to past, present and future real-world needs; defense; education; environment; human nature; humor; politics; religion; weather modification, and others.This book shows the wisdom of the Martians by presenting their thoughts and ideas in their own words and placing them into context. Their wisdom is intriguing, witty, provocative and thought provoking. It extended over many aspects of life and culture that impinge on our existence. While we cannot always agree with what they say, they are never boring. The power of their words and their philosophies will inspire the readers to pursue their own dreams.
Epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) is a clinically important driver alteration affecting approximately one-third of lung cancer patients. Treatments for EGFR-exon 19 deletion and exon 21 L858R NSCLC have evolved over the last decade from first-generation reversible tyrosine kinase inhibitors (TKI) to third-generation irreversible TKIs, of which osimertinib has been the widely accepted as first-line therapy. Despite survival improvement seen with osimertinib and its efficacy against acquired T790M mutation, resistance through on-target and off-target pathways eventually develop. This Element describes the structural biology and pathophysiology of EGFR-mutant NSCLC and discusses past, current, and future treatment options in the metastatic, neoadjuvant, and adjuvant settings. It describes the biology and recently approved treatment for EGFR-exon 20 insertion mutation and the treatment for the uncommon exon 18 (G719X), 20 (S768I), and 21 (L861Q) mutations. It also outlines the promising clinical applications of circulating tumor DNA (ctDNA).
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