Abstract:
The year 2024 is the 20th anniversary of the discovery of activating epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC). Since then, tremendous advances have been made in the treatment of NSCLC based on this discovery. Some of these studies have led to seismic changes in the concept of oncology research and spurred treatment advances beyond NSCLC, leading to a current true era of precision oncology for all solid tumors. We now routinely molecularly profile all tumor types and even plasma samples of patients with NSCLC for multiple actionable driver mutations, independent of patient clinical characteristics nor is profiling limited to the advanced incurable stage. We are increasingly monitoring treatment responses and detecting resistance to targeted therapy by using plasma genotyping. Furthermore, we are now profiling early-stage NSCLC for appropriate adjuvant targeted treatment leading to an eventual potential \"cure\" in early-stage EGFR+ NSCLC which have societal implication on implementing lung cancer screening in never-smokers as most EGFR+ NSCLC patients are never-smokers. All these advances were unfathomable in 2004 when the five papers that described \"discoveries\" of activating EGFR mutations (del19, L858R, exon 20 insertions, and \"uncommon\" mutations) were published. To commemorate this 20th anniversary, we assembled a global panel of thoracic medical oncology experts to select the top 20 papers (publications or congress presentation) from the 20 years since this seminal discovery with December 31, 2023 as the cutoff date for inclusion of papers to be voted on. Papers ranked 21 to 30 were considered \"honorable mention\" and also annotated. Our objective is that these 30 papers with their annotations about their impact and even all the ranked papers will serve as \"syllabus\" for the education of future thoracic oncology trainees. Finally, we mentioned potential practice-changing clinical trials to be reported. One of them, LAURA was published online on June 2, 2024 was not included in the list of papers to be voted on but will surely be highly ranked if this consensus survery is performed again on the 25th anniversay of the discovery EGFR mutations (i.e. top 25 papers on the 25 years since the discovery of activating EGFR mutations).
摘要:
2024年是在非小细胞肺癌(NSCLC)中发现激活表皮生长因子受体(EGFR)突变的20周年。从那以后,基于这一发现,NSCLC的治疗取得了巨大进展.其中一些研究导致肿瘤学研究概念发生了重大变化,并刺激了NSCLC以外的治疗进展。导致当前所有实体瘤的精确肿瘤学的真正时代。我们现在常规地对所有肿瘤类型,甚至NSCLC患者的血浆样本进行分子分析,以了解多种可操作的驱动突变。独立于患者的临床特征,也不限于晚期无法治愈的阶段。我们越来越多地通过使用血浆基因分型来监测治疗反应并检测对靶向治疗的抗性。此外,我们现在对早期NSCLC进行分析,寻找合适的辅助靶向治疗,从而在早期EGFR+NSCLC中最终实现潜在的"治愈",这对于在不吸烟者中实施肺癌筛查具有社会意义,因为大多数EGFR+NSCLC患者是不吸烟者.所有这些进展在2004年都是深不可测的,当时五篇论文描述了激活EGFR突变的“发现”(del19,L858R,外显子20插入,和“不常见”突变)发表。为了纪念这20周年,我们组建了一个由胸部肿瘤医学专家组成的全球小组,以2023年12月31日为纳入论文的截止日期,从这一开创性发现后的20年中选出前20篇论文(出版物或大会报告).排名21至30的论文被认为是“荣誉奖”,也有注释。我们的目标是,这30篇论文及其对其影响的注释,甚至所有排名的论文都将作为未来胸部肿瘤学学员教育的“教学大纲”。最后,我们提到了可能改变实践的临床试验。其中一个,LAURA于2024年6月2日在线发布,未被列入要投票的论文列表,但如果在发现EGFR突变的25周年纪念日再次进行这一共识评估(即自发现激活EGFR突变以来25年的前25篇论文),肯定会排名很高。