Lung cancer is the leading cause of death among malignant diseases in humans worldwide. In the last\r\ndecade development of new targeted drugs for the treatment of non-small cell lung cancer proved to be a\r\npromising approach to prolong the otherwise very poor prognosis of patients with advanced UICC stages.\r\nEpidermal growth factor receptor (EGFR) has been in the focus of this lung cancer science and specific activating\r\nmutations are eligible for the treatment with specific tyrosine kinase inhibitors like gefitinib or erlotinib. Beside\r\ntypical deletions in exon 19 and point mutations in exons 18 and 21 several insertions in exon 19 have been\r\ndescribed and attributed activating properties as well. This is the first European and overall the 5th description in\r\nEnglish literature of one of these specific insertions. To elucidate its structural changes leading to the activating\r\nproperties we performed molecular modeling studies. These revealed conformational and electrostatic force field\r\nchanges in the kinase domain of EGFR. To not miss uncommon mutations thorough and precise characterization of\r\nEGFR hotspots, i. e. at least exons 18, 19 and 21, should therefore be conducted to provide best medical care and\r\nto offer lung cancer patients appropriate cancer treatment.
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