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Treatment choice in epidermal growth factor receptor mutation-positive non-small cell lung carcinoma: latest evidence

Oscar Juan1, Sanjay Popat2

  • 1Department of Medical Oncology, University Hospital La Fe, Valencia, Spain.

Therapeutic Advances in Medical Oncology
|March 28, 2017
PubMed

Insights

First-generation EGFR TKIs improve outcomes for lung cancer patients with EGFR mutations. Emerging third-generation inhibitors and ongoing research address resistance and treatment choices for better patient management.

Area of Science:

  • Oncology
  • Molecular Biology
  • Pharmacology

Background:

  • Epidermal growth factor receptor (EGFR) mutations drive lung cancer growth.
  • EGFR tyrosine kinase inhibitors (TKIs) have revolutionized lung cancer treatment.
  • First-generation EGFR TKIs show superior efficacy over chemotherapy in EGFR-mutation positive patients.

Purpose of the Study:

  • To review recent advances in treating EGFR-mutation positive lung cancer.
  • To address current controversies and challenges in EGFR TKI therapy.
  • To discuss emerging treatment strategies and future directions.

Main Methods:

  • Literature review of recent clinical trials and studies.
  • Analysis of head-to-head comparisons of EGFR TKIs.
  • Summary of data on third-generation EGFR TKIs and resistance mechanisms.

Main Results:

  • First-generation EGFR TKIs (gefitinib, erlotinib, afatinib) offer improved response rates and progression-free survival.
  • Acquired resistance, often via T790M mutation, is a significant challenge.
  • Third-generation EGFR TKIs (e.g., osimertinib) show promise against T790M mutations.

Conclusions:

  • Optimal selection among first-generation EGFR TKIs requires further clarification.
  • Management of elderly or comorbid patients and acquired resistance remain key issues.
  • Emerging third-generation TKIs represent a significant advancement in overcoming resistance.
Keywords:
EGFRmutationnon-small cell lung carcinomatyrosine kinase inhibitors

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