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Lung cancer management: monitoring and treating resistance development in third-generation EGFR TKIs

D Franceschini1, S Rossi2, M Loi1

  • 1Radiotherapy and Radiosurgery Department- Humanitas Clinical and Research Center, IRCCS , Rozzano, Italy.

Expert Review of Anticancer Therapy
|August 7, 2020
PubMed
Abstract

Insights

Third-generation EGFR TKIs resistance is inevitable in cancer patients. Early detection via instrumental follow-up and liquid biopsy can enable timely interventions and personalized treatment strategies.

Area of Science:

  • Oncology
  • Molecular Biology
  • Genetics

Background:

  • Third-generation EGFR TKIs are crucial for treating specific cancers.
  • Treatment resistance to these TKIs eventually develops in patients.

Purpose of the Study:

  • To review resistance mechanisms to third-generation EGFR TKIs, focusing on osimertinib.
  • To explore early detection methods for treatment resistance, including liquid biopsy.
  • To discuss current and future treatment options for patients with acquired resistance.

Main Methods:

  • Literature review of third-generation EGFR TKIs and resistance mechanisms.
  • Evaluation of diagnostic techniques for resistance detection.
  • Analysis of treatment strategies and clinical trials for resistant disease.

Main Results:

  • Common resistance mechanisms to third-generation EGFR TKIs are under active investigation.
  • Liquid biopsy shows promise for non-invasively detecting and characterizing resistance.
  • Early detection of oligoprogression may allow for local therapies to delay systemic treatment changes.

Conclusions:

  • Regular instrumental follow-up is essential for early resistance detection.
  • Liquid biopsy can guide individualized treatment selection by elucidating resistance mechanisms.
  • Future developments in understanding resistance will enhance therapeutic options for patients.
Keywords:
Third-generation EGFR TKIsliquid biopsylocal ablative therapyoligoprogressionosimertinibresistance mechanisms

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