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Establishing Dual Resistance to EGFR-TKI and MET-TKI in Lung Adenocarcinoma Cells In Vitro with a 2-step Dose-escalation Procedure
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Optimizing the Treatment for Advanced Non-Small-Cell Lung Cancer with Mutated Epidermal Growth Factor Receptor in

Mousa Alali1, Maher Saifo1,2

  • 1Department of Oncology, Albairouni University Hospital, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic.

Journal of Immunotherapy and Precision Oncology
|August 28, 2023
PubMed
Abstract

Insights

Osimertinib is preferred for EGFR-mutated advanced non-small-cell lung cancer (NSCLC). First- and second-generation TKIs remain viable options, particularly for low-income nations unable to afford newer treatments.

Area of Science:

  • Oncology
  • Pharmacology
  • Medical Economics

Background:

  • Osimertinib is the standard treatment for advanced EGFR-mutated NSCLC.
  • High costs limit access to osimertinib in low-income countries, posing treatment challenges.
  • Developing cost-effective treatment plans is crucial for these populations.

Purpose of the Study:

  • To review tyrosine kinase inhibitors (TKIs) for advanced NSCLC.
  • To establish an appropriate treatment strategy for Syrian patients with advanced NSCLC.

Main Methods:

  • Conducted an electronic literature search of phase II and III studies.
  • Included studies published between January 2003 and May 2022.
  • Focused on the efficacy of EGFR-TKIs in advanced NSCLC.

Main Results:

  • Seventeen articles were reviewed, comparing various EGFR-TKIs.
  • Afatinib and dacomitinib showed longer progression-free and overall survival than gefitinib.
  • Osimertinib demonstrated efficacy against the T790M mutation but is less cost-effective as a first-line therapy.

Conclusions:

  • Osimertinib is the preferred first-line treatment for EGFR-mutated advanced NSCLC.
  • First- and second-generation TKIs are suitable alternatives, especially in resource-limited settings.
  • Treatment decisions should consider both efficacy and cost-effectiveness for NSCLC patients.
Keywords:
Syriacost-effectivenessepidermal growth factor receptorlow-income countriesnon–small-cell lung cancertyrosine kinase inhibitors

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