First-line management of EGFR-mutated advanced lung adenocarcinoma: Recent developments
Journal
Drugs
Journal Volume
73
Journal Issue
4
Pages
357-369
Date Issued
2013
Author(s)
Abstract
Gefitinib and erlotinib are small-molecule reversible tyrosine kinase inhibitors (TKIs) of epidermal growth factor receptor (EGFR). Objective responses have been observed frequently in patients with non-small cell lung cancer (NSCLC) harbouring activating EGFR mutations, the most common being deletions in exon 19 and the exon 21 L858R mutation. EGFR mutations are prevalent in female patients, those who have never smoked, those of Asian ethnicity and those who have adenocarcinoma histology. Given the efficacy of EGFR TKIs in advanced NSCLC in the salvage setting, and their favourable toxicity profile compared with conventional chemotherapy, there is considerable interest in evaluating their efficacy in the first-line treatment of advanced NSCLC. To date, there have been several phase II and phase III studies that have examined the efficacy of first-line single-agent EGFR TKIs in unselected, clinically selected or molecularly selected populations. Here we review and compare the differences in these phase III trials. Most phase III trials chose progression-free survival (PFS) rather than overall survival (OS) as their primary endpoint. PFS was prolonged but OS was not. The recent development of novel irreversible EGFR TKIs, such as afatinib and dacomitinib, is also reviewed. ? 2013 Springer International Publishing Switzerland.
SDGs
Other Subjects
afatinib; bevacizumab; carboplatin; cisplatin; dacomitinib; docetaxel; epidermal growth factor receptor; erlotinib; gefitinib; gemcitabine; hydroxychloroquine; olaparib; paclitaxel; pemetrexed; acne; anemia; anorexia; cancer combination chemotherapy; cancer survival; dermatitis; diarrhea; drug efficacy; drug eruption; drug safety; exon; fatigue; gene mutation; gene sequence; histology; human; interstitial lung disease; lung adenocarcinoma; lung non small cell cancer; Medline; monotherapy; neutropenia; overall survival; paronychia; phase 2 clinical trial (topic); phase 3 clinical trial (topic); polymerase chain reaction; progression free survival; quality of life; rash; review; side effect; survival rate; survival time; treatment failure; treatment response; Adenocarcinoma; Antineoplastic Agents; Carcinoma, Non-Small-Cell Lung; Clinical Trials, Phase III as Topic; Female; Humans; Lung Neoplasms; Male; Mutation; Protein Kinase Inhibitors; Receptor, Epidermal Growth Factor; Risk Factors; Sex Factors; Treatment Outcome
Type
review