Radiotherapy of non-small-cell lung cancer in the era of EGFR gene mutations and EGF receptor tyrosine kinase inhibitors

Future Oncol. 2015;11(16):2329-42. doi: 10.2217/fon.15.156.

Abstract

Non-small-cell lung cancer (NSCLC) occurs, approximately, in 80-85% of all cases of lung cancer. The majority of patients present locally advanced or metastatic disease when diagnosed, with poor prognosis. The discovery of activating mutations in the EGFR gene has started a new era of personalized treatment for NSCLC patients. To improve the treatment outcome in patients with unresectable NSCLC and, in particular, EGFR mutated, a combined strategy of radiotherapy and medical treatment can be undertaken. In this review we will discuss preclinical data regarding EGF receptor (EGFR) tyrosine kinase inhibitors (TKIs) and radiotherapy, available clinical trials investigating efficacy and toxicity of combined treatment (thoracic or whole brain radiotherapy and EGFR-TKIs) and, also, the role of local radiation in mutated EGFR patients who developed EGFR-TKI resistance.

Keywords: EGFR; brain radiotherapy; non-small-cell lung cancer; thoracic radiotherapy; tyrosine kinase inhibitors.

Publication types

  • Review

MeSH terms

  • Animals
  • Brain Neoplasms / drug therapy
  • Brain Neoplasms / radiotherapy
  • Brain Neoplasms / secondary
  • Carcinoma, Non-Small-Cell Lung / drug therapy
  • Carcinoma, Non-Small-Cell Lung / genetics*
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / radiotherapy*
  • Clinical Trials as Topic
  • Combined Modality Therapy
  • Drug Evaluation, Preclinical
  • Drug Resistance, Neoplasm
  • ErbB Receptors / genetics*
  • Humans
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / genetics*
  • Lung Neoplasms / pathology
  • Lung Neoplasms / radiotherapy*
  • Mutation*
  • Protein Kinase Inhibitors / therapeutic use
  • Radiotherapy* / methods

Substances

  • Protein Kinase Inhibitors
  • ErbB Receptors