Treatment of Non-small Cell Lung Cancer with EGFR-mutations

J UOEH. 2019;41(2):153-163. doi: 10.7888/juoeh.41.153.

Abstract

The discovery of activating mutations in the epidermal growth factor receptor (EGFR) gene and development of tyrosine kinase inhibitors (TKIs) of EGFR have achieved a paradigm shift in treatment strategy of non-small cell lung cancer (NSCLC). For advanced NSCLC harboring activating EGFR mutations, an EGFR-TKI is preferably prescribed as it provides a superior survival benefit over platinum-based chemotherapy. To further improve the therapeutic outcomes, more potent EGFR-TKIs through irreversible inhibition of tyrosine kinase have been developed. In a recent clinical trial, an irreversible EGFR-TKI (osimertinib) showed a superior survival benefit with lower toxicity profile. In addition, combination treatments such as an EGFR-TKI plus platinum-based chemotherapy may achieve a long-term survival. For earlier-stage resectable NSCLC with EGFR-mutations, several clinical trials to assess the efficacy of EGFR-TKIs in pre-operative induction setting and in postoperative adjuvant setting are now ongoing. Here we review and discuss the current status and future perspectives of treatment for EGFR-mutated NSCLC.

Keywords: activating mutation; epidermal growth factor receptor (EGFR); lung cancer; resistance mutation; tyrosine kinase inhibitor (TKI).

Publication types

  • Review

MeSH terms

  • Acrylamides / therapeutic use*
  • Aniline Compounds / therapeutic use*
  • Carcinoma, Non-Small-Cell Lung / genetics*
  • Carcinoma, Non-Small-Cell Lung / therapy*
  • Chemotherapy, Adjuvant
  • Clinical Trials as Topic
  • Enzyme Inhibitors / therapeutic use*
  • ErbB Receptors / genetics
  • Humans
  • Induction Chemotherapy
  • Lung Neoplasms / genetics*
  • Lung Neoplasms / therapy*
  • Molecular Targeted Therapy*
  • Mutation*
  • Protein-Tyrosine Kinases / antagonists & inhibitors*

Substances

  • Acrylamides
  • Aniline Compounds
  • Enzyme Inhibitors
  • osimertinib
  • EGFR protein, human
  • ErbB Receptors
  • Protein-Tyrosine Kinases