Epidermal growth factor receptor tyrosine kinase inhibitors in advanced nonsmall cell lung cancer: what is the preferred first-line therapy?

Purpose of review Epidermal growth factor receptor (EGFR) mt+ nonsmall cell lung cancer (NSCLC) were the first molecularly described NSCLC with an established ‘targeted’ therapy inhibiting mutated EGFR [EGFR tyrosine kinase inhibitor (TKI)]. EGFR TKI of first and second generation have led to an unprecedented improvement in objective response rate, progression-free survival (PFS) and overall survival (OS) compared with chemotherapy with a significantly reduced toxicity and improved quality of life. Fast elucidation of the most frequent resistance mechanism against first and second-generation TKI, T790M, led to the approval of the third-generation TKI osimertinib in second line. Recent findings Recently, the FLAURA study showed an impressive PFS benefit and immature OS data for osimertinib against solely first-generation TKI's. Also, the ARCHER study comparing dacomitinib against first-generation TKI showed a PFS and also OS benefit. Two studies combining EGFR TKI and antiangiogenesis showed PFS but no OS benefit. Lately, the combination of TKI and chemotherapy has seen a revival with the NEJ009 study, resulting in an impressive median OS of 55 months. Summary Therefore, potentially four different therapeutic options are available in first-line therapy of EGFR mt+ NSCLC, first, second, third generation, TKI + antiangiogenic agent and TKI + chemotherapy. The purpose of the review is to help to guide physicians to decide in their treatment choice and ...
Source: Current Opinion in Oncology - Category: Cancer & Oncology Tags: LUNG AND MEDIASTINUM: Edited by Robert Pirker Source Type: research

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Source: Anti-Cancer Drugs - Category: Cancer & Oncology Tags: Preclinical Papers Source Type: research
Authors: Inoue M, Kusumoto H, Shiono H, Shintani Y, Ose N, Sakamaki Y, Okami J, Higashiyama M, Takeuchi Y Abstract Feasibility is one of the major concerns during adjuvant chemotherapy in patients with completely resected non-small cell lung cancer. A phase II clinical trial of adjuvant chemotherapy with four courses of carboplatin (AUC 5 at day 1) and S-1 (80 mg/m2/day for 2 weeks followed by a 2-week rest) was performed to evaluate the feasibility (UMIN 9101). The primary endpoint was the completion rate and the secondary endpoints were adverse events, 2-year overall survival and disease-free rates....
Source: Journal of Chemotherapy - Category: Cancer & Oncology Tags: J Chemother Source Type: research
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Source: CancerNetwork - Category: Cancer & Oncology Authors: Source Type: news
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Source: Oncology - Category: Cancer & Oncology Authors: Tags: Oncology Source Type: research
Squamous cell carcinoma, characterized by large keratinizing and atypical polygonal cells in the respiratory bronchial epithelium [1], affects 30% of patients with lung cancer [2]. Historically, patients with squamous NSCLC were treated with first-line platinum-based chemotherapy [3]. Unlike non-squamous NSCLC, there have been no validated, targetable oncogenic drivers to date. The development and recent approval of targeted immunotherapies, either alone or in combination with platinum-doublet chemotherapy based on improved overall survival, offer a new treatment approach for patients with advanced squamous NSCLC.[4,5] How...
Source: Lung Cancer - Category: Cancer & Oncology Authors: Source Type: research
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Source: Journal of Cancer Research and Therapeutics - Category: Cancer & Oncology Authors: Source Type: research
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Source: The Oncologist - Category: Cancer & Oncology Authors: Tags: Lung Cancer Source Type: research
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Source: Current Oncology Reports - Category: Cancer & Oncology Source Type: research
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Source: Clinical Cancer Research - Category: Cancer & Oncology Authors: Tags: Clin Cancer Res Source Type: research
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Source: Biomedicine and pharmacotherapy = Biomedecine and pharmacotherapie - Category: Drugs & Pharmacology Authors: Tags: Biomed Pharmacother Source Type: research
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