EGFR TKI as first-line treatment for patients with advanced EGFR mutation-positive non-small-cell lung cancer

Abstract

After the discovery of activating mutations in EGFR, EGFR tyrosine kinase inhibitors (TKIs) have been introduced into the first-line treatment of non-small-cell lung cancer (NSCLC). A series of studies have shown that EGFR TKI monotherapy as first-line treatment can benefit NSCLC patients harbouring EGFR mutations. Besides, combination strategies based on EGFR TKIs in the first line treatment have also been proved to delay the occurrence of resistance. In this review, we summarize the scientific literature and evidence of EGFR TKIs as first-line therapy from the first-generation EGFR TKIs to conceptually proposed fourth-generation EGFR TKI, and also recommend the application of monotherapy and combination therapies of the EGFR-based targeted therapy with other agents such as chemotherapy, anti-angiogenic drugs and immunecheckpoint inhibitors.

A Single-Center Retrospective Study of Patients with Double Primary Cancers: Breast Cancer and <b><i>EGFR</i></b>-Mutant Non-Small Cell Lung Cancer

“…The characteristics, treatment, and outcome of our patients were generally in line with previous reports on EGFR -mutant NSCLC [6]. Interestingly though, while most LC patients present with advanced disease, 54.5% of our patients were diagnosed with early-stage disease, perhaps reflecting the close follow-up of BC patients.…”

“…Our stage IV patients also received accepted standard first-line treatment with EGFR-TKI. Median PFS with EGFR-TKIs in our patients was within the norm, but OS was longer than reported [6]. …”

“…Epidermal growth factor receptor ( EGFR )-activating mutations occur in approximately 16% of Caucasian non-small cell lung cancer (NSCLC) patients, and EGFR-tyrosine kinase inhibitors (TKIs) confer benefit in these patients [6]. EGFR, also known as Erb1 or HER (in addition to Erb2 or HER2, which represents the most relevant member of the EGFR family in BC) is also a relevant target in BC [7] although results with EGFR-targeted therapies in BC have so far been disappointing [8].…”

SHR‐A1403, a novel c‐mesenchymal‐epithelial transition factor (c‐Met) antibody‐drug conjugate, overcomes AZD9291 resistance in non‐small cell lung cancer cells overexpressing c‐Met

“…In recent years, EGFR‐TKI have become the first‐line therapy for NSCLC patients with EGFR‐activating mutations . However, drug resistance becomes an obstacle to EGFR‐TKI treatment in the clinic .…”

“…Non‐small cell lung cancer accounts for 80%‐85% of all lung cancers, and represents the leading cause of cancer‐related deaths in men and women worldwide . First‐generation EGFR TKI, gefitinib and erlotinib, and the second‐generation EGFR inhibitor afatinib, used as first‐line treatments for advanced NSCLC patients with EGFR‐activating mutations, have shown promising clinical results with superior progression‐free survival compared with platinum doublet chemotherapy regimens . Third‐generation EGFR inhibitors, such as AZD9291, have been developed with the aim of overcoming resistance induced by the EGFR T790M mutation, which occurs in approximately half of patients on EGFR‐TKI therapy that show disease progression .…”