EGFR tyrosine kinase inhibitors in non-small cell lung cancer: treatment paradigm, current evidence, and challenges
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SAGE Publications Ltd
Abstract
Therapy with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) for patients with EGFR-mutated non-small cell lung cancer (NSCLC) has been shown to have superior outcomes when compared to chemotherapy. First-generation EGFR TKI, including gefitinib and erlotinib, and second-generation EGFR TKI, including afatinib and dacomitinib, proved to be effective in patients with NSCLC harboring EGFR-sensitizing mutation. Later, resistance mutations were identified. Consequently, osimertinib, a third-generation EGFR TKI, was studied and demonstrated activity against EGFR-sensitizing and resistant mutations. Osimertinib moved recently to the first-line setting with the positive results of the FLAURA (AZD9291 Versus Gefitinib or Erlotinib in Patients With Locally Advanced or Metastatic Non-small Cell Lung Cancer) trial. The use of these drugs is limited by their cost and availability mainly in middle- to low-income countries. © Fondazione IRCCS Istituto Nazionale dei Tumori 2020.
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Cost, Epidermal growth factor receptor, Non-small cell lung cancer, Resistance, Tyrosine kinase inhibitor, Acrylamides, Afatinib, Aniline compounds, Antineoplastic agents, Antineoplastic combined chemotherapy protocols, Carcinoma, non-small-cell lung, Cost-benefit analysis, Erbb receptors, Erlotinib hydrochloride, Gefitinib, Humans, Lung neoplasms, Protein kinase inhibitors, Quinazolinones, Erlotinib, Osimertinib, Protein tyrosine kinase inhibitor, Acrylamide derivative, Aniline derivative, Antineoplastic agent, Dacomitinib, Protein kinase inhibitor, Quinazolinone derivative, Advanced cancer, Algorithm, Cancer patient, Cancer therapy, Comparative study, Cost effectiveness analysis, Enzyme activity, Human, Non small cell lung cancer, Review, Cost benefit analysis, Lung tumor