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Treatment choice in epidermal growth factor receptor mutation-positive non-small cell lung carcinoma: latest evidence and clinical implications.

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Publication Date
2017-03
ICR Author
Popat, Sanjay
Marsden,
Author
Juan, O
Popat, S
Type
Journal Article
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Abstract
Discovery of sensitizing mutations in epidermal growth factor receptor (<i>EGFR)</i> and the subsequent development of EGFR tyrosine kinase inhibitors (TKIs) have substantially changed the treatment of lung cancer. First-line treatment with EGFR TKIs (gefitinib, erlotinib and afatinib) has demonstrated a superior response rate and progression-free survival (PFS) compared with chemotherapy in <i>EGFR</i>-mutation positive patients. However, a number of open questions remain, such as choice between the three EGFR TKIs licensed, treatment of patients unsuitable for chemotherapy due to morbidity or advanced age, management of acquired resistance and optimal biological sample to determine <i>EGFR</i> status. Recently the first head-to-head trial comparing gefitinib and afatinib (LUX-Lung 7) has been reported. Moreover, third-generation EGFR TKIs such as osimertinib, rociletinib, olmutinib and ASP8273, with preferential activity against T790M mutant tumours, the commonest resistance mechanism to EGFR TKIs, have shown promising results in early clinical trials, with osimertinib now licensed. In this review, we summarize latest advances in the treatment of <i>EGFR</i>-mutation positive patients focusing on controversial areas and emerging challenges to optimally treat these patients in the future.
URL
https://repository.icr.ac.uk/handle/internal/1279
Collections
  • Clinical Studies
Version of record
10.1177/1758834016687262
Research team
Thoracic Oncology
Language
eng
Date accepted
2016-11-09
License start date
2017-03
Citation
Therapeutic advances in medical oncology, 2017, 9 (3), pp. 201 - 216

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