Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors in Advanced Non-Small Cell Lung Cancer

Abstract

The advent of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) has led to a paradigm shift in the management of advanced adenocarcinoma of the lung. The key to success of these therapies lies in the precise identification of their molecular targets, i.e. sensitizing EGFR mutations. The variations in the prevalence of these mutations among different ethnicities necessitate regional studies for a better understanding of the molecular epidemiology of the disease and clinical decision-making. This is even more relevant for countries like India where genetic heterogeneity is a rule. Here, we make an attempt to review the epidemiology of EGFR mutations in India versus other Asian countries and the West. We also review the clinical experience with EGFR TKIs and suggest the way forward in a resource-limited setting.

Gefitinib provides similar effectiveness and improved safety than erlotinib for east Asian populations with advanced non–small cell lung cancer: a meta-analysis

“…The number of patients with lung cancer has increased rapidly by the year [ 1 , 2 ]. The discovery and development of therapeutics targeting epidermal growth factor receptor (EGFR), namely tyrosine kinase inhibitors (TKIs), in the past decade was an important clinical advance in non–small cell lung cancer (NSCLC) treatment [ 3 , 4 ]. Recommended by clinical guidelines, both gefitinib (Iressa) and erlotinib (Tarceva) are now widely accepted as standard-of-care therapy for patients with NSCLC whose tumors harbor activating EGFR mutations, especially patients with certain clinical characteristics (Asian descent, female gender, never-smoker, adenocarcinoma) [ 5 – 8 ].…”

Gefitinib provides similar effectiveness and improved safety than erlotinib for advanced non-small cell lung cancer

“…[ 1 , 2 ] The discovery and development of therapeutics targeting epidermal growth factor receptor tyrosine kinase (EGFR TKI) was an important clinical advancement for NSCLC treatment in the past decade. [ 3 , 4 ] As the first generation EGFR TKIs, gefitinib (iressa) and erlotinib (tarceva) have been proved as safe and effective to treat NSCLC. Recently, both EGFR TKIs have been used widely as first line treatments of NSCLC in chemotherapy-naïve/EGFR mutation-positive patients, or line 2+ treatment after failure of chemotherapy.…”

Impact of PD-L1 Expression in Patients with Surgically Resected Non-Small-Cell Lung Cancer

“…type, for which conventional platinum-based chemotherapy and molecular-targeted therapy remain the standards in advanced disease stages [2][3][4][5] . However, resistance to chemotherapy develops in most patients, and >50% of patients with lung adenocarcinoma lack targetable mutations, thereby necessitating alternative therapeutic approaches [6] .…”