Recent advances and new insights in the management of early-stage epidermal growth factor receptor-mutated non-small-cell lung cancer

Abstract

Patients with early-stage non-small-cell lung cancer (NSCLC) are candidates for curative surgery; however, despite multiple advances in lung cancer management, recurrence rates remain high. Adjuvant chemotherapy has been demonstrated to significantly prolong overall survival (OS), but this benefit is modest and there is an urgent need for effective new therapies to provide a cure for more patients. The high efficacy of tyrosine kinase inhibitors (TKIs) against epidermal growth factor receptor-mutated (EGFR) in patients with advanced EGFR-mutated NSCLC has led to the evaluation of these agents in early stages of the disease. Multiple clinical trials have evaluated the safety and efficacy of EGFR TKIs as an adjuvant treatment, in patients with resected EGFR-mutated NSCLC, and shown that they significantly prolong disease-free survival (DFS), but this benefit does not translate to OS. Recently, an interim analysis of the ADAURA trial demonstrated that, surprisingly, osimertinib improved DFS. This led to the study being stopped early, leaving many unanswered questions about its potential effect on OS and its incorporation as a standard adjuvant treatment in this patient subgroup. These targeted agents are also being evaluated in locally-advanced disease, with promising results, although prospective studies with larger sample sizes are needed to confirm these results. In this article, we review the most relevant studies on the role of EGFR TKIs in the management of early-stage EGFR-mutated NSCLC.

Next-generation sequencing of homologous recombination genes could predict efficacy of platinum-based chemotherapy in non-small cell lung cancer

“…Many mechanistic studies have shown that driver mutations play an important role in NSCLC tumorigenesis and progression. Some have even been used as treatment targets in clinical settings ( 41 , 42 ). Thus, our results indicate that the roles played by both classical driver mutations as well as HR gene mutations deserve equal attention when clinically treating NSCLC.…”

Systematic analysis of the prognostic and immunological role of DHX33 in pan‐cancer

“…Lung adenocarcinoma (LUAD) is the main type of lung cancer, responsible for ~40% of lung cancers; importantly, its incidence continues to increase every year 4 . Some patients with LUAD do not benefit from traditional treatment strategies such as surgery, radiation, or chemotherapy because of the high rates of recurrence and metastasis 5–7 . Although immunotherapy may increase the survival rate of patients, the 5‐year overall survival (OS) rate remains less than 20%.…”

“…4 Some patients with LUAD do not benefit from traditional treatment strategies such as surgery, radiation, or chemotherapy because of the high rates of recurrence and metastasis. [5][6][7] Although immunotherapy may increase the survival rate of patients, the 5-year overall survival (OS) rate remains less than 20%. Thus, the pathogenesis of LUAD requires further clarification to identify new and effective therapeutic targets.…”

Comprehensive analysis of DTYMK in pan-cancer and verification in lung adenocarcinoma

“…The most prevalent histological type of lung cancer is LUAD representing 40% of all cases of the disease [ 4 ]. The overall survival probability of people who have LUAD is still unsatisfactory, despite the advancements that have been made in diagnosis and therapy over the last several years [ 5 ]. According to the available statistics, the mean survival probability over 5 years is below 20%.…”