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Management of EGFR mutated nonsmall cell lung carcinoma patients.
- Source :
-
The European respiratory journal [Eur Respir J] 2015 Apr; Vol. 45 (4), pp. 1132-41. Date of Electronic Publication: 2015 Feb 19. - Publication Year :
- 2015
-
Abstract
- Tyrosine kinase inhibitors (TKIs) targeting the epidermal growth factor receptor (EGFR) are common in the therapeutic armentarium of lung cancer today. Initially tested in an unselected population, they have been of limited usefulness until the identification EGFR gene mutations. Activating mutations generate conformational changes that result in a shift toward an active state of the catalytic domain and are associated with sensitivity to first generation EGFR TKI. Other mutations have been associated with resistance to these drugs, but for rare mutations there is limited data concerning their role in predicting response to EGFR TKI. To date, four molecules have been approved for the treatment of EGFR mutated lung cancer. Gefitinib and/or erlotinib are available in almost all countries. Afatinib has been approved by the US Food and Drug Administration and by the European Medicines Agency, and icotinib has been approved only in China. Other, more active, third generation agents with a higher binding affinity for the receptor, or that are directed against specific mutations, are under development. EGFR TKIs have a favourable impact on progression-free survival when given as first line treatment in mutated patients, but may also have a moderate effect as a salvage therapy and in maintenance in an unselected population.<br /> (Copyright ©ERS 2015.)
- Subjects :
- Aged
Carcinoma, Non-Small-Cell Lung mortality
Disease-Free Survival
Erlotinib Hydrochloride therapeutic use
Female
Gefitinib
Humans
Lung Neoplasms mortality
Male
Middle Aged
Molecular Targeted Therapy
Mutation
Prognosis
Quinazolines therapeutic use
Risk Assessment
Survival Analysis
Treatment Outcome
Carcinoma, Non-Small-Cell Lung drug therapy
Carcinoma, Non-Small-Cell Lung genetics
ErbB Receptors genetics
Lung Neoplasms drug therapy
Lung Neoplasms genetics
Protein Kinase Inhibitors therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1399-3003
- Volume :
- 45
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The European respiratory journal
- Publication Type :
- Academic Journal
- Accession number :
- 25700389
- Full Text :
- https://doi.org/10.1183/09031936.00156614