Overall treatment strategy for patients with metastatic NSCLC with activating EGFR mutations

Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (EGFR-TKIs) are standard of care in the first-line (1L) setting for patients with metastatic non-small cell lung cancer (mNSCLC) with activating EGFR mutations. EGFR activating mutations are a predictive factor for response to EGFR-T...

Descripción completa

Detalles Bibliográficos
Autores: Hayashi, Hidetoshi, Nadal, Ernest, Gray, Jhanelle E., Ardizzoni, Andrea, Caria, Nicola, Puri, Tarun, Grohe, Christian
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/183523
Acceso en línea:https://hdl.handle.net/2445/183523
Access Level:acceso abierto
Palabra clave:Càncer de pulmó
Assaigs clínics
Metàstasi
Lung cancer
Clinical trials
Metastasis
id ES_2bc8a39e449eeac6c048dfc94e7924ea
oai_identifier_str oai:diposit.ub.edu:2445/183523
network_acronym_str ES
network_name_str España
repository_id_str
spelling Overall treatment strategy for patients with metastatic NSCLC with activating EGFR mutationsHayashi, HidetoshiNadal, ErnestGray, Jhanelle E.Ardizzoni, AndreaCaria, NicolaPuri, TarunGrohe, ChristianCàncer de pulmóAssaigs clínicsMetàstasiLung cancerClinical trialsMetastasisEpidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (EGFR-TKIs) are standard of care in the first-line (1L) setting for patients with metastatic non-small cell lung cancer (mNSCLC) with activating EGFR mutations. EGFR activating mutations are a predictive factor for response to EGFR-TKIs. Meta-analyses have shown that patients with exon 21_L858R mutations exhibit reduced sensitivity to EGFR-TKIs, resulting in inferior patient outcomes compared to those with exon 19 deletion mutations, with worse overall survival, progression-free survival, objective response, and disease control rates. Clinical activity observed with 1L therapy with first-generation (1G), second-generation (2G), and third-generation (3G) EGFR-TKIs is not permanent, and resistance inevitably develops in all cases, supporting the importance of overall treatment planning. The introduction of the 3G EGFR-TKI, osimertinib, provides an opportunity to overcome T790M-mediated resistance to 1G, and 2G EGFR-TKIs. Additionally, with the use of osimertinib, fewer T790M mutations are being detected as T790M is not a reported resistance mechanism to 3G EGFR-TKIs. However, there are currently no approved targeted therapies after 3G EGFR-TKIs. In order to further improve patient outcomes, there is a need to explore additional options for the overall treatment strategy for patients, including 1L and beyond. Combination of vascular endothelial growth factor (VEGF) inhibitors and EGFR-TKIs or chemotherapy and EGFR-TKIs may be a potential therapeutic approach in the 1L setting. This review discusses current treatment options for mNSCLC with activating EGFR mutations based on tumor, patient, and treatment characteristics and how an overall treatment plan may be developed.Elsevier BV2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/183523Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1016/j.cllc.2021.10.009Clinical Lung Cancer, 2021, vol. 23, num. 1, p. e69-e82https://doi.org/10.1016/j.cllc.2021.10.009cc by-nc-nd (c) Hayashi, Hidetoshi et al., 2021http://creativecommons.org/licenses/by-nc-nd/3.0/es/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/1835232026-05-27T06:46:51Z
dc.title.none.fl_str_mv Overall treatment strategy for patients with metastatic NSCLC with activating EGFR mutations
title Overall treatment strategy for patients with metastatic NSCLC with activating EGFR mutations
spellingShingle Overall treatment strategy for patients with metastatic NSCLC with activating EGFR mutations
Hayashi, Hidetoshi
Càncer de pulmó
Assaigs clínics
Metàstasi
Lung cancer
Clinical trials
Metastasis
title_short Overall treatment strategy for patients with metastatic NSCLC with activating EGFR mutations
title_full Overall treatment strategy for patients with metastatic NSCLC with activating EGFR mutations
title_fullStr Overall treatment strategy for patients with metastatic NSCLC with activating EGFR mutations
title_full_unstemmed Overall treatment strategy for patients with metastatic NSCLC with activating EGFR mutations
title_sort Overall treatment strategy for patients with metastatic NSCLC with activating EGFR mutations
dc.creator.none.fl_str_mv Hayashi, Hidetoshi
Nadal, Ernest
Gray, Jhanelle E.
Ardizzoni, Andrea
Caria, Nicola
Puri, Tarun
Grohe, Christian
author Hayashi, Hidetoshi
author_facet Hayashi, Hidetoshi
Nadal, Ernest
Gray, Jhanelle E.
Ardizzoni, Andrea
Caria, Nicola
Puri, Tarun
Grohe, Christian
author_role author
author2 Nadal, Ernest
Gray, Jhanelle E.
Ardizzoni, Andrea
Caria, Nicola
Puri, Tarun
Grohe, Christian
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Càncer de pulmó
Assaigs clínics
Metàstasi
Lung cancer
Clinical trials
Metastasis
topic Càncer de pulmó
Assaigs clínics
Metàstasi
Lung cancer
Clinical trials
Metastasis
description Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (EGFR-TKIs) are standard of care in the first-line (1L) setting for patients with metastatic non-small cell lung cancer (mNSCLC) with activating EGFR mutations. EGFR activating mutations are a predictive factor for response to EGFR-TKIs. Meta-analyses have shown that patients with exon 21_L858R mutations exhibit reduced sensitivity to EGFR-TKIs, resulting in inferior patient outcomes compared to those with exon 19 deletion mutations, with worse overall survival, progression-free survival, objective response, and disease control rates. Clinical activity observed with 1L therapy with first-generation (1G), second-generation (2G), and third-generation (3G) EGFR-TKIs is not permanent, and resistance inevitably develops in all cases, supporting the importance of overall treatment planning. The introduction of the 3G EGFR-TKI, osimertinib, provides an opportunity to overcome T790M-mediated resistance to 1G, and 2G EGFR-TKIs. Additionally, with the use of osimertinib, fewer T790M mutations are being detected as T790M is not a reported resistance mechanism to 3G EGFR-TKIs. However, there are currently no approved targeted therapies after 3G EGFR-TKIs. In order to further improve patient outcomes, there is a need to explore additional options for the overall treatment strategy for patients, including 1L and beyond. Combination of vascular endothelial growth factor (VEGF) inhibitors and EGFR-TKIs or chemotherapy and EGFR-TKIs may be a potential therapeutic approach in the 1L setting. This review discusses current treatment options for mNSCLC with activating EGFR mutations based on tumor, patient, and treatment characteristics and how an overall treatment plan may be developed.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/183523
url https://hdl.handle.net/2445/183523
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1016/j.cllc.2021.10.009
Clinical Lung Cancer, 2021, vol. 23, num. 1, p. e69-e82
https://doi.org/10.1016/j.cllc.2021.10.009
dc.rights.none.fl_str_mv cc by-nc-nd (c) Hayashi, Hidetoshi et al., 2021
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc by-nc-nd (c) Hayashi, Hidetoshi et al., 2021
http://creativecommons.org/licenses/by-nc-nd/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier BV
publisher.none.fl_str_mv Elsevier BV
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869405180290662400
score 15,301603

Similares en LA Referencia