For patients with advanced (metastatic) non-small cell lung cancer (NSCLC) whose tumours have epidermal growth factor receptor (EGFR) mutations, researchers have developed drugs called EGFR tyrosine kinase inhibitors (EGFR TKIs) that specifically target the genetic changes that cause cancer.27
The goal of targeted therapies is to accurately target the individual tumor, which hopefully leads to more effective treatments and less side effects. Targeted therapies work in similar ways in all cancers but certain drugs are more effective in certain subtypes of lung cancer.19
Medical studies have demonstrated that EGFR TKIs are effective first-line treatment options in patients with EGFR-mutated (EGFR-positive) non-small cell lung cancer.28 The latest National Comprehensive Cancer Network (NCCN) guidelines recommended a third generation TKI as the preferred first-line treatment option for sensitizing EGFR-mutation-positive metastatic NSCLC.62
About first- second- and third-generation EGFR TKIs
The first-generation EGFR-TKIs (epidermal growth factor receptor tyrosine kinase inhibitors) are effective as first-line treatment of advanced non-small cell lung cancer (NSCLC) harboring activating EGFR mutations.39
The second-generation EGFR-TKI can irreversibly bind to the tyrosine kinase of EGFR and other ErbB-family members.39 It is also effective as first-line treatment of advanced NSCLC harboring activating EGFR mutations.39
The third-generation EGFR-TKI can inhibit both EGFR activating and resistance mutations, while sparing wild-type EGFR.39 In medical studies, it demonstrated promising response rates against tumors with EGFR T790M mutation in whom advanced NSCLC had progressed during first-line EGFR-TKI therapy.38 The latest National Comprehensive Cancer Network (NCCN) guidelines recommended the third-generation EGFR-TKI as the preferred first-line treatment option for sensitizing EGFR-mutation-positive metastatic NSCLC.62
19. LCA. Targeted Therapy for Lung Cancer. Available at: https://lungcanceralliance.org/wp-content/uploads/2017/09/Targeted_Therapy_Brochure_2017X.pdf. Accessed: 3 May 2019.
27. Gerber DE. Drug Dev Res 2008;69(6):359-372.
28. Decoster L, et al. Transl Lung Cancer Res 2018;7(Suppl 2):S134-S137.
39. Liao BC, et al. Curr Opin Oncol 2015;27(2):94-101.
62. NCCN Clinical Practice Guidelines in Oncology - Non-small Cell Lung Cancer. Version 3.2019. NSCL-18.