Treatment Strategies for Non-Small Cell Lung Cancer with Common EGFR Mutations: A Review of the History of EGFR TKIs Approval and Emerging Data

Author:

Marin-Acevedo Julian A.1ORCID,Pellini Bruna23ORCID,Kimbrough ErinMarie O.4,Hicks J. Kevin5ORCID,Chiappori Alberto23

Affiliation:

1. Division of Medical Oncology, Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN 46202, USA

2. Department of Thoracic Oncology, Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA

3. Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL 33620, USA

4. Division of Hematology and Oncology, Mayo Clinic, Jacksonville, FL 32224, USA

5. Department of Individualized Cancer Management, Moffitt Cancer Center, Tampa, FL 33612, USA

Abstract

The development of targeted therapies over the past two decades has led to a dramatic change in the management of EGFR-mutant non-small cell lung cancer (NSCLC). While there are currently five approved EGFR tyrosine kinase inhibitors (TKIs) for treating EGFR-mutant NSCLC in the first-line setting, therapy selection after progression on EGFR TKIs remains complex. Multiple groups are investigating novel therapies and drug combinations to determine the optimal therapy and treatment sequence for these patients. In this review, we summarize the landmark trials and history of the approval of EGFR TKIs, their efficacy and tolerability, and the role of these therapies in patients with central nervous system metastasis. We also briefly discuss the mechanisms of resistance to EGFR TKIs, ongoing attempts to overcome resistance and improve outcomes, and finalize by offering treatment sequencing recommendations.

Publisher

MDPI AG

Subject

Cancer Research,Oncology

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