Onkológia 6/2016

How to improve the first line treatment of NSCLC with EGFR mutation?

Progression free survival (PFS) and quality of life have been improved significantly with EGFR-TKIs (epidermal growth factor receptor tyrosine kinase inhibitors) in a group of patients with advanced NSCLC (non-small cell lung cancer) harbouring activating EGFR mutations (EGFRM+ NSCLC). However, the treatment with EGFR-TKIs is not curative and medians of PFS are approximately between 10 – 13 months. Several new approaches, which should improve the first line treatment in patients with advanced EGFRM+ NSCLC, are in clinical trials. Combinations of EGFR-TKIs and angiogenesis inhibitors are so far best studied, and combination of erlotinib with bevacizumab has been recently approved in the EU. Other studied treatment strategies are combinations of EGFR-TKI with pemetrexed, or with immune checkpoint blockers. Also phase III trials with the 3 rd generation EGFR-TKIs (osimertinib and ASP8273) in the first line treatment are ongoing.

Keywords: NSCLC, EGFR mutations, EGFR-TKIs, new treatments