Onkológia 1/2021

Treatment of EGFR- mutated non-small cell lung cancer – update

For more than ten years, tyrosine kinase inhibitors (TKIs) have been used to treat non-small cell lung cancer (NSCLC) with EGFR (epidermal growth factor receptor) mutations. TKIs are more effective than chemotherapy, and there are three generations of TKIs in clinical practice. However, after a year to a year and a half of TKI treatment, resistance develops. This review focuses on new insights in the treatment of EGFR-mutated NSCLC. Research is focused on increasing the response to TKI by adding another drug, e.g. an angiogenesis inhibitor or chemotherapy, using immunotherapy, new drugs are being investigated, such as MET inhibitors, third-generation EGFR TKIs, fourth-generation TKIs. The indications of TKI are extending beyond the advanced/metastatic stage to early forms of NSCLC. The knowledge of TKI efficacy in uncommon EGFR mutations (except for deletions on exon 19 and the point mutation L858R on exon 21) is applied, we encounter uncommon EGFR mutations relatively more often due to more advanced molecular-genetic diagnostic methods and as a manifestation of resistance to third-generation TKI.

Keywords: EGFR-mutated non-small cell lung cancer, tyrosinekinase inhibitors, treatment update