Cargando…

EGFR Mutation Positive Stage IV Non-Small-Cell Lung Cancer: Treatment Beyond Progression

Non-small-cell lung cancer (NSCLC) is the leading cause of death from cancer for both men and women. Chemotherapy is the mainstay of treatment in advanced disease, but is only marginally effective. In about 30% of patients with advanced NSCLC in East Asia and in 10–15% in Western countries, epiderma...

Descripción completa

Detalles Bibliográficos
Autores principales: Van Assche, Katrijn, Ferdinande, Liesbeth, Lievens, Yolande, Vandecasteele, Katrien, Surmont, Veerle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4259002/
https://www.ncbi.nlm.nih.gov/pubmed/25538894
http://dx.doi.org/10.3389/fonc.2014.00350
_version_ 1782347951710928896
author Van Assche, Katrijn
Ferdinande, Liesbeth
Lievens, Yolande
Vandecasteele, Katrien
Surmont, Veerle
author_facet Van Assche, Katrijn
Ferdinande, Liesbeth
Lievens, Yolande
Vandecasteele, Katrien
Surmont, Veerle
author_sort Van Assche, Katrijn
collection PubMed
description Non-small-cell lung cancer (NSCLC) is the leading cause of death from cancer for both men and women. Chemotherapy is the mainstay of treatment in advanced disease, but is only marginally effective. In about 30% of patients with advanced NSCLC in East Asia and in 10–15% in Western countries, epidermal growth factor receptor (EGFR) mutations are found. In this population, first-line treatment with the tyrosine kinase inhibitors (TKIs) erlotinib, gefitinib, or afatinib is recommended. The treatment beyond progression is less well-defined. In this paper, we present three patients, EGFR mutation positive, with local progression after an initial treatment with TKI. These patients were treated with local radiotherapy. TKI was temporarily stopped and restarted after radiotherapy. We give an overview of the literature and discuss the different treatment options in case of progression after TKI: TKI continuation with or without chemotherapy, TKI continuation with local therapy, alternative dosing or switch to next-generation TKI or combination therapy. There are different options for treatment beyond progression in EGFR mutation positive metastatic NSCLC, but the optimal strategy is still to be defined. Further research on this topic is ongoing.
format Online
Article
Text
id pubmed-4259002
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-42590022014-12-23 EGFR Mutation Positive Stage IV Non-Small-Cell Lung Cancer: Treatment Beyond Progression Van Assche, Katrijn Ferdinande, Liesbeth Lievens, Yolande Vandecasteele, Katrien Surmont, Veerle Front Oncol Oncology Non-small-cell lung cancer (NSCLC) is the leading cause of death from cancer for both men and women. Chemotherapy is the mainstay of treatment in advanced disease, but is only marginally effective. In about 30% of patients with advanced NSCLC in East Asia and in 10–15% in Western countries, epidermal growth factor receptor (EGFR) mutations are found. In this population, first-line treatment with the tyrosine kinase inhibitors (TKIs) erlotinib, gefitinib, or afatinib is recommended. The treatment beyond progression is less well-defined. In this paper, we present three patients, EGFR mutation positive, with local progression after an initial treatment with TKI. These patients were treated with local radiotherapy. TKI was temporarily stopped and restarted after radiotherapy. We give an overview of the literature and discuss the different treatment options in case of progression after TKI: TKI continuation with or without chemotherapy, TKI continuation with local therapy, alternative dosing or switch to next-generation TKI or combination therapy. There are different options for treatment beyond progression in EGFR mutation positive metastatic NSCLC, but the optimal strategy is still to be defined. Further research on this topic is ongoing. Frontiers Media S.A. 2014-12-08 /pmc/articles/PMC4259002/ /pubmed/25538894 http://dx.doi.org/10.3389/fonc.2014.00350 Text en Copyright © 2014 Van Assche, Ferdinande, Lievens, Vandecasteele and Surmont. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Van Assche, Katrijn
Ferdinande, Liesbeth
Lievens, Yolande
Vandecasteele, Katrien
Surmont, Veerle
EGFR Mutation Positive Stage IV Non-Small-Cell Lung Cancer: Treatment Beyond Progression
title EGFR Mutation Positive Stage IV Non-Small-Cell Lung Cancer: Treatment Beyond Progression
title_full EGFR Mutation Positive Stage IV Non-Small-Cell Lung Cancer: Treatment Beyond Progression
title_fullStr EGFR Mutation Positive Stage IV Non-Small-Cell Lung Cancer: Treatment Beyond Progression
title_full_unstemmed EGFR Mutation Positive Stage IV Non-Small-Cell Lung Cancer: Treatment Beyond Progression
title_short EGFR Mutation Positive Stage IV Non-Small-Cell Lung Cancer: Treatment Beyond Progression
title_sort egfr mutation positive stage iv non-small-cell lung cancer: treatment beyond progression
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4259002/
https://www.ncbi.nlm.nih.gov/pubmed/25538894
http://dx.doi.org/10.3389/fonc.2014.00350
work_keys_str_mv AT vanasschekatrijn egfrmutationpositivestageivnonsmallcelllungcancertreatmentbeyondprogression
AT ferdinandeliesbeth egfrmutationpositivestageivnonsmallcelllungcancertreatmentbeyondprogression
AT lievensyolande egfrmutationpositivestageivnonsmallcelllungcancertreatmentbeyondprogression
AT vandecasteelekatrien egfrmutationpositivestageivnonsmallcelllungcancertreatmentbeyondprogression
AT surmontveerle egfrmutationpositivestageivnonsmallcelllungcancertreatmentbeyondprogression