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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2014
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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 |
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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 |
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