Cargando…

Recent advances and new insights in the management of early-stage epidermal growth factor receptor-mutated non-small-cell lung cancer

Patients with early-stage non-small-cell lung cancer (NSCLC) are candidates for curative surgery; however, despite multiple advances in lung cancer management, recurrence rates remain high. Adjuvant chemotherapy has been demonstrated to significantly prolong overall survival (OS), but this benefit i...

Descripción completa

Detalles Bibliográficos
Autores principales: Sotelo, Miguel J, Luis García, José, Torres-Mattos, Cesar, Milián, Héctor, Carracedo, Carlos, González-Ruiz, María Ángeles, Mielgo-Rubio, Xabier, Trujillo-Reyes, Juan Carlos, Couñago, Felipe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8546659/
https://www.ncbi.nlm.nih.gov/pubmed/34733613
http://dx.doi.org/10.5306/wjco.v12.i10.912
_version_ 1784590230877110272
author Sotelo, Miguel J
Luis García, José
Torres-Mattos, Cesar
Milián, Héctor
Carracedo, Carlos
González-Ruiz, María Ángeles
Mielgo-Rubio, Xabier
Trujillo-Reyes, Juan Carlos
Couñago, Felipe
author_facet Sotelo, Miguel J
Luis García, José
Torres-Mattos, Cesar
Milián, Héctor
Carracedo, Carlos
González-Ruiz, María Ángeles
Mielgo-Rubio, Xabier
Trujillo-Reyes, Juan Carlos
Couñago, Felipe
author_sort Sotelo, Miguel J
collection PubMed
description Patients with early-stage non-small-cell lung cancer (NSCLC) are candidates for curative surgery; however, despite multiple advances in lung cancer management, recurrence rates remain high. Adjuvant chemotherapy has been demonstrated to significantly prolong overall survival (OS), but this benefit is modest and there is an urgent need for effective new therapies to provide a cure for more patients. The high efficacy of tyrosine kinase inhibitors (TKIs) against epidermal growth factor receptor-mutated (EGFR) in patients with advanced EGFR-mutated NSCLC has led to the evaluation of these agents in early stages of the disease. Multiple clinical trials have evaluated the safety and efficacy of EGFR TKIs as an adjuvant treatment, in patients with resected EGFR-mutated NSCLC, and shown that they significantly prolong disease-free survival (DFS), but this benefit does not translate to OS. Recently, an interim analysis of the ADAURA trial demonstrated that, surprisingly, osimertinib improved DFS. This led to the study being stopped early, leaving many unanswered questions about its potential effect on OS and its incorporation as a standard adjuvant treatment in this patient subgroup. These targeted agents are also being evaluated in locally-advanced disease, with promising results, although prospective studies with larger sample sizes are needed to confirm these results. In this article, we review the most relevant studies on the role of EGFR TKIs in the management of early-stage EGFR-mutated NSCLC.
format Online
Article
Text
id pubmed-8546659
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Baishideng Publishing Group Inc
record_format MEDLINE/PubMed
spelling pubmed-85466592021-11-02 Recent advances and new insights in the management of early-stage epidermal growth factor receptor-mutated non-small-cell lung cancer Sotelo, Miguel J Luis García, José Torres-Mattos, Cesar Milián, Héctor Carracedo, Carlos González-Ruiz, María Ángeles Mielgo-Rubio, Xabier Trujillo-Reyes, Juan Carlos Couñago, Felipe World J Clin Oncol Minireviews Patients with early-stage non-small-cell lung cancer (NSCLC) are candidates for curative surgery; however, despite multiple advances in lung cancer management, recurrence rates remain high. Adjuvant chemotherapy has been demonstrated to significantly prolong overall survival (OS), but this benefit is modest and there is an urgent need for effective new therapies to provide a cure for more patients. The high efficacy of tyrosine kinase inhibitors (TKIs) against epidermal growth factor receptor-mutated (EGFR) in patients with advanced EGFR-mutated NSCLC has led to the evaluation of these agents in early stages of the disease. Multiple clinical trials have evaluated the safety and efficacy of EGFR TKIs as an adjuvant treatment, in patients with resected EGFR-mutated NSCLC, and shown that they significantly prolong disease-free survival (DFS), but this benefit does not translate to OS. Recently, an interim analysis of the ADAURA trial demonstrated that, surprisingly, osimertinib improved DFS. This led to the study being stopped early, leaving many unanswered questions about its potential effect on OS and its incorporation as a standard adjuvant treatment in this patient subgroup. These targeted agents are also being evaluated in locally-advanced disease, with promising results, although prospective studies with larger sample sizes are needed to confirm these results. In this article, we review the most relevant studies on the role of EGFR TKIs in the management of early-stage EGFR-mutated NSCLC. Baishideng Publishing Group Inc 2021-10-24 2021-10-24 /pmc/articles/PMC8546659/ /pubmed/34733613 http://dx.doi.org/10.5306/wjco.v12.i10.912 Text en ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Minireviews
Sotelo, Miguel J
Luis García, José
Torres-Mattos, Cesar
Milián, Héctor
Carracedo, Carlos
González-Ruiz, María Ángeles
Mielgo-Rubio, Xabier
Trujillo-Reyes, Juan Carlos
Couñago, Felipe
Recent advances and new insights in the management of early-stage epidermal growth factor receptor-mutated non-small-cell lung cancer
title Recent advances and new insights in the management of early-stage epidermal growth factor receptor-mutated non-small-cell lung cancer
title_full Recent advances and new insights in the management of early-stage epidermal growth factor receptor-mutated non-small-cell lung cancer
title_fullStr Recent advances and new insights in the management of early-stage epidermal growth factor receptor-mutated non-small-cell lung cancer
title_full_unstemmed Recent advances and new insights in the management of early-stage epidermal growth factor receptor-mutated non-small-cell lung cancer
title_short Recent advances and new insights in the management of early-stage epidermal growth factor receptor-mutated non-small-cell lung cancer
title_sort recent advances and new insights in the management of early-stage epidermal growth factor receptor-mutated non-small-cell lung cancer
topic Minireviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8546659/
https://www.ncbi.nlm.nih.gov/pubmed/34733613
http://dx.doi.org/10.5306/wjco.v12.i10.912
work_keys_str_mv AT sotelomiguelj recentadvancesandnewinsightsinthemanagementofearlystageepidermalgrowthfactorreceptormutatednonsmallcelllungcancer
AT luisgarciajose recentadvancesandnewinsightsinthemanagementofearlystageepidermalgrowthfactorreceptormutatednonsmallcelllungcancer
AT torresmattoscesar recentadvancesandnewinsightsinthemanagementofearlystageepidermalgrowthfactorreceptormutatednonsmallcelllungcancer
AT milianhector recentadvancesandnewinsightsinthemanagementofearlystageepidermalgrowthfactorreceptormutatednonsmallcelllungcancer
AT carracedocarlos recentadvancesandnewinsightsinthemanagementofearlystageepidermalgrowthfactorreceptormutatednonsmallcelllungcancer
AT gonzalezruizmariaangeles recentadvancesandnewinsightsinthemanagementofearlystageepidermalgrowthfactorreceptormutatednonsmallcelllungcancer
AT mielgorubioxabier recentadvancesandnewinsightsinthemanagementofearlystageepidermalgrowthfactorreceptormutatednonsmallcelllungcancer
AT trujilloreyesjuancarlos recentadvancesandnewinsightsinthemanagementofearlystageepidermalgrowthfactorreceptormutatednonsmallcelllungcancer
AT counagofelipe recentadvancesandnewinsightsinthemanagementofearlystageepidermalgrowthfactorreceptormutatednonsmallcelllungcancer