The Treatment of Metastatic Non-Small Cell Lung Cancer with Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors
Pp. 184-238 (55)
Lung cancer is one of the most commonly diagnosed malignancies and the
leading cause of cancer-related mortality in North America. The heterogeneity of nonsmall
cell lung cancer (NSCLC) and the importance of linking new, targeted agents to
the appropriate disease subtype require an individualized approach to treatment. In
patients with epidermal growth factor receptor (EGFR) mutations, EGFR tyrosine
kinase inhibitors (EGFR-TKIs) provide a highly effective treatment option, with
improved toxicity compared with standard chemotherapy. Newer irreversible EGFRTKIs
have additional advantages and are able to overcome the resistance seen with the
older reversible agents. A number of clinical trials using EGFR-TKIs are showing
promising results, including a superior side-effect profile and improved quality of life
when compared with standard chemotherapy. Studies using EGFR-TKIs will aid in
determining the optimal positioning of these therapies. With improvements in both
testing and access to treatment, targeted use of EGFR-TKIs may greatly improve
outcomes in NSCLC.
Non-small cell lung cancer, epidermal growth factor receptor,
epidermal growth factor receptor mutation, epidermal growth factor receptortyrosine
kinase inhibitors, afatinib, erlotinib, gefitinib, adverse drug event, skin
rash, diarrhea, quality of life.
Chief, Hematology-Oncology Services, Santa Cabrini Hospital; Associate Physician, Oncology Services, Royal Victoria Hospital and Montréal General Hospital; Associate Professor, Department of Oncology, Faculty of Medicine, McGill University, Montréal, Québec, Canada.