Advanced EGFR Mutation-Positive Non-Small-Cell Lung Cancer: State of the Art Estado da Arte dos Doentes com Cancro do Pulmão de Não Pequenas Células: Doença Avançada e Mutação EGFR Positiva

Abstract

The emergence of targeted therapies, brought in the last decade a large hope for patients with lung cancer. EGFR tyrosine kinase inibitors, (TKI) erlotinib and gefitinib, changed the last 10 years the practice of treatment for advanced non-small-cell lung cancer (NSCLC) with the discovery of EGFR mutations that confer sensitivity to tyrosine kinase inhibitors in NSCLC.

The year of 2004 marked the Era of Precision Medicine for lung cancer. The studies randomized phase III investigated the role of two inhibitors of EGFR-TKI, gefitinib and erlotinib, as the treatment of first line compared with platinum-based chemotherapy in NSCLC patients with advanced disease, EGFR activating mutations.

A second generation TKI (afatinib) is already approved for the same indication (EMA) with the good results of the clinical trials, Lux Lung 3 and 6. However patients with EGFR positive mutation, usually have a progressive disease after 10-12 months, with need of new treatment options. Inhibitors third generation however developed (for resistance mutation, T790M and others, after rebiopsy), demonstrated a remarkable efficacy in patients already treated, and with a toxicity profile better than TKI of 1st and 2nd generation.

Received: 30/05/2016 - Accepted: 03/06/2016