The role of EGFR tyrosine kinase inhibitors in the treatment of non-small cell lung cancer

Abstract

Lung cancer is the leading cause of cancer related death. The results of treatment of advanced lung cancer are poor. The EGFR tyrosine kinase inhibitors (erlotinib and gefitinib) provide a new treatment option for patients with locally advanced lung cancer. In phase II clinical trials with both gefitinib and erlotonib in second or third line chemotherapy, promising response rates and cancer related symptoms relief were found. However, out of 6 randomized trials with tyrosine kinase inhibitors, only one revealed the improvement of overall survival. So minimal effect of tyrosine kinase inhibitors most likely reflected the lack of appropriate inclusion criteria. Conducted molecular and clinical studies showed clinical benefit mostly in patients with EGFR tyrosine kinase domain mutation. These mutations are present in 10% of non small cell lung cancer, more frequently in women, Asian rase, non-smokers and adenocarcinoma and bronchioalveolar cancer. These are ongoing studies focused on finding optimal criteria for the use of tyrosine kinase inhibitors in patients with non small cell lung cancer.