Abstract
In the last decade, important advances have been made in understanding of cancer biology, particularly non-small-cell lung cancer (NSCLC) with the discovery of oncogenic drivers of the disease. The epidermal growth factor receptor (EGFR) gene and its pathways was the first oncogenic driver discovered to be mutated and treatable in lung cancer. Treatment with EGFR tyrosine kinase inhibitors (TKIs) is the standard of care for molecularly selected EGFR-mutant patients, while its role in unselected lung cancer patients is nowadays controversial. This review will provide an overview of the EGFR pathway and options for its treatment of lung cancer.
Highlights
The majority of non-small-cell lung cancer (NSCLC) patients are diagnosed with locally advanced or metastatic disease, meaning chemotherapy is the treatment of choice
overall survival (OS) for the epidermal growth factor receptor (EGFR)-mutant patients had not been reached for this subgroup receiving erlotinib at time of publication (HR 0.83; 95% CI: 0.34-2.02; p = 0.6810)
The results of this study demonstrated non-inferiority of gefitinib vs docetaxel in terms of OS with a median 7.6 and 8.0 months (HR 1.020, 95% CI 0.905-1.150)
Summary
The majority of non-small-cell lung cancer (NSCLC) patients are diagnosed with locally advanced or metastatic disease, meaning chemotherapy is the treatment of choice. In the TRIBUTE trial, 1059 patients were included with a median survival of 10.6 months and 10.5 months for the erlotinib and placebo arms, respectively. In the TALENT trial, 1172 patients were included with a median survival of 10.75 and 11 months for erlotinib and placebo, respectively.
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