Journal
EXPERT OPINION ON PHARMACOTHERAPY
Volume 15, Issue 9, Pages 1203-1213Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1517/14656566.2014.909412
Keywords
afatinib; crizotinib; erlotinib; gefitinib; NSCLC
Categories
Funding
- Italian Association for Cancer Research [IG 2012 -- 13157]
- Fondazione Ricerca Traslazionale
- Istituto Tumori Toscano Project [F13/16]
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Introduction: Activating mutations of the EGFR and rearrangement of anaplastic lymphoma kinase (ALK) best illustrate the therapeutic relevance of molecular characterization in NSCLC patients. Areas covered: For this review article, all published data on the most relevant Phase III trials with tyrosine kinase inhibitors (TKIs) for the treatment of NSCLC were collected and analyzed. Expert opinion: Eight Phase III trials clearly established EGFR TKIs as the best therapeutic option for front-line therapy in EGFR-mutated patients. In pretreated NSCLC, EGFR TKIs are considered more effective than standard monotherapy with cytotoxics in presence of classical EGFR mutations, whereas in the EGFR wild-type population, a similar efficacy to docetaxel or pemetrexed in term of survival has been demonstrated. In ALK-translocated NSCLC, a Phase III trial demonstrated the superiority of a multi-target TKI, including ALK, in terms of progression-free survival, response rate and toxicity profile when compared to standard second-line chemotherapy. New agents targeting EGFR or ALK are under evaluation particularly in individuals with acquired resistance to EGFR TKIs or crizotinib.
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