Personalized treatment of early-stage non-small-cell lung cancer: the challenging role of EGFR inhibitors

• Published in: Future oncology (London, England) Vol. 11; no. 8; pp. 1259 - 1274
• Main Authors: Santarpia, Mariacarmela, Altavilla, Giuseppe, Pitini, Vincenzo, Rosell, Rafael
• Format: Journal Article
• Language: English
• Published: England Future Medicine Ltd 01.04.2015
• Subjects: adjuvant therapy; Antibodies, Monoclonal - therapeutic use; Antineoplastic Agents - therapeutic use; Cancer; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - therapy; Care and treatment; Cetuximab - therapeutic use; Clinical Trials, Phase II as Topic; Clinical Trials, Phase III as Topic; Combined Modality Therapy; EGF receptor inhibitors; Humans; Lung cancer; Lung cancer, Non-small cell; Lung Neoplasms - pathology; Lung Neoplasms - therapy; Molecular Targeted Therapy; mutations; Neoplasm Staging; non-small-cell lung cancer; NSCLC; Oncology, Experimental; personalized treatment; Precision Medicine; Protein Kinase Inhibitors - therapeutic use; Receptor, Epidermal Growth Factor - antagonists & inhibitors; adjuvant therapy; EGFR mutations; NSCLC; personalized treatment; EGF receptor inhibitors; non-small-cell lung cancer
• ISSN: 1479-6694; 1744-8301; 1744-8301
• DOI: 10.2217/fon.14.320

Adjuvant cisplatin-based chemotherapy significantly improves outcomes of completely resected early-stage non-small-cell lung cancer (NSCLC) patients. However, its effect on overall survival is limited and may be unsuitable for many patients due to toxicity. Targeted therapies and individualization of adjuvant treatment offer the potential to improve curability and extend survival of these patients while decreasing toxicity. Here we review Phase II and III studies examining the role of EGF receptor inhibitors, including tyrosine kinase inhibitors and the monoclonal antibody cetuximab, as adjuvant therapy in resected patients or as part of multimodality treatment for stage III NSCLC. Recent results from genotype-directed adjuvant tyrosine kinase inhibitors trials including early-stage NSCLC patients with mutations are promising, but more data are needed to support their use in this setting.