EGFR mutation positive stage IV non-small-cell lung cancer : Treatment beyond progression
Non-small-cell lung cancer (NSCLC) is the leading cause of death from cancer for both men en women. Chemotherapy is the mainstay of treatment in advanced disease, but is only marginally effective. In about 30% of patients with advanced NSCLC in East Asia and in 10-15% in Western countries, EGFR muta...
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doaj-5f5cac2bf1fe4786bc57fa323bc05e422020-11-24T21:29:48ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2014-12-01410.3389/fonc.2014.00350117834EGFR mutation positive stage IV non-small-cell lung cancer : Treatment beyond progressionKatrijn eVan Assche0Katrien eVandecasteele1Liesbeth eFerdinande2Yolande eLievens3Veerle eSurmont4University Hospital GhentUniversity Hospital GhentUniversity Hospital GhentUniversity Hospital GhentUniversity Hospital GhentNon-small-cell lung cancer (NSCLC) is the leading cause of death from cancer for both men en women. Chemotherapy is the mainstay of treatment in advanced disease, but is only marginally effective. In about 30% of patients with advanced NSCLC in East Asia and in 10-15% in Western countries, EGFR mutations are found. In this population, first-line treatment with the tyrosine kinase inhibitors (TKI) erlotinib, gefitinib or afatinib is recommended. The treatment beyond progression is less well-defined. In this paper we present 3 patients, EGFR mutation positive, with local progression after an initial treatment with TKI. These patients were treated with local radiotherapy. TKI was temporarily stopped and restarted after radiotherapy. We give an overview of the literature and discuss the different treatment options in case of progression after TKI: TKI continuation with or without chemotherapy, TKI continuation with local therapy, alternative dosing or switch to next-generation TKI or combination therapy. There are different options for treatment beyond progression in EGFR mutation positive metastatic NSCLC, but the optimal strategy is still to be defined. Further research on this topic is ongoing.http://journal.frontiersin.org/Journal/10.3389/fonc.2014.00350/fullRadiotherapytyrosine kinase inhibitoradvanced non-small-cell lung cancerEGFR mutationlocal progression |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Katrijn eVan Assche Katrien eVandecasteele Liesbeth eFerdinande Yolande eLievens Veerle eSurmont |
spellingShingle |
Katrijn eVan Assche Katrien eVandecasteele Liesbeth eFerdinande Yolande eLievens Veerle eSurmont EGFR mutation positive stage IV non-small-cell lung cancer : Treatment beyond progression Frontiers in Oncology Radiotherapy tyrosine kinase inhibitor advanced non-small-cell lung cancer EGFR mutation local progression |
author_facet |
Katrijn eVan Assche Katrien eVandecasteele Liesbeth eFerdinande Yolande eLievens Veerle eSurmont |
author_sort |
Katrijn eVan Assche |
title |
EGFR mutation positive stage IV non-small-cell lung cancer : Treatment beyond progression |
title_short |
EGFR mutation positive stage IV non-small-cell lung cancer : Treatment beyond progression |
title_full |
EGFR mutation positive stage IV non-small-cell lung cancer : Treatment beyond progression |
title_fullStr |
EGFR mutation positive stage IV non-small-cell lung cancer : Treatment beyond progression |
title_full_unstemmed |
EGFR mutation positive stage IV non-small-cell lung cancer : Treatment beyond progression |
title_sort |
egfr mutation positive stage iv non-small-cell lung cancer : treatment beyond progression |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Oncology |
issn |
2234-943X |
publishDate |
2014-12-01 |
description |
Non-small-cell lung cancer (NSCLC) is the leading cause of death from cancer for both men en women. Chemotherapy is the mainstay of treatment in advanced disease, but is only marginally effective. In about 30% of patients with advanced NSCLC in East Asia and in 10-15% in Western countries, EGFR mutations are found. In this population, first-line treatment with the tyrosine kinase inhibitors (TKI) erlotinib, gefitinib or afatinib is recommended. The treatment beyond progression is less well-defined. In this paper we present 3 patients, EGFR mutation positive, with local progression after an initial treatment with TKI. These patients were treated with local radiotherapy. TKI was temporarily stopped and restarted after radiotherapy. We give an overview of the literature and discuss the different treatment options in case of progression after TKI: TKI continuation with or without chemotherapy, TKI continuation with local therapy, alternative dosing or switch to next-generation TKI or combination therapy. There are different options for treatment beyond progression in EGFR mutation positive metastatic NSCLC, but the optimal strategy is still to be defined. Further research on this topic is ongoing. |
topic |
Radiotherapy tyrosine kinase inhibitor advanced non-small-cell lung cancer EGFR mutation local progression |
url |
http://journal.frontiersin.org/Journal/10.3389/fonc.2014.00350/full |
work_keys_str_mv |
AT katrijnevanassche egfrmutationpositivestageivnonsmallcelllungcancertreatmentbeyondprogression AT katrienevandecasteele egfrmutationpositivestageivnonsmallcelllungcancertreatmentbeyondprogression AT liesbetheferdinande egfrmutationpositivestageivnonsmallcelllungcancertreatmentbeyondprogression AT yolandeelievens egfrmutationpositivestageivnonsmallcelllungcancertreatmentbeyondprogression AT veerleesurmont egfrmutationpositivestageivnonsmallcelllungcancertreatmentbeyondprogression |
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