EGFR tyrosine kinase inhibitors in non-small cell lung cancer patients: How do we interpret the clinical and biomarker data?

Raffaele Califano, Fiona H. Blackhall, Giovanna Finocchiaro, Luca Toschi, Nicholas Thatcher, Federico Cappuzzo, Lucio Crinò

Research output: Contribution to journalArticle

Abstract

The clinical development of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) for treatment of non-small cell lung cancer (NSCLC) is a major breakthrough in the field. Erlotinib is the first of this class of drug demonstrated in a placebo-controlled trial to prolong survival of patients with previously treated NSCLC. The challenge now is how best to select patients for this treatment. Clinical factors including female gender, East Asian ethnic origin, adenocarcinoma histology, and a history of never-smoking are associated with better response rates, but response to erlotinib is not exclusive to these populations or essential for a survival benefit. Molecular factors such as EGFR mutation and increased EGFR gene copy number provide objective tests that may be superior to clinical factors for patient selection, but assay for these factors is crucially dependent on available tumor tissue and to date, there are no published data from randomized trials where tumor tissue is available from all patients. Here we review the clinical and biological factors that may be applied to select patients for treatment with EGFR-TKIs and conclude that the available data are premature for definitive guidelines to select against an EGFR-TKI.

Original languageEnglish
Pages (from-to)173-186
Number of pages14
JournalTargeted Oncology
Volume3
Issue number3
DOIs
Publication statusPublished - Jul 2008

Keywords

  • EGFR
  • Erlotinib
  • Gefitinib
  • Non-small cell lung cancer
  • Tyrosine kinase inhibitors

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Pharmacology (medical)

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