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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Curr+Oncol
2015 ; 22
(3
): e183-215
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Use of the epidermal growth factor receptor inhibitors gefitinib, erlotinib,
afatinib, dacomitinib, and icotinib in the treatment of non-small-cell lung
cancer: a systematic review
#MMPMID26089730
Ellis PM
; Coakley N
; Feld R
; Kuruvilla S
; Ung YC
Curr Oncol
2015[Jun]; 22
(3
): e183-215
PMID26089730
show ga
INTRODUCTION: This systematic review addresses the use of epidermal growth factor
receptor (egfr) inhibitors in three populations of advanced non-small-cell lung
cancer (nsclc) patients-unselected, selected, and molecularly selected-in three
treatment settings: first line, second line, and maintenance. METHODS: Ninety-six
randomized controlled trials found using the medline and embase databases form
the basis of this review. RESULTS: In the first-line setting, data about the
efficacy of egfr tyrosine kinase inhibitors (tkis) compared with platinum-based
chemotherapy are inconsistent. Results from studies that selected patients based
on clinical characteristics are also mixed. There is high-quality evidence that
an egfrtki is preferred over a platinum doublet as initial therapy for patients
with an activating mutation of the EGFR gene. The egfrtkis are associated with a
higher likelihood of response, longer progression-free survival, and improved
quality of life. Multiple trials of second-line therapy have compared an egfrtki
with chemotherapy. Meta-analysis of those data demonstrates similar
progression-free and overall survival. There is consequently no preferred
sequence for second-line egfrtki or second-line chemotherapy. The egfrtkis have
also been evaluated as switch-maintenance therapy. No molecular marker could
identify patients in whom a survival benefit was not observed; however, the
magnitude of the benefit was modest. CONCLUSIONS: Determination of EGFR mutation
status is essential to making appropriate treatment decisions in patients with
nsclc. Patients who are EGFR mutation-positive should be treated with an egfrtki
as first-line therapy. An egfrtki is still appropriate therapy in patients who
are EGFR wild-type, but the selected agent should be administered as second- or
third-line therapy.