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10.3747/co.22.2566

http://scihub22266oqcxt.onion/10.3747/co.22.2566
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C4462541!4462541!26089730
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suck abstract from ncbi


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pmid26089730      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 P; Coakley N; Feld R; Kuruvilla S; Ung Y
  • Curr Oncol 2015[Jun]; 22 (3): e183-215 PMID26089730show 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.
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