title: [What is the best sequence of treatment for patients with EGFR mutations?].
abstract: The arrival of tyrosine kinase inhibitors (TKI) in first line of treatment for advanced non-small cell lung cancer with EGFR mutations has changed the strategy of treatment of theses patients. Indeed, response rates in these cases reach around 60 to 70%, with a progression-free survival greatly prolonged, up to 10 months. It seems that these patients with mutated tumor benefit from TKI whatever the treatment line, with the same efficacy. So, the best sequence of treatment (TKI in first line then chemotherapy in second line, or the opposite) needs still to be defined in this sub-group of NSCLC. The choice has to take in account the data of efficacy of TKIs and chemotherapy in the EGFR mutated tumors, with an anticipation of subsequent lines from the first line. Besides, data of toxicity and quality of life have also to be considered.
authors.affiliation: Service de pneumologie, institut Gustave Roussy, 114, rue Edouard Vaillant, 94805 Villejuif, France.
authors.forename: B
authors.initials: B
authors.lastname: Besse
authors.forename: G
authors.initials: G
authors.lastname: Zalcman
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000235:genetics; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D000077547:Crizotinib; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D066246:ErbB Receptors / Q000235:genetics; D019317:Evidence-Based Medicine; D000077156:Gefitinib; D018773:Genes, erbB-1 / Q000235:genetics*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D009154:Mutation; D009367:Neoplasm Staging; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D011720:Pyrazoles / Q000008:administration & dosage; D011725:Pyridines / Q000008:administration & dosage; D011788:Quality of Life; D011799:Quinazolines / Q000008:administration & dosage; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D047428:Protein Kinase Inhibitors; D011720:Pyrazoles; D011725:Pyridines; D011799:Quinazolines; D000077547:Crizotinib; D066246:ErbB Receptors; D011505:Protein-Tyrosine Kinases; D000077156:Gefitinib