title: Oral tyrosine kinase inhibitors in the first-line treatment of advanced non-small cell lung cancer.
abstract: BACKGROUND
  In EGFR mutated advanced NSCLC, tyrosine kinase inhibitors are new valid options as first-line treatment. Gefitinib appears a valid alternative to chemotherapy as first-line therapy, in EGFR mutated elderly or unfit patients too, while erlotinib remains an option for subsequent lines of treatment.
  
  
  METHODS
  Areas covered in this review include two international trials, which evaluated erlotinib in chemo-naive EGFR mutated patients both in an Asian and caucasian population, showing a dramatic advantage in terms of progression-free survival and overall response rate as well as gefitinib. Results showed a good safety profile, with side effects of mild to moderate intensity, usually manageable with temporary interruption of treatment.
  
  
  CONCLUSIONS
  Investigating EGFR mutations is critical in order to obtain sufficient data. It has now become mandatory for molecular characterization, as part of baseline diagnostic procedures. This approach is also becoming increasingly important during progression of the disease as a sort of 'molecular follow up'. It plays a central role in the right choice of treatment, in an aim to give the best drug to the right patients, overcoming other well known prognostic factors.
authors.affiliation: High Specialization Hospitals, Oncological Pulmonary 1st Unit, San Camillo-Forlanini, Rome, Italy. bruno.gori@yahoo.it
authors.forename: Bruno
authors.initials: B
authors.lastname: Gori
authors.forename: Serena
authors.initials: S
authors.lastname: Ricciardi
authors.forename: Ester
authors.initials: E
authors.lastname: del Signore
authors.forename: Alberto
authors.initials: A
authors.lastname: Fulvi
authors.forename: Filippo
authors.initials: F
authors.lastname: de Marinis
mesh_terms: D000284:Administration, Oral; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D066246:ErbB Receptors / Q000235:genetics; D000069347:Erlotinib Hydrochloride; D000077156:Gefitinib; D006801:Humans; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D011799:Quinazolines / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; C512478:EGFR protein, human; D066246:ErbB Receptors; D011505:Protein-Tyrosine Kinases; D000077156:Gefitinib