title: Management of NSCLC Disease Progression After First-Line EGFR Tyrosine Kinase Inhibitors: What Are the Issues and Potential Therapies?
abstract: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) represent the standard of care for advanced non-small cell lung cancer (NSCLC) patients whose tumor harbors an activating EGFR mutation. The vast majority of patients will experience disease control with an EGFR-TKI but inevitably all patients will progress, often within a year of treatment. There is no current standard of care for this scenario but, in clinical practice, most of the patients will be offered platinum-based doublet chemotherapy. In some situations, continuation of the EGFR-TKI beyond radiological progression, with or without use of local treatments in case of oligo-progressive disease, represents a reasonable therapeutic option. The aim of this review is to describe the different treatment strategies that have been developed to tackle progression on EGFR-TKIs, including specific clinical scenarios and novel agents designed to tackle the common T790M resistance mutation.
authors.affiliation: Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK. raffaele.califano@christie.nhs.uk.|Department of Medical Oncology, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK. raffaele.califano@christie.nhs.uk.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Califano
authors.affiliation: Medical Oncology Unit, Papageorgiou General Hospital, Thessaloniki, Greece.
authors.forename: Ourania
authors.initials: O
authors.lastname: Romanidou
authors.affiliation: Department of Medical Oncology, University of Athens School of Medicine, Athens, Greece.
authors.forename: Giannis
authors.initials: G
authors.lastname: Mountzios
authors.affiliation: Istituto Toscano Tumori, Ospedale Civile di Livorno,, Leghorn, Italy.
authors.forename: Lorenza
authors.initials: L
authors.lastname: Landi
authors.affiliation: Istituto Toscano Tumori, Ospedale Civile di Livorno,, Leghorn, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Cappuzzo
authors.affiliation: Department of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, M20 4BX, UK.|University of Manchester, Manchester, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Blackhall
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000818:Animals; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D018450:Disease Progression; D019008:Drug Resistance, Neoplasm / Q000235:genetics; D004359:Drug Therapy, Combination; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D006801:Humans; D007167:Immunotherapy; D008175:Lung Neoplasms / Q000188:drug therapy*; D051379:Mice; D058990:Molecular Targeted Therapy; D009154:Mutation; D017671:Platinum Compounds / Q000627:therapeutic use; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D017671:Platinum Compounds; D047428:Protein Kinase Inhibitors; D066246:ErbB Receptors