Department of Hematology & Oncology, University Department Internal Medicine-Oncology, Pius-Hospital, Medical Campus University of Oldenburg, Oldenburg, Germany.
Department of Respiratory Medicine, Evangelische Lungenklinik Berlin, Berlin, Germany.
Future Oncol. 2021 Feb;17(4):471-486. doi: 10.2217/fon-2020-0854. Epub 2020 Oct 23.
Clinical trial and real-world data in non-small-cell lung cancer indicate that 10-60% of patients that progressed on first- or second-generation EGFR-targeting tyrosine kinase inhibitors (TKI) do not receive systemic second-line therapy. In our article, we discuss efficacy, safety and treatment duration with different EGFR-TKIs and stress the need for delivery of the most efficacious therapy in the first-line. We also provide our perspective on analysis of circulating tumor DNA and the role of EGFR-TKI in combined therapies. Finally, we review new therapeutic options to overcome resistance to EGFR-TKI. We believe that overall treatment duration and access to different medications in subsequent lines of therapy should be considered when planning the optimal treatment strategy.
临床研究和真实世界的数据表明，在接受第一代或第二代 EGFR 靶向酪氨酸激酶抑制剂（TKI）治疗后进展的非小细胞肺癌患者中，有 10%-60%未接受系统二线治疗。在我们的文章中，我们讨论了不同 EGFR-TKI 的疗效、安全性和治疗持续时间，并强调了在一线治疗中提供最有效的治疗方法的必要性。我们还对循环肿瘤 DNA 的分析以及 EGFR-TKI 在联合治疗中的作用提出了看法。最后，我们回顾了克服 EGFR-TKI 耐药性的新治疗选择。我们认为，在制定最佳治疗策略时，应考虑整体治疗持续时间和后续治疗线中不同药物的可及性。
