Cansouline Xavier, Lipan Béatrice, Sizaret Damien, Tallet Anne, Vandier Christophe, Carmier Delphine, Legras Antoine
Department of Thoracic Surgery, Tours University Hospital, 37170 Chambray-Lès-Tours, France.
Nutrition, Croissance et Cancer, INSERM UMR 1069, University of Tours, 37000 Tours, France.
Cancers (Basel). 2022 Apr 30;14(9):2257. doi: 10.3390/cancers14092257.
The ADAURA trial has been significant for the perception of tyrosine kinase inhibitors (TKIs) as a tool for early stage non-small-cell lung cancer (NSCLC). It produced such great insight that the main TKI, Osimertinib, was rapidly integrated into international guidelines for adjuvant use. However, -mutant NSCLC is a complex entity and has various targeting drugs, and the benefits for patients might not be as clear as they seem. We reviewed trials and meta-analyses considering TKI adjuvant and neoadjuvant use. We also explored the influence of mutation variability and financial evaluations. We found that TKIs often show disease-free survival (DFS) benefits, yet studies have struggled to improve the overall survival (OS); however, the results from the literature might be confusing because of variability in the stages and mutations. The safety profiles and adverse events are acceptable, but costs remain high and accessibility might not be optimal. TKIs are promising drugs that could allow for tailored treatment designs.
ADAURA试验对于将酪氨酸激酶抑制剂（TKIs）视为早期非小细胞肺癌（NSCLC）治疗工具的认知具有重要意义。它带来了深刻见解，以至于主要的TKI药物奥希替尼迅速被纳入国际辅助治疗指南。然而，-突变型NSCLC是一个复杂的实体，有多种靶向药物，对患者的益处可能并不像看起来那么明确。我们回顾了考虑TKI辅助和新辅助使用的试验及荟萃分析。我们还探讨了突变变异性和财务评估的影响。我们发现TKIs通常显示出无病生存期（DFS）益处，但研究在改善总生存期（OS）方面仍面临困难；然而，由于分期和突变的变异性，文献结果可能令人困惑。安全性和不良事件是可接受的，但成本仍然很高，可及性可能也不理想。TKIs是有前景的药物，有望实现个性化治疗设计。
