Adjuvant therapy in non-small cell lung cancer: is targeted therapy joining the standard of care?
| Autor: | C. Gabay, Alessandro Russo, Luis E. Raez, Christian Rolfo Cervetto |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Oncology
medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Population Targeted therapy Gefitinib Carcinoma Non-Small-Cell Lung Internal medicine medicine Adjuvant therapy Humans Pharmacology (medical) Osimertinib education Lung cancer Protein Kinase Inhibitors education.field_of_study business.industry Standard of Care medicine.disease respiratory tract diseases ErbB Receptors Clinical trial Mutation Erlotinib business medicine.drug |
| Zdroj: | Expert Review of Anticancer Therapy. 21:1229-1235 |
| ISSN: | 1744-8328 1473-7140 |
| DOI: | 10.1080/14737140.2021.1982387 |
| Popis: | Introduction Surgical resection is the standard of care in non-small cell lung cancer (NSCLC) for early stage disease (stage I-IIIA). Despite the use of adjuvant chemotherapy, the 5- year overall survival (OS) rates remain low. In NSCLC with advanced stages (stage IV), tailored strategies have become the gold standard approach applying precision medicine thanks to the introduction of genomic analysis with next generation sequencing (NGS) and the development of targeted therapy and immunotherapy. We hope to translate these benefits in preventing recurrences and increasing survival in early-stage NSCLC. Areas covered We discuss systemic adjuvant therapy approaches in resected NSCLC with a focus on targeted therapies and emerging data in the EGFR mutated population. As we know, deletions in the EGFR exon 19 (Del19) and EGFR L858R point mutations (L858R) in exon 21 are the most common druggable molecular drivers in NSCLC. EGFR tyrosine kinase inhibitors (TKIs) are the standard of care in metastatic NSCLC and we discuss their emerging role as an adjuvant therapy for this disease. Expert opinion We have seen the results of the first adjuvant clinical trial with TKIs that showed increase DFS in patients with early stage lung cancer. Despite the fact that using osimertinib as an adjuvant treatment seems promising, several open questions need to be answered. If osimertinib reaches a significant advantage in OS, undergoing 3 years of treatment is worthwhile but if there is not an OS benefit then maybe DFS is not enough. In the meantime, should we treat patients with osimertinib as adjuvant therapy until the OS data is available? There is not an easy answer for this but most of us are in favor of giving osimertinib a chance until we have definitive data or better options to prevent recurrence and prolong DFS in our early-stage NSCLC patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|