Extract
10 years ago, the US Food and Drug Administration approved erlotinib in the second and third line settings for unselected advanced nonsmall cell lung cancer (NSCLC) patients. Activating EGFR mutations were discovered by analysing patient subgroups who responded to oral, first-generation, single-target reversible EGFR tyrosine kinase inhibitor (TKI). Nine randomised phase III chemotherapy-controlled trials in EGFR-mutant NSCLC naive patients showed the superiority of gefitinib, erlotinib and afatinib, respectively, in terms of response rate and progression-free survival. Response rate is in the range of 70% and progression-free survival about 1 year. Exon 19 in-frame deletions represent about 45% of overall EGFR mutations and half of the sensitising ones [1]. New generation targeted therapies are currently under clinical development. However, treatment sequence is still debated after a first line of EGFR TKI regimen in these molecularly selected patients. We herein report a case of a metastatic EGFR-mutated lung adenocarcinoma patient who achieved a prolonged survival of 10 years through multiple surgical and medical treatments (fig. 1)
Abstract
TKI should be used sequentially with chemotherapy and local procedures to prolong life in EGFR-mutated lung cancer http://ow.ly/KRWP4
Footnotes
Conflict of interest: Disclosures can be found alongside the online version of this article at erj.ersjournals.com
- Received January 30, 2015.
- Accepted March 9, 2015.
- Copyright ©ERS 2015