J Cancer Clin | Volume 1, Issue 2 | Case Report | Open Access

Longterm Follow-Up on Patients with EGFR-Mutated Lung Cancer Treated with an EGFR-TKI and Concurrent Chemotherapy and Literature Review: Is there a Tail on the Curve?

Elizabeth Dudnik¹, Ryan B Natale² and Ronald B Natale^3*

¹Division of Oncology, Davidoff Cancer Center, Rabin Medical Center, Israel
²Division of Oncology, New York Presbyterian Brooklyn Hospital, USA
³Division of Oncology, Cedars Sinai Medical Center, USA

^*Correspondance to: Ronald B Natale 

Fulltext PDF

Abstract

Nine major randomized clinical trials of 1^st or 2^nd generation Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors (EGFR-TKIs) vs. platinum-based chemotherapy in patients with newly diagnosed advanced EGFR-mutated lung cancer established EGFR-TKIs as the 1^st line standard of care. As detailed in Table 1 below, EGFR-TKIs demonstrated superiority over chemotherapy with respect to Overall Response Rates (ORR) of 56%-85% vs. 15%-47% and median Progression Free Survivals (PFS) of 8.0-13.7 months vs. 5.2-6.9 months, respectively. Despite the superiority of EGFR-TKIs over chemotherapy as initial therapy, treatment cross-over in both arms of the studies resulted in nearly equivalent overall survival strongly suggesting independent and non-cross resistant mechanisms of action between TKIs and chemotherapy [1-11]. Since additive to supra-additive effects can sometimes be achieved with the concurrent use of non-cross resistant treatments, we hypothesized that the concurrent use of EGFR-TKIs and chemotherapy may be superior to their sequential use.

Citation:

Dudnik E, Natale RB, Natale RB. Longterm Follow-Up on Patients with EGFR-Mutated Lung Cancer Treated with an EGFR-TKI and Concurrent Chemotherapy and Literature Review: Is there a Tail on the Curve? J Cancer Clin. 2018; 1(2): 1006.