Navigating the “No Man's Land” of TKI-Failed EGFR-Mutated Non–Small Cell Lung Cancer (NSCLC): A Review

Bryan Oronsky, Patrick Ma, Tony R. Reid, Pedro Cabrales, Michelle Lybeck, Arnold Oronsky, Neil Oronsky, Corey A. Carter

Research output: Contribution to journalReview article

7 Citations (Scopus)

Abstract

As the leading cause of cancer-related mortality, lung cancer is a worldwide health issue that is overwhelmingly caused by smoking. However, a substantial minority (~25%) of patients with non–small cell lung cancer (NSCLC) has never smoked. In these patients, activating mutations of the epidermal growth factor receptor (EGFR) are more likely, which render their tumors susceptible for a finite period to treatment with EGFR tyrosine kinase inhibitors (TKIs) and confer a better prognosis than EGFR wild-type NSCLC. On progression, due to the inevitable insurgence of resistance, TKIs are generally followed by second- or third-line salvage chemotherapy until treatment failure, after which no standard treatment options are available, resulting in a poor prognosis and a high risk of death. With the focus of clinical attention on treatment with TKIs, few studies on optimal salvage therapies, including cytotoxic chemotherapy, after failure of EGFR TKIs have been reported. Despite a paucity of available data, the aim of this review is to summarize the “no-man's land” of TKI-failed EGFR-mutated NSCLC and expand on alternative strategies as well as potential future directions.

Original languageEnglish (US)
Pages (from-to)92-98
Number of pages7
JournalNeoplasia (United States)
Volume20
Issue number1
DOIs
StatePublished - Jan 2018

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Epidermal Growth Factor Receptor
Non-Small Cell Lung Carcinoma
Protein-Tyrosine Kinases
Drug Therapy
Salvage Therapy
Treatment Failure
Lung Neoplasms
Neoplasms
Therapeutics
Smoking
Mutation
Mortality

All Science Journal Classification (ASJC) codes

  • Cancer Research

Cite this

Oronsky, Bryan ; Ma, Patrick ; Reid, Tony R. ; Cabrales, Pedro ; Lybeck, Michelle ; Oronsky, Arnold ; Oronsky, Neil ; Carter, Corey A. / Navigating the “No Man's Land” of TKI-Failed EGFR-Mutated Non–Small Cell Lung Cancer (NSCLC) : A Review. In: Neoplasia (United States). 2018 ; Vol. 20, No. 1. pp. 92-98.
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title = "Navigating the “No Man's Land” of TKI-Failed EGFR-Mutated Non–Small Cell Lung Cancer (NSCLC): A Review",
abstract = "As the leading cause of cancer-related mortality, lung cancer is a worldwide health issue that is overwhelmingly caused by smoking. However, a substantial minority (~25{\%}) of patients with non–small cell lung cancer (NSCLC) has never smoked. In these patients, activating mutations of the epidermal growth factor receptor (EGFR) are more likely, which render their tumors susceptible for a finite period to treatment with EGFR tyrosine kinase inhibitors (TKIs) and confer a better prognosis than EGFR wild-type NSCLC. On progression, due to the inevitable insurgence of resistance, TKIs are generally followed by second- or third-line salvage chemotherapy until treatment failure, after which no standard treatment options are available, resulting in a poor prognosis and a high risk of death. With the focus of clinical attention on treatment with TKIs, few studies on optimal salvage therapies, including cytotoxic chemotherapy, after failure of EGFR TKIs have been reported. Despite a paucity of available data, the aim of this review is to summarize the “no-man's land” of TKI-failed EGFR-mutated NSCLC and expand on alternative strategies as well as potential future directions.",
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Oronsky, B, Ma, P, Reid, TR, Cabrales, P, Lybeck, M, Oronsky, A, Oronsky, N & Carter, CA 2018, 'Navigating the “No Man's Land” of TKI-Failed EGFR-Mutated Non–Small Cell Lung Cancer (NSCLC): A Review', Neoplasia (United States), vol. 20, no. 1, pp. 92-98. https://doi.org/10.1016/j.neo.2017.11.001

Navigating the “No Man's Land” of TKI-Failed EGFR-Mutated Non–Small Cell Lung Cancer (NSCLC) : A Review. / Oronsky, Bryan; Ma, Patrick; Reid, Tony R.; Cabrales, Pedro; Lybeck, Michelle; Oronsky, Arnold; Oronsky, Neil; Carter, Corey A.

In: Neoplasia (United States), Vol. 20, No. 1, 01.2018, p. 92-98.

Research output: Contribution to journalReview article

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AU - Oronsky, Bryan

AU - Ma, Patrick

AU - Reid, Tony R.

AU - Cabrales, Pedro

AU - Lybeck, Michelle

AU - Oronsky, Arnold

AU - Oronsky, Neil

AU - Carter, Corey A.

PY - 2018/1

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