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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
Article

Use of the Epidermal Growth Factor Receptor Inhibitors Gefitinib, Erlotinib, Afatinib, Dacomitinib, and Icotinib in the Treatment of Non-Small-Cell Lung Cancer: A Systematic Review

by 1,2, 1,3,*, 4, 5 and 6
1
Department of Oncology, McMaster University, Hamilton, ON, Canada
2
Juravinski Cancer Centre, Hamilton, ON, Canada
3
Cancer Care Ontario, Program in Evidence-Based Care, Hamilton, ON, Canada
4
Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, and University Health Network, University of Toronto, Toronto, ON, Canada
5
Department of Oncology, The University of Western Ontario, and London Regional Cancer Program, London, ON, Canada
6
Department of Radiation Oncology, University of Toronto, and Odette Cancer Centre, Toronto, ON, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2015, 22(3), 183-215; https://doi.org/10.3747/co.22.2566
Received: 4 March 2015 / Revised: 8 April 2015 / Accepted: 6 May 2015 / Published: 1 June 2015
Introduction: This systematic review addresses the use of epidermal growth factor receptor (egfr) inhibitors in three populations of advanced non-small-cell lung cancer (nsclc) patients—unselected, selected, and molecularly selected—in three treatment settings: first line, second line, and maintenance. Methods: Ninety-six randomized controlled trials found using the medline and embase databases form the basis of this review. Results: In the first-line setting, data about the efficacy of egfr tyrosine kinase inhibitors (tkis) compared with platinum-based chemotherapy are inconsistent. Results from studies that selected patients based on clinical characteristics are also mixed. There is high-quality evidence that an egfr tki is preferred over a platinum doublet as initial therapy for patients with an activating mutation of the EGFR gene. The egfr tkis are associated with a higher likelihood of response, longer progression-free survival, and improved quality of life. Multiple trials of second-line therapy have compared an egfr tki with chemotherapy. Meta-analysis of those data demonstrates similar progression-free and overall survival. There is consequently no preferred sequence for second-line egfr tki or second-line chemotherapy. The egfr tkis have also been evaluated as switch-maintenance therapy. No molecular marker could identify patients in whom a survival benefit was not observed; however, the magnitude of the benefit was modest. Conclusions: Determination of EGFR mutation status is essential to making appropriate treatment decisions in patients with nsclc. Patients who are EGFR mutation–positive should be treated with an egfr tki as first-line therapy. An egfr tki is still appropriate therapy in patients who are EGFR wild-type, but the selected agent should be administered as second- or third-line therapy.
Keywords: Non-small-small cell lung cancer; egfr inhibitors; mutation status; systematic review Non-small-small cell lung cancer; egfr inhibitors; mutation status; systematic review
MDPI and ACS Style

Ellis, P.M.; Coakley, N.; Feld, R.; Kuruvilla, S.; Ung, Y.C. Use of the Epidermal Growth Factor Receptor Inhibitors Gefitinib, Erlotinib, Afatinib, Dacomitinib, and Icotinib in the Treatment of Non-Small-Cell Lung Cancer: A Systematic Review. Curr. Oncol. 2015, 22, 183-215. https://doi.org/10.3747/co.22.2566

AMA Style

Ellis PM, Coakley N, Feld R, Kuruvilla S, Ung YC. Use of the Epidermal Growth Factor Receptor Inhibitors Gefitinib, Erlotinib, Afatinib, Dacomitinib, and Icotinib in the Treatment of Non-Small-Cell Lung Cancer: A Systematic Review. Current Oncology. 2015; 22(3):183-215. https://doi.org/10.3747/co.22.2566

Chicago/Turabian Style

Ellis, P.M.; Coakley, N.; Feld, R.; Kuruvilla, S.; Ung, Y.C. 2015. "Use of the Epidermal Growth Factor Receptor Inhibitors Gefitinib, Erlotinib, Afatinib, Dacomitinib, and Icotinib in the Treatment of Non-Small-Cell Lung Cancer: A Systematic Review" Curr. Oncol. 22, no. 3: 183-215. https://doi.org/10.3747/co.22.2566

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