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Combination of EGFR-TKIs and chemotherapy in advanced EGFR mutated NSCLC: Review of the literature and future perspectives

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Published:31st Jan 2020

Author: Rebuzzi SE, Alfieri R, La Monica S, Minari R, Petronini PG, Tiseo M.

Source: Critical Reviews in Oncology/Hematology

Ref.:Crit Rev Oncol Hematol. 2020 Feb;146:102820.

DOI:10.1016/j.critrevonc.2019.102820

Combination of EGFR-TKIs and chemotherapy in advanced EGFR mutated NSCLC: Review of the literature and future perspectives

Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) improved clinical outcome compared to chemotherapy in EGFR mutated advanced non-small cell lung cancer (NSCLC) patients. Nonetheless, acquired resistance develops within 10–14 months and 20–30% of EGFR-mutated patients do not respond to EGFR-TKI.

In order to delay or overcome acquired resistance to EGFR-TKIs, combination therapies of EGFR-TKIs with chemotherapy has been investigated with conflicting results. Early studies failed to show a survival benefit because of a lack of patient selection, but more recently clinical studies in EGFR mutated patients have shown promising results.

This review summarizes preclinical and clinical studies of combination of EGFR-TKIs, including the third-generation TKI osimertinib, with chemotherapy in first- and second-line settings, using concurrent or intercalated treatment strategies.

In the new era of third-generation EGFR-TKIs, new studies of this combination strategy are warranted.

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