Long Term Therapeutic Plan for Patients with Non-Small Cell Lung Cancer Harboring EGFR Mutation
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Àå½ÂÈÆ(Jang Seung-Hun) - Hallym University College of Medicine Department of Internal Medicine
Abstract
Non-small cell lung cancer harboring epidermal growth factor receptor (EGFR) sensitizing mutations has a distinct disease entity. Patients with this cancer have better prognosis, and frequently achieve long-term survival. EGFR-tyrosine kinase inhibitor (TKI) is the drug of choice for this cancer; but the disease inevitably progresses, after durable response. The tumor is a mixture of EGFR-TKI sensitive clones and resistant clones, regardless of their molecular mechanisms. EGFR-TKI sensitive clones are very susceptible to this drug, but rarely eradicated; so, withdrawal of the drug permits rapid regrowth of drug sensitive clones, possibly causing ¡°disease flare.¡± Re-administration or continuation of EGFR-TKI can effectively suppress the expansion of drug sensitive clones, even when the total tumor volume continuously increases. Chemotherapy can definitely prolong the survival of patients experiencing EGFR-TKI failure. Prospective clinical trials are warranted to compare efficacies of chemotherapeutic agents. A few retrospective studies suggested that a taxane-based regimen may be superior to others. Here, we reviewed therapeutic options and clinical evidence about this unique disease entity.
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Recepto, Epidermal Growth Factor, Carcinoma, Non-Small Cell Lung, Drug Therapy
KMID :
0383820140760010008
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Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) can effectively suppress the expansion of drug sensitive clones, even when the total tumor volume continuously increases. EGFR-TKI is the drug of choice but the disease inevitably progress after dura¬ble response.