Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Oct 24;12(10):912-925.
doi: 10.5306/wjco.v12.i10.912.

Recent advances and new insights in the management of early-stage epidermal growth factor receptor-mutated non-small-cell lung cancer

Miguel J Sotelo  1 , José Luis García  2 , Cesar Torres-Mattos  3 , Héctor Milián  4 , Carlos Carracedo  5 , María Ángeles González-Ruiz  6 , Xabier Mielgo-Rubio  7 , Juan Carlos Trujillo-Reyes  8 , Felipe Couñago  9
Affiliations
Review

Recent advances and new insights in the management of early-stage epidermal growth factor receptor-mutated non-small-cell lung cancer

Miguel J Sotelo et al. World J Clin Oncol. .

Abstract

Patients with early-stage non-small-cell lung cancer (NSCLC) are candidates for curative surgery; however, despite multiple advances in lung cancer management, recurrence rates remain high. Adjuvant chemotherapy has been demonstrated to significantly prolong overall survival (OS), but this benefit is modest and there is an urgent need for effective new therapies to provide a cure for more patients. The high efficacy of tyrosine kinase inhibitors (TKIs) against epidermal growth factor receptor-mutated (EGFR) in patients with advanced EGFR-mutated NSCLC has led to the evaluation of these agents in early stages of the disease. Multiple clinical trials have evaluated the safety and efficacy of EGFR TKIs as an adjuvant treatment, in patients with resected EGFR-mutated NSCLC, and shown that they significantly prolong disease-free survival (DFS), but this benefit does not translate to OS. Recently, an interim analysis of the ADAURA trial demonstrated that, surprisingly, osimertinib improved DFS. This led to the study being stopped early, leaving many unanswered questions about its potential effect on OS and its incorporation as a standard adjuvant treatment in this patient subgroup. These targeted agents are also being evaluated in locally-advanced disease, with promising results, although prospective studies with larger sample sizes are needed to confirm these results. In this article, we review the most relevant studies on the role of EGFR TKIs in the management of early-stage EGFR-mutated NSCLC.

Keywords: Adjuvant; Early stage; Epidermal growth factor receptor-mutated; Epidermal growth factor receptor-mutated-tyrosine kinase inhibitor; Neoadjuvant; Non-small-cell lung cancer.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: Dr. MIELGO-RUBIO reports personal fees and non-financial support from ROCHE, personal fees from ASTRA ZENECA, grants, personal fees and non-financial support from BMS, personal fees from MSD, personal fees from ABBOTT, personal fees from KIOWA-KIRIN, outside the submitted work. Rest of authors declares no conflict of interest.

Similar articles

See all similar articles

Cited by

References

    1. Langer CJ, Besse B, Gualberto A, Brambilla E, Soria JC. The evolving role of histology in the management of advanced non-small-cell lung cancer. J Clin Oncol. 2010;28:5311–5320. - PubMed
    1. Bradbury P, Sivajohanathan D, Chan A, Kulkarni S, Ung Y, Ellis PM. Postoperative Adjuvant Systemic Therapy in Completely Resected Non-Small-Cell Lung Cancer: A Systematic Review. Clin Lung Cancer. 2017;18:259–273.e8. - PubMed
    1. Wakelee H, Chhatwani L. Adjuvant chemotherapy for resected non-small cell lung cancer. Semin Thorac Cardiovasc Surg. 2008;20:198–203. - PubMed
    1. Molina JR, Yang P, Cassivi SD, Schild SE, Adjei AA. Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. Mayo Clin Proc. 2008;83:584–594. - PMC - PubMed
    1. Le Chevalier T. Adjuvant chemotherapy for resectable non-small-cell lung cancer: where is it going? Ann Oncol. 2010;21 Suppl 7:vii196–vii198. - PubMed