Erlotinib, gefitinib, or chemotherapy for EGFR mutation-positive lung cancer?

摘要

Clinical practice in non-small-cell lung cancer (NSCLC) has changed greatly since the introduction of EGFR tyrosine Idnase inhibitors (TKIs). Subsequent discovery of activating mutations of EGFR in a subset of patients with NSCLC in 2004 opened the era of personalised therapy in thoracic oncology. The initial findings that the EGFR mutation was associated with increased sensitivity to TKIs and was most common intheAsian population, never-smokers, women, and patients with adenocarcinoma led to the first phase 3 trial comparing an EGFRTKI with chemotherapy in the first-line setting.1 IPASS selected patients by their clinical background (eg, Asian patients with adenocarcinoma who were light smokers or had never smoked) and showed overall superiority of gefitinibtocarboplatin plus paclitaxel in progression-free survival (PFS).