The role of second-generation EGFR inhibitors in lung cancer therapy in the realities of modern clinical practice

Izmailov A.A.; Nasretdinov A.F.; Sultanbaev A.V.; Sakaeva D.D.; Menshikov K.V.; Sultanbaeva N.I.; Musin Sh.I.

doi:https://doi.org/10.17116/onkolog20211004175

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Abstract:

Modern third-generation tyrosine kinase inhibitors (TKIs) show amazing results in the treatment of EGFR-mutated lung tumors, overshadowing the earlier generation representatives. Does this mean that it is necessary to completely abandon other TKIs in favor of osimertinib? In search of an answer to this question, the authors have analyzed works on the efficacy of the most interesting representative of TKIs, such as second-generation irreversible non-selective EGFR inhibitors. Afatinib from this group has been registered in the Russian Federation. The paper reveals possible niches for the use of afatinib, gives its comparative efficacy with other TKIs, assesses the possible mechanisms of its antitumor effect, and considers the problems that can be encountered when interpreting the results of studies. Afatinib as a representative of second-generation EGFR inhibitors shows extremely good results in the treatment of non-small cell lung cancer: it demonstrates effectiveness in first-line therapy, can bring benefits to patients after T790M-independent progression in first- and second-line TKI therapy for squamous cell lung cancer after progression during platinum-based therapy, and also has promising data from sequential afatinib — osimertinib treatment.

Keywords:

lung cancer

afatinib

gilotrif

osimertinib

erlotinib

lung adenocarcinoma

squamous cell lung cancer

Authors:

Izmailov A.A.

P.A. Herzen Moscow Oncology Research Institute — Branch of the National Medical Radiology Research Center of the Ministry of Health of Russia

ORCID: 0000-0001-5836-0066

Nasretdinov A.F.

Republican Clinical Oncology Dispensary

Sultanbaev A.V.

Republican Clinical Oncology Dispensary

Sakaeva D.D.

Bashkir State Medical University

Menshikov K.V.

Republican Clinical Oncology Dispensary;
Bashkir State Medical University

Sultanbaeva N.I.

Republican Clinical Oncology Dispensary

Musin Sh.I.

Republican Clinical Oncology Dispensary

Received:

25.06.2021

Accepted:

28.06.2021

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References:

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