[Current status of EGFR/ErbB inhibitors in non-small cell lung carcinoma]

Med Clin (Barc). 2016 Apr:146 Suppl 1:2-6. doi: 10.1016/S0025-7753(16)30256-1.
[Article in Spanish]

Abstract

In the last 10 years, there has been a major change in the treatment of lung cancer (LC). The discovery of activating mutations in the epidermal growth factor receptor (EGFR) in some histological subtypes of LC and its sensitivity to tyrosine kinase inhibitors (TKI) has represented a substantial advance in the treatment of this entity. Until then, the only available option to treat this type of tumour was based on chemotherapy, with a small but significant benefit in terms of survival and quality of life. The arrival of new agents that act against activating EGFR mutations gave rise to the era of precision medicine with targeted therapies able to act on the origin of the tumour, thus providing a therapeutic benefit while minimizing adverse effects and delaying administration of chemotherapy. In addition, this has produced a change in the diagnostic paradigm of lung cancer (as well as in that of all tumours), with a shift from a purely histological diagnosis to a classification of tumours based on their mutational characteristics. This shift has been made possible by the development of technologies allowing complex DNA analysis. Together with the efforts of researchers from all over the world, these techniques allow continued discovery of genetic alterations that could be the target of new drugs as well as definition of the mechanisms of activity and resistance to treatments. This extraordinary development of targeted therapies cannot change the fact that metastatic lung cancer continues to be an incurable disease and, at the present time, only a few patients will benefit from targeted therapies. Ongoing research will shed new light on the molecular alterations that give rise to LC and will provide new treatment alternatives for this disease.

Keywords: Carcinoma de pulmón no microcítico; EGFR/ErbB; Inhibidores de la tirosincinasa; Small cell lung carcinoma; Targeted treatments; Tratamientos dirigidos; Tyrosine kinase inhibitors.

Publication types

  • Review

MeSH terms

  • Afatinib
  • Antineoplastic Agents / therapeutic use*
  • Carcinoma, Non-Small-Cell Lung / diagnosis
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / genetics
  • Carcinoma, Non-Small-Cell Lung / metabolism
  • Erlotinib Hydrochloride / therapeutic use
  • Gefitinib
  • Genes, erbB-2*
  • Genetic Markers
  • Humans
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / genetics
  • Lung Neoplasms / metabolism
  • Mutation
  • Precision Medicine
  • Protein Kinase Inhibitors / therapeutic use*
  • Quinazolines / therapeutic use
  • Receptor, ErbB-2 / antagonists & inhibitors*
  • Receptor, ErbB-2 / genetics
  • Receptor, ErbB-2 / metabolism
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Genetic Markers
  • Protein Kinase Inhibitors
  • Quinazolines
  • Afatinib
  • Erlotinib Hydrochloride
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • Gefitinib