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Systemic therapy for advanced non-small cell lung cancer with an activating mutation in the epidermal growth factor receptor

Author
Rogerio C Lilenbaum, MD, FACP
Section Editor
James R Jett, MD
Deputy Editor
Sadhna R Vora, MD

INTRODUCTION

Treatment of patients with lung cancer depends upon the cell type (non-small cell lung cancer [NSCLC] versus small cell lung cancer), molecular characteristics, tumor stage, and an assessment of the patient's overall medical condition.

Patients with stage I, II, or III NSCLC (table 1) are generally treated with curative intent using surgery or radiation therapy (RT), sometimes combined with concurrent or adjuvant chemotherapy. In contrast, palliative systemic therapy is appropriate for patients who have stage IV disease at presentation. Palliative systemic therapy is also used for patients who have relapsed with advanced disease following prior definitive treatment.

An improved understanding of the molecular pathways that drive malignancy in NSCLC has led to the development of agents that target specific molecular pathways in malignant cells. Therapy can then be individualized based upon the specific abnormality, if any, present in a given patient.

The use of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) for the treatment of patients with advanced NSCLC that contains a somatic mutation in EGFR will be reviewed here. The use of these agents in patients without an EGFR mutation (ie, wild type EGFR) either as maintenance therapy after initial chemotherapy or as subsequent therapy after initial progression is discussed separately. (See "Systemic therapy for the initial management of advanced non-small cell lung cancer without a driver mutation", section on 'Avoidance of EGFR TK inhibitors' and "Advanced non-small cell lung cancer: Subsequent systemic therapies for previously treated patients".)

Other relevant topics include:

                            

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Literature review current through: Nov 2016. | This topic last updated: Mon Oct 24 00:00:00 GMT+00:00 2016.
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