Have adjuvant tyrosine kinase inhibitors lost their shine? Journal Article
| Authors: | Sabari, J. K.; Chaft, J. E. |
| Article Title: | Have adjuvant tyrosine kinase inhibitors lost their shine? |
| Abstract: | Despite broad advances in molecularly targeted therapies, lung cancer remains the leading cause of cancer related mortality in the United States. Epidermal growth factor receptor (EGFR) mutations occur in approximately 17% of advanced non-small cell lung cancer (NSCLC) in the US population. The remarkable efficacy of small-molecule EGFR tyrosine kinase inhibitors (TKIs) in this unique subset of patients has revolutionized the therapeutic approach to lung cancer. The success of these agents in the metastatic setting leads to the logical question of what role these drugs may have in the adjuvant setting for patients with earlier stage disease. RADIANT, an international randomized, double-blind, placebo controlled phase III study in patients with completely resected stage IB to IIIA NSLC whose tumors expressed EGFR by IHC and EGFR amplification by FISH, attempted to answer the question of whether erlotinib would improve disease free survival and overall survival in the adjuvant setting. While RADIANT does not conclude for or against adjuvant use of EGFR-TKIs, all data points towards benefit in a selected population. As clinicians, we must continue to enroll to potentially practice changing therapeutic neoadjuvant and adjuvant chemotherapy studies internationally. © Annals of Translational Medicine. All rights reserved. |
| Keywords: | immunohistochemistry; gene mutation; overall survival; bevacizumab; cisplatin; erlotinib; placebo; advanced cancer; drug withdrawal; note; adjuvant therapy; cancer adjuvant therapy; disease free survival; carboplatin; multiple cycle treatment; gene amplification; epidermal growth factor receptor; protein tyrosine kinase inhibitor; fluorescence in situ hybridization; dosage schedule comparison; gefitinib; pemetrexed; chemoradiotherapy; non small cell lung cancer; adjuvant; molecularly targeted therapy; afatinib; human; non-small cell lung cancer (nsclc); epidermal growth factor receptor (egfr); tyrosine kinase inhibitor (tki); osimertinib |
| Journal Title: | Annals of Translational Medicine |
| Volume: | 4 |
| Issue: | 15 |
| ISSN: | 2305-5839 |
| Publisher: | AME Publishing Company |
| Date Published: | 2016-08-01 |
| Start Page: | 285 |
| Language: | English |
| DOI: | 10.21037/atm.2016.07.18 |
| PROVIDER: | scopus |
| PMCID: | PMC4980379 |
| PUBMED: | 27568486 |
| DOI/URL: | |
| Notes: | Note -- Export Date: 3 January 2017 -- Source: Scopus |
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