PMID- 31496745
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 1178-6930 (Print)
IS  - 1178-6930 (Electronic)
IS  - 1178-6930 (Linking)
VI  - 12
DP  - 2019
TI  - Second-generation EGFR and ErbB tyrosine kinase inhibitors as first-line 
      treatments for non-small cell lung cancer.
PG  - 6535-6548
LID - 10.2147/OTT.S198945 [doi]
AB  - The discovery that mutations in the EGFR gene are present in up to 50% of 
      patients with lung adenocarcinoma, and the development of highly efficacious EGFR 
      tyrosine kinase inhibitors (TKIs), has revolutionized the way this common 
      malignancy is treated. Three generations of EGFR TKIs are now approved for use in 
      EGFR mutation-positive non-small cell lung cancer (NSCLC); the first-generation 
      agents erlotinib, gefitinib, and icotinib; the second-generation ErbB family 
      blockers afatinib and dacomitinib; and most recently, osimertinib, a 
      third-generation EGFR TKI. The second-generation agents have demonstrated 
      impressive efficacy relative to both standard platinum-based chemotherapy and 
      first-generation EGFR TKIs, significantly improving response and progression-free 
      and overall survival. Data from real-world studies suggest that afatinib is as 
      effective and well tolerated in routine clinical practice as it is in clinical 
      studies and is effective in patients with certain uncommon EGFR mutations, 
      patients with brain metastases, and older patients. Few real-world data are 
      available for dacomitinib in the first-line setting. Afatinib and dacomitinib 
      have similar safety profiles, with acne/skin dryzness, diarrhea, stomatitis, and 
      paronychia the most common adverse events (AEs) reported in clinical and 
      real-world studies. Numerous studies have shown that tolerability-guided dose 
      reductions can help manage afatinib-related AEs without reducing efficacy. As the 
      number of therapeutic options for advanced NSCLC increases, the optimal choice 
      for first-line treatment will be determined by considering patient factors such 
      as the presence of brain metastases, the type of EGFR mutation, tolerability, and 
      subsequent therapy options for long-term treatment.
FAU - Wang, Shouzheng
AU  - Wang S
AD  - Department of Medical Oncology, National Cancer Center/National Clinical Research 
      Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking 
      Union Medical College, Beijing, People's Republic of China.
FAU - Li, Junling
AU  - Li J
AD  - Department of Medical Oncology, National Cancer Center/National Clinical Research 
      Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking 
      Union Medical College, Beijing, People's Republic of China.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20190815
PL  - New Zealand
TA  - Onco Targets Ther
JT  - OncoTargets and therapy
JID - 101514322
PMC - PMC6700283
OTO - NOTNLM
OT  - afatinib
OT  - dacomitinib
OT  - epidermal growth factor receptor
OT  - non-small-cell lung cancer
COIS- The authors report a grant from Boehringer Ingelheim. The authors report no other 
      conflicts of interest in this work.
EDAT- 2019/09/10 06:00
MHDA- 2019/09/10 06:01
PMCR- 2019/08/15
CRDT- 2019/09/10 06:00
PHST- 2018/12/21 00:00 [received]
PHST- 2019/05/13 00:00 [accepted]
PHST- 2019/09/10 06:00 [entrez]
PHST- 2019/09/10 06:00 [pubmed]
PHST- 2019/09/10 06:01 [medline]
PHST- 2019/08/15 00:00 [pmc-release]
AID - 198945 [pii]
AID - 10.2147/OTT.S198945 [doi]
PST - epublish
SO  - Onco Targets Ther. 2019 Aug 15;12:6535-6548. doi: 10.2147/OTT.S198945. 
      eCollection 2019.