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A Comparison Between First-, Second- and Third-Generation Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors in Patients with Non-Small-Cell Lung Cancer and Brain Metastases
| Content Provider | MDPI |
|---|---|
| Author | Caponnetto, Salvatore Cantale, Ornella Friedlaender, Alex Gomes, Fabio Daryanani, Sunil Gelibter, Alain Cortellini, Alessio Giuffrida, Dario Addeo, Alfredo Banna, Giuseppe Luigi |
| Copyright Year | 2021 |
| Description | Patients with non-small-cell lung cancer (NSCLC), harboring Epidermal Growth Factor Receptor (EGFR) mutations, are more susceptible to brain metastases (BM). Comparisons of the efficacy of different-generation EGFR-tyrosine kinase inhibitors (TKI) on BMs from NSCLC are currently limited. We identified studies comparing different EGFR-TKIs for NSCLC through Pubmed literature search and selected those with neurological outcome data. By two retrospective analyses, Erlotinib showed longer neurological time-to-progression (30 months vs. 15.8 months, P = 0.024) and reduced the risk of central nervous system (CNS) progression (Hazard Ratio (HR) 0.25; 95% CI, 0.08–0.81; P = 0.021) compared to Gefitinib. In a phase 2b randomized trial, 16% of patients with BMs had a similar Progression Free Survival (PFS) (HR 0.76, 95% CI 0.41–1.44) or Overall Survival (OS) (HR 1.16, 95% CI 0.61–2.21) with Afatinib versus Gefitinib; a lower risk of developing subsequent BMs with Afatinib than Gefitinib (HR 0.49; 95% CI 0.34–0.71; P < 0.001) was reported by a retrospective study. A randomized phase 3 trial proved that patients with BMs treated with Osimertinib had longer PFS (HR 0.47, 95% CI 0.30–0.74) and OS (HR 0.79, 95% CI 0.61–1.01) than with Gefitinib, and lower incidence of CNS progression (6% vs. 15%, respectively). Although there is limited evidence, differences in CNS activity may exist between EGFR-TKIs. |
| e-ISSN | 26735261 |
| DOI | 10.3390/jmp2010001 |
| Journal | Journal of Molecular Pathology |
| Issue Number | 1 |
| Volume Number | 2 |
| Language | English |
| Publisher | MDPI |
| Publisher Date | 2021-01-12 |
| Access Restriction | Open |
| Subject Keyword | Journal of Molecular Pathology Oncology Lung Cancer Egfr Brain Metastases Tyrosine-kinase Inhibitors Tki Third Generation |
| Content Type | Text |
| Resource Type | Article |
