Cited by 163Lung Cancer Treatments and MutationsHER2/EGFR in Cancer ResearchPharmacogenetics and Drug Metabolism

Oral epidermal growth factor receptor tyrosine kinase inhibitors for the treatment of non-small cell lung cancer: Comparative pharmacokinetics and drug–drug interactions

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Peters, Solange, Zimmermann, Stefan, Adjei, Alex A.·2014·Cancer Treatment Reviews

Abstract

The development of orally active small molecule inhibitors of the epidermal growth factor receptor (EGFR) has led to new treatment options for non-small cell lung cancer (NSCLC). Patients with activating mutations of the EGFR gene show sensitivity to, and clinical benefit from, treatment with EGFR tyrosine kinase inhibitors (EGFR-TKls). First generation reversible ATP-competitive EGFR-TKls, gefitinib and erlotinib, are effective as first, second-line or maintenance therapy. Despite initial benefit, most patients develop resistance within a year, 50-60% of cases being related to the appearance of a T790M gatekeeper mutation. Newer, irreversible EGFR-TKls - afatinib and dacomitinib - covalently bind to and inhibit multiple receptors in the ErbB family (EGFR, HER2 and HER4). These agents have been mainly evaluated for first-line treatment but also in the setting of acquired resistance to first-generation EGFR-TKls. Afatinib is the first ErbB family blocker approved for patients with NSCLC with activating EGFR mutations; dacomitinib is in late stage clinical development. Mutant-selective EGFR inhibitors (AZD9291, CO-1686, HM61713) that specifically target the T790M resistance mutation are in early development. The EGFR-TKIs differ in their spectrum of target kinases, reversibility of binding to EGFR receptor, pharmacokinetics and potential for drug-drug interactions, as discussed in this review. For the clinician, these differences are relevant in the setting of polymedicated patients with NSCLC, as well as from the perspective of innovative anticancer drug combination strategies.

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Crossref · 10.1016/j.ctrv.2014.06.010

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Authors
Peters, S., Zimmermann, S., & Adjei, A. A.
Affiliations
  • Centre Hospitalier Universitaire Vaudois (CH)
  • Roswell Park Comprehensive Cancer Center (US)
Corresponding author
Peters, Solange
Venue
Cancer Treatment Reviews
Publisher
Elsevier BV
Published
2014-09
Volume
40
Issue
8
Pages
917-926
ISSN
0305-7372 (ISSN-L)
OpenAlex
W2097781997
Cited by
155
References
115
Citations by year
2026: 5 · 2025: 10 · 2024: 10 · 2023: 9 · 2022: 14 · 2021: 12 · 2020: 10 · 2019: 24 · 2018: 10 · 2017: 18 · 2016: 16 · 2015: 16 · 2014: 1
FWCI
13.64
Type
journal article
Language
en
Open access
Locations
  • Cancer Treatment Reviews (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • IRIS (submittedVersion)
  • SERVAL (Université de Lausanne) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
  • Health Sciences › Medicine › Oncology › HER2/EGFR in Cancer Research
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacogenetics and Drug Metabolism
Keywords
EGFR tyrosine kinase inhibitors, non-small cell lung cancer, gefitinib, erlotinib, afatinib, dacomitinib, T790M mutation, acquired drug resistance, pharmacokinetics, drug-drug interactions, ErbB family, mutant-selective inhibitors, oral anticancer drugs, combination therapy
MeSH terms
Administration, Oral, Carcinoma, Non-Small-Cell Lung, Drug Interactions, Humans, Lung Neoplasms, Protein Kinase Inhibitors, ErbB Receptors

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