Retos y avances del cáncer de pulmón de células no pequeñas metastásico EGFR mutado: Challenges and advances in metastatic non-small cell lung cancer with mutated EGFR

Melanie Castro-Mollo; Rossana Ruiz; Katia Roque; Luis Mas

doi:10.25176/RFMH.v24i2.6441

Authors

Melanie Castro-Mollo Universidad San Martín de Porres. Lima, Perú. Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú
Rossana Ruiz Oncosalud – AUNA. Lima, Perú. Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú.
Katia Roque Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú.
Luis Mas Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú. Universidad Peruana Cayetano Heredia. Lima, Perú.

DOI:

https://doi.org/10.25176/RFMH.v24i2.6441

Keywords:

Seleccionado:Epidermal growth factor receptor, Non-small cell Lung cancer, Tyrosine kinase inhibitors.

Abstract

Tyrosine kinase inhibitors have dramatically changed the clinical outcomes for patients with advanced non-small cell lung cancer with epidermal growth factor receptor mutations. However, there are still challenges in the management of patients with this mutation in a metastatic setting, such as intrinsic and acquired resistance to tyrosine kinase inhibitors. We will discuss the latest advances and new strategies in first-line treatment, osimertinib resistance, and exon 20 mutation treatment.

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References

Kratzer TB, Bandi P, Freedman ND, Smith RA, Travis WD, Jemal A, et al. Lung cancer statistics, 2023. Cancer. 2024 Disponible en: https://acsjournals.onlinelibrary.wiley.com/doi/abs/10.1002/cncr.35128

Cancer Today [Internet]. [cited 2024 Mar 12]. Disponible en: https://gco.iarc.fr/today/en

Thai AA, Solomon BJ, Sequist LV, Gainor JF, Heist RS. Lung cancer. Lancet Lond Engl. 2021 Aug 7;398(10299):535–54. Disponible: https://pubmed.ncbi.nlm.nih.gov/34273294/

Ruiz R, Galvez-Nino M, Poquioma E, Limache-García A, Amorin E, Olivera M, et al. Lung Cancer in Peru. J Thorac Oncol. 2020 Jun 1;15(6):891–8. Disponible en: https://www.jto.org/article/S1556-0864(20)30058-7/fulltext

Gazdar AF. Activating and resistance mutations of EGFR in non-small-cell lung cancer: role in clinical response to EGFR tyrosine kinase inhibitors. Oncogene. 2009 Aug;28(1):S24–31. Disponible en: https://www.nature.com/articles/onc2009198

Stockhammer P, Grant M, Wurtz A, Foggetti G, Expósito F, Gu J, et al. Co-Occurring Alterations in Multiple Tumor Suppressor Genes Are Associated With Worse Outcomes in Patients With EGFR-Mutant Lung Cancer. J Thorac Oncol. 2024 Feb 1;19(2):240–51. Disponible en: https://pubmed.ncbi.nlm.nih.gov/37806385/

Howlader N, Forjaz G, Mooradian MJ, Meza R, Kong CY, Cronin KA, et al. The Effect of Advances in Lung-Cancer Treatment on Population Mortality. N Engl J Med. 2020 Aug 13;383(7):640–9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32786189/

Galvez-Nino M, Ruiz R, Roque K, Coanqui O, Valdivieso N, Olivera M, et al. Real-world outcomes of anti-EGFR therapy in advanced non–small cell lung cancer EGFR mutated in Peru. Thorac Cancer. 2023;14(1):61–7. Disponible en: https://pubmed.ncbi.nlm.nih.gov/36369763/

Overall Survival with Osimertinib in Untreated, EGFR-Mutated Advanced NSCLC | NEJM [Internet]. [cited 2024 Mar 12]. Disponible en: https://www.nejm.org/doi/full/10.1056/NEJMoa1913662

Passaro A, Jänne PA, Mok T, Peters S. Overcoming therapy resistance in EGFR-mutant lung cancer. Nat Cancer. 2021 Apr;2(4):377–91. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35122001/

Lu S, Dong X, Jian H, Chen J, Chen G, Sun Y, et al. AENEAS: A Randomized Phase III Trial of Aumolertinib Versus Gefitinib as First-Line Therapy for Locally Advanced or MetastaticNon-Small-Cell Lung Cancer With EGFR Exon 19 Deletion or L858R Mutations. J Clin Oncol Off J Am Soc Clin Oncol. 2022 Sep 20;40(27):3162–71. Disponible en: https://pubmed.ncbi.nlm.nih.gov/35580297/

Cho BC, Ahn MJ, Kang JH, Soo RA, Reungwetwattana T, Yang JCH, et al. Lazertinib Versus Gefitinib as First-Line Treatment in Patients With EGFR-Mutated Advanced Non-Small-Cell Lung Cancer: Results From LASER301. J Clin Oncol Off J Am Soc Clin Oncol. 2023 Sep 10;41(26):4208–17. Disponible en: https://pubmed.ncbi.nlm.nih.gov/37379502/

Mok TS, Wu YL, Thongprasert S, Yang CH, Chu DT, Saijo N, et al. Gefitinib or Carboplatin–Paclitaxel in Pulmonary Adenocarcinoma. N Engl J Med. 2009 Sep 3;361(10):947–57. Disponible en: https://pubmed.ncbi.nlm.nih.gov/19692680/

Moore S, Wheatley-Price P. EGFR Combination Therapy Should Become the New Standard First-Line Treatment in Advanced EGFR-Mutant NSCLC. J Thorac Oncol. 2021 Nov 1;16(11):1788–92. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34716002/

Puri N, Salgia R. Synergism of EGFR and c-Met pathways, cross-talk and inhibition, in non-small cell lung cancer. J Carcinog. 2008;7:9. Disponible en: https://pubmed.ncbi.nlm.nih.gov/19240370/

Cho BC, Simi A, Sabari J, Vijayaraghavan S, Moores S, Spira A. Amivantamab, an Epidermal Growth Factor Receptor (EGFR) and Mesenchymal-epithelial Transition Factor (MET) Bispecific Antibody, Designed to Enable Multiple Mechanisms of Action and Broad Clinical Applications. Clin Lung Cancer. 2023 Mar 1;24(2):89–97. Disponible en: https://pubmed.ncbi.nlm.nih.gov/36481319/

Planchard D, Jänne PA, Cheng Y, Yang JCH, Yanagitani N, Kim SW, et al. Osimertinib with or without Chemotherapy in EGFR-Mutated Advanced NSCLC. N Engl J Med. 2023 Nov 23;389(21):1935–48. Disponible en: https://pubmed.ncbi.nlm.nih.gov/37937763/

Lu S, Cho BC, Lee JS, Lee SH, Danchaivijitr P, Liu B, et al. LBA10 Amivantamab plus lazertinib vs osimertinib as first-line treatment among Asian patients with EGFR-mutated, advanced non-small cell lung cancer (NSCLC): MARIPOSA subgroup analysis. Ann Oncol. 2023 Nov 1;34:S1661. Disponible en: https://www.annalsofoncology.org/article/S0923-7534(23)04788-9/fulltext

Wu Q, Luo W, Li W. First-Generation EGFR-TKI Plus Chemotherapy Versus EGFR-TKI Alone as First-Line Treatment in Advanced NSCLC With EGFR Activating Mutation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Oncol [Internet]. 2021 Apr 13 [cited 2024 Mar 11];11. Disponible en: https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.598265/full

Noronha V, Patil VM, Joshi A, Menon N, Chougule A, Mahajan A, et al. Gefitinib Versus Gefitinib Plus Pemetrexed and Carboplatin Chemotherapy in EGFR-Mutated Lung Cancer. J Clin Oncol Off J Am Soc Clin Oncol. 2020 Jan 10;38(2):124–36. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31411950/

Hosomi Y, Morita S, Sugawara S, Kato T, Fukuhara T, Gemma A, et al. Gefitinib Alone Versus Gefitinib Plus Chemotherapy for Non-Small-Cell Lung Cancer With Mutated Epidermal Growth Factor Receptor: NEJ009 Study. J Clin Oncol Off J Am Soc Clin Oncol. 2020 Jan 10;38(2):115–23. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31411950/

Saito H, Fukuhara T, Furuya N, Watanabe K, Sugawara S, Iwasawa S, et al. Erlotinib plus bevacizumab versus erlotinib alone in patients with EGFR-positive advanced non-squamous non-small-cell lung cancer (NEJ026): interim analysis of an open-label, randomised, multicentre, phase 3 trial. Lancet Oncol. 2019 May;20(5):625–35. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30975627/

Leonetti A, Sharma S, Minari R, Perego P, Giovannetti E, Tiseo M. Resistance mechanisms to osimertinib in EGFR-mutated non-small cell lung cancer. Br J Cancer. 2019 Oct;121(9):725–37. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31564718/

Chee-Seng Tan, Gilligan D, Pacey S. Treatment approaches for EGFR-inhibitor-resistant patients with non-small-cell lung cancer. Lancet Oncol. 2015 Sep 1;16(9):e447–59. Disponible en: https://pubmed.ncbi.nlm.nih.gov/26370354/

Bronte G, Belloni A, Calabrò L, Crinò L. The great need to overcome osimertinib resistance in advanced non-small cell lung cancer: from combination strategies to fourth-generation tyrosine kinase inhibitors. Front Oncol [Internet]. 2023 [cited 2024 Mar 12];13. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10803613/

Shu CA, Goto K, Ohe Y, Besse B, Lee SH, Wang Y, et al. Amivantamab and lazertinib in patients with EGFR-mutant non–small cell lung (NSCLC) after progression on osimertinib and platinum-based chemotherapy: Updated results from CHRYSALIS-2. J Clin Oncol. 2022 Jun;40(16_suppl):9006–9006. Disponible en: https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/101802

Passaro A, Wang J, Wang Y, Lee SH, Melosky B, Shih JY, et al. Amivantamab plus chemotherapy with and without lazertinib in EGFR-mutant advanced NSCLC after disease progression on osimertinib: primary results from the phase III MARIPOSA-2 study☆. Ann Oncol. 2024 Jan 1;35(1):77–90. Disponible en: https://www.sciencedirect.com/science/article/pii/S0923753423042813

Meador CB, Sequist LV, Piotrowska Z. Targeting EGFR Exon 20 Insertions in Non-Small Cell Lung Cancer: Recent Advances and Clinical Updates. Cancer Discov. 2021 Sep;11(9):2145–57. Disponible en: https://pubmed.ncbi.nlm.nih.gov/34301786/

Zhou C, Tang KJ, Cho BC, Liu B, Paz-Ares L, Cheng S, et al. Amivantamab plus Chemotherapy in NSCLC with EGFR Exon 20 Insertions. N Engl J Med. 2023 Nov 30;389(22):2039–51. Disponible en: https://pubmed.ncbi.nlm.nih.gov/37870976/

Low JL, Lim SM, Lee JB, Cho BC, Soo RA. Advances in the management of non-small-cell lung cancer harbouring EGFR exon 20 insertion mutations. Ther Adv Med Oncol. 2023 Jan 27;15:17588359221146131. Disponible en: https://pubmed.ncbi.nlm.nih.gov/36756143/