Do tyrosine kinase inhibitors benefit patients with mutant inoperable NSCLC?

This study evaluated whether patients with unresectable non-small-cell lung cancer (NSCLC) having genetic mutations could benefit from first-line treatment with tyrosine kinase inhibitor (TKI) therapy. The data showed that TKIs could be a good option for these patients.

NSCLC is the most common form of lung cancer. NSCLC is responsible for around 85% of all lung cancer diagnoses. Standard treatment for advanced NSCLC involves surgical removal of solid tumors and chemoradiotherapy (CRT). CRT involves administering both chemotherapy (CT) and performing radiation therapy (RT). Tumors that cannot be removed surgically (unresectable) can be difficult to treat. For patients with unresectable tumors, CRT is the standard treatment.

Genetic mutations (abnormalities) in the epidermal growth factor receptor (EGFR) can lead to NSCLC. EGFR helps cancer cells grow and spread faster. EGFR TKIs, such as gefitinib (Iressa) and erlotinib (Tarceva), are drugs used to block the activity of these proteins. TKI is a type of targeted therapy that works by blocking the growth of cancer cells. However, whether patients with unresectable NSCLC and gene mutations could benefit from first-line treatment with TKIs therapy is still unclear.

This study involved 81 patients with unresectable stage III NSCLC who had genetic mutations. All patients received TKI targeted therapy.

The average survival without cancer worsening was 13.87 months. The average overall survival was 41.47 months. 91% of the patients were alive after 1-year, 80.3% were alive after 2-years, 56.1% were alive after 3-years, 45.5% were alive after 4-years and 32.5% were alive after 5-years.

After first-line TKIs therapy, 7 patients (8.6%) were re-evaluated as eligible for surgery and proceeded to surgery. Younger female non-smokers tended to have a better prognosis with longer survival without cancer progression and overall survival.

This study concluded that TKIs could be a good option for patients with mutant stage III unresectable NSCLC.

The sample size was very small and the follow-up time was very short. This study only included patients from 2 institutions in China. This might limit the conclusions.