AUTHOR=Bulbul Ajaz , Husain Hatim 

TITLE=First-Line Treatment in EGFR Mutant Non-Small Cell Lung Cancer: Is There a Best Option?

JOURNAL=Frontiers in Oncology

VOLUME=8

YEAR=2018

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2018.00094

DOI=10.3389/fonc.2018.00094

ISSN=2234-943X

ABSTRACT=<p>First generation or second generation EGFR tyrosine kinase inhibitors are currently the standard of care for the first-line management of non-small cell lung cancer (NSCLC) patients with activating mutations within the kinase domain of the epidermal growth factor receptor gene (<xref ref-type="bibr" rid="B1">1</xref>, <xref ref-type="bibr" rid="B2">2</xref>). Resistance to targeted therapy can develop after 9–11 months (<xref ref-type="bibr" rid="B3">3</xref>–<xref ref-type="bibr" rid="B8">8</xref>). Third generation inhibitors were developed to target the EGFR T790M clone, which is the most common dominant second site resistance mutation after first or second generation inhibitors. Osimertinib received full FDA approval for the second-line treatment of advanced NSCLC based on a phase III study comparing the compound to chemotherapy. Recent data demonstrates an important impact for osimertinib in the front-line space based on results comparing the compound to first-generation erlotinib or gefitinib therapy.</p>