Published online Aug 10, 2015. doi: 10.5306/wjco.v6.i4.45
Peer-review started: February 22, 2015
First decision: April 20, 2015
Revised: May 8, 2015
Accepted: June 4, 2015
Article in press: June 8, 2015
Published online: August 10, 2015
Processing time: 177 Days and 18.1 Hours
Non-small cell lung cancer (NSCLC) is the most common type of lung cancer with a world-wide annual incidence of around 1.3 million. The majority of patients are diagnosed with advanced disease and survival remains poor. However, relevant advances have occurred in recent years through the identification of biomarkers that predict for benefit of therapeutic agents. This is exemplified by the efficacy of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors for the treatment of EGFR mutant patients. These drugs have also shown efficacy in unselected populations but this point remains controversial. Here we have reviewed the clinical data that demonstrate a small but consistent subgroup of EGFR wild-type patients with NSCLC that obtain a clinical benefit from these drugs. Moreover, we review the biological rationale that may explain this benefit observed in the clinical setting.
Core tip: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors are well established as the treatment of choice in EGFR-mutant non-small cell lung cancer. However, they are approved and have shown efficacy in patients with wild-type disease. Here, we review the clinical data showing this consistent benefit in a subgroup of patients and the potential biological mechanisms of this clinical effect.