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World J Clin Oncol. Aug 10, 2015; 6(4): 45-56
Published online Aug 10, 2015. doi: 10.5306/wjco.v6.i4.45
Is there a role for epidermal growth factor receptor tyrosine kinase inhibitors in epidermal growth factor receptor wild-type non-small cell lung cancer?
Edurne Arriola, Álvaro Taus, David Casadevall
Edurne Arriola, Álvaro Taus, David Casadevall, Oncology Department, Hospital del Mar, 08003 Barcelona, Spain
Author contributions: The research was designed by Arriola E; Taus A and Casadevall D conducted this work; Arriola E, Taus A and Casadevall D analysed the data; Arriola E, Taus A and Casadevall D wrote the paper.
Conflict-of-interest statement: The authors disclose no potential conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Edurne Arriola, Oncology Department, Hospital del Mar, Passeig Marítim de la Barceloneta, 25-29, 08003 Barcelona, Spain. earriola@parcdesalutmar.cat
Telephone: +34-932-483000 Fax: +34-932-483366
Received: February 20, 2015
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
Abstract

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.

Keywords: Non-small cell lung cancer; Tyrosine kinase inhibitors; Epidermal growth factor receptors

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.