Tyrosine Kinase Inhibitors for Lung Cancer

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Drug Development".

Deadline for manuscript submissions: 31 December 2024 | Viewed by 4925

Special Issue Editor

Department of Internal Medicine, Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Jeonnam, Republic of Korea
Interests: lung cancer; chronic obstructive pulmonary disease; interstitial lung disease; smoking
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Special Issue Information

Dear Colleagues,

Precision oncology has fundamentally changed the diagnosis and treatment of cancer. Driver mutations are essential for carcinogenesis as well as tumor progression as they confer a selective growth advantage to cancer cells. Identification of driver mutations in growth-related protein kinases, especially tyrosine kinases has led to the clinical development of an array of tyrosine kinase inhibitors (TKIs) in various malignancies, including lung cancer. In recent decades, there has been a significant development in the management of patients with oncogene-addicted advanced-stage non–small cell lung cancer. For example, inhibition of epidermal growth factor receptors and anaplastic lymphoma kinase tyrosine kinases have proven to be of meaningful clinical benefit. An improved understanding of tyrosine kinase biology has also led to faster drug development, identification of resistance mechanisms and ways to overcome resistance.

This Special Issue will highlight the efficacy, toxicity and resistance mechanism of TKIs in patients with lung cancer.

Dr. In-Jae Oh
Guest Editor

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Keywords

  • tyrosine kinase inhibitor
  • driver mutation
  • oncogen addiction
  • epidermal growth factor receptor
  • resistance mechanism

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Published Papers (2 papers)

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Research

15 pages, 2026 KiB  
Article
A Real-World Study of Patient Characteristics and Clinical Outcomes in EGFR Mutated Lung Cancer Treated with First-Line Osimertinib: Expanding the FLAURA Trial Results into Routine Clinical Practice
by Hollis Viray, Andrew J. Piper-Vallillo, Page Widick, Emmeline Academia, Meghan Shea, Deepa Rangachari, Paul A. VanderLaan, Susumu S. Kobayashi and Daniel B. Costa
Cancers 2024, 16(6), 1079; https://doi.org/10.3390/cancers16061079 - 7 Mar 2024
Cited by 2 | Viewed by 2991
Abstract
Osimertinib is a tyrosine kinase inhibitor of the epidermal growth factor receptor (EGFR) that is used for first-line therapy in EGFR mutated non-small cell lung cancer (NSCLC) based on the results of the randomized FLAURA trial (ClinicalTrials.gov number NCT02296125). We performed a retrospective [...] Read more.
Osimertinib is a tyrosine kinase inhibitor of the epidermal growth factor receptor (EGFR) that is used for first-line therapy in EGFR mutated non-small cell lung cancer (NSCLC) based on the results of the randomized FLAURA trial (ClinicalTrials.gov number NCT02296125). We performed a retrospective analysis of baseline characteristics and clinical outcomes in 56 real-world patients treated with osimertinib. In total, 45% of patients were determined to be FLAURA-eligible and 55% were FLAURA-ineligible based on the published inclusion/exclusion criteria of the aforementioned trial. For clinical outcomes, the median osimertinib time to treatment discontinuation (TTD) for all patients was 16.9 months (95% CI: 12.6–35.1), whereas the median TTD was 31.1 months (95% CI: 14.9–not reached) in the FLAURA-eligible cohort and the median TTD was 12.2 months (95% CI: 8.1–34.6 months) in the FLAURA-ineligible cohort. Re-biopsy at acquired resistance disclosed both on- and off-target mechanisms. The most common therapies following osimertinib included local therapies followed by post-progression osimertinib, platinum-doublet chemotherapy with or without osimertinib, and osimertinib combinatory targeted therapies. The median overall survival for all patients was 32.0 months (95% CI: 15.7–not reached), the median survival was not reached for the FLAURA-eligible cohort, and it was 16.5 months for the FLAURA-ineligible cohort. Our data support the use of osimertinib in real-word settings and highlight the need for designing registration trials that are more inclusive of patient/disease characteristics seen in routine clinical practice. It is yet to be determined if the use of evolving first-line EGFR inhibitor combination strategies (either platinum-doublet chemotherapy plus osimertinib or amivantamab plus lazertinib) will similarly translate from clinical trials to real-word settings. Full article
(This article belongs to the Special Issue Tyrosine Kinase Inhibitors for Lung Cancer)
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16 pages, 1540 KiB  
Article
Real-World Treatment Outcomes and Safety of Afatinib in Advanced Squamous Cell Lung Cancer Progressed after Platinum-Based Doublet Chemotherapy and Immunotherapy (SPACE Study)
by Wonjun Ji, In-Jae Oh, Cheol-Kyu Park, Sung Yong Lee, Juwhan Choi, Jae Cheol Lee, Jiwon Kim and Seung Hyeun Lee
Cancers 2023, 15(23), 5568; https://doi.org/10.3390/cancers15235568 - 24 Nov 2023
Viewed by 1443
Abstract
This study aimed to evaluate treatment outcomes and safety of afatinib in patients with squamous cell carcinoma of the lung (LSCC) who progressed after chemotherapy and immunotherapy. We recruited patients both retrospectively and prospectively and collected the outcomes and safety data. Additionally, we [...] Read more.
This study aimed to evaluate treatment outcomes and safety of afatinib in patients with squamous cell carcinoma of the lung (LSCC) who progressed after chemotherapy and immunotherapy. We recruited patients both retrospectively and prospectively and collected the outcomes and safety data. Additionally, we performed next-generation sequencing using tumor tissue and/or plasma to explore potential molecular biomarkers. Altogether, 42 patients were included in the final analysis. The median number of prior treatments was three (range 1–8), and the median TTF was 2.1 months. Objective response rate and disease control rate were 16.2% and 59.5%, respectively, and median duration of response was 4.0 months among response evaluable patients (n = 37). Treatment-related adverse events (TRAEs, including diarrhea, stomatitis, and paronychia) occurred in 22 (52.3%) patients; however, most were grade 2 or lower, and only 5 cases were grade 3. TRAEs led to dose modification in 17 (40.5%) and discontinuation in 4 (9.5%) patients. The TTF in patients with ERBB2 mutations was significantly longer than that in patients without (6.8 vs. 2.1 months, p = 0.045). Our results highlight that afatinib is a reasonable treatment option in terms of effectiveness and safety, and ERBB2 mutation can be used as a predictive biomarker in clinical settings. Full article
(This article belongs to the Special Issue Tyrosine Kinase Inhibitors for Lung Cancer)
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