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Open Access Review

EGFR inhibition in non-small cell lung cancer: current evidence and future directions

Alexander Chi1*, Scot Remick2 and William Tse3

Author Affiliations

1 Department of Radiation Oncology, West Virginia University, Morgantown, WV, 26506, USA

2 Mary-Babb Randolph Cancer Center, West Virginia University, Morgantown, WV, 26506, USA

3 Department of Hematology and Oncology, West Virginia University, Morgantown, WV, 26506, USA

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Biomarker Research 2013, 1:2  doi:10.1186/2050-7771-1-2

Published: 16 January 2013

Abstract

EGFR inhibition has emerged to be an important strategy in the treatment of non-small cell lung cancer (NSCLC). Small molecule tyrosine kinase inhibitors (TKIs) and mono-clonal antibodies (mAbs) to the EGFR have been tested in multiple large randomized phase III studies alone or combined with chemotherapy, as well as small phase I-II studies which investigated their efficacy as radiosensitizers when combined with radiotherapy. In this review, we described the current clinical outcome after treatment with EGFR TKIs and mAbs alone or combined with chemotherapy in advanced stage NSCLC, as well as the early findings in feasibility/phase I or II studies regarding to whether EGFR TKI or mAb can be safely and effectively combined with radiotherapy in the treatment of locally advanced NSCLC. Furthermore, we explore the potential predictive biomarkers for response to EGFR TKIs or mAbs in NSCLC patients based on the findings in the current clinical trials; the mechanisms of resistance to EGFR inhibition; and the strategies of augmenting the antitumor activity of the EGFR inhibitors alone or when combined with chemotherapy or radiotherapy.

Keywords:
EGFR; NSCLC; EGFR mutations; Radiotherapy; Resistance