The Pharmacological Costs of TKIs in First-Line for Advanced NSCLC Patients with Activating EGFR-Mutations: A Review of Pivotal Phase III RCTs

Many driver mutations that determine the malignant behavior of lung cancer have been identified in recent years 1. The epidermal growth factor receptor (EGFR) signaling pathway is crucial for regulating tumorigenesis and cell survival and may be important in the development and progression of non-small cell lung cancer (NSCLC) 2. Activating mutation in exons 19 or 21 of EGFR in NSCLC are associated with increased sensitivity to EGFR-tyrosne kinase inhibitors (TKIs) 3. The 2nd ESMO Consensus Conference on Lung Cancer 3 has recommended that an EGFR TKI is the preferred first-line treatment in patients with EGFR-mutated NSCLC (strength of recommendation: A, level of evidence: I), as demonstrated by several randomised trials, with a superior response rate (RR) and progression free survival (PFS) as well as better Quality of Life (QoL) scores when compared with combination chemotherapy in the first-line setting.

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