Der Einsatz von Tyrosinkinase-Inhibitoren bei aktivierenden EGFR-Mutationen in der Erstlinientherapie beim fortgeschrittenen nicht-kleinzelligen Lungenkarzinom (NSCLC) – aktueller Stand und Entwicklungen

R. Wiewrodt; M. Serke; C. Grohé; W. Brückl

doi:10.1055/s-0033-1344337

Pneumologie 2013; 67(09): 494-501
DOI: 10.1055/s-0033-1344337

Übersicht

Der Einsatz von Tyrosinkinase-Inhibitoren bei aktivierenden EGFR-Mutationen in der Erstlinientherapie beim fortgeschrittenen nicht-kleinzelligen Lungenkarzinom (NSCLC) – aktueller Stand und Entwicklungen

Employing Tyrosine Kinase Inhibitors in the First Line Treatment of EGFR-Positive Metastatic NSCLC – State of the Art and Recent Developments

R. Wiewrodt

¹Klinik und Poliklinik für Innere Medizin A (Hämatologie, Onkologie und Pneumologie) Universitätsklinikum Münster

,

M. Serke

²Lungenklinik Hemer

,

C. Grohé

³Evangelische Lungenklinik Berlin

,

W. Brückl

⁴Med. Klinik 3, Klinikum Nürnberg

› Author Affiliations

Abstract

Zusammenfassung

In diesem Artikel präsentieren wir einen Überblick über die aktuellen Entwicklungen im Bereich der EGFR-TKI beim Lungenkarzinom. Neben den etablierten Substanzen Erlotinib und Gefitinib liegt der Fokus auf klinischen Daten zu den irreversiblen TKI der zweiten Generation wie Afatinib, Dacomitinib, Neratinib, Pelitinib und Canertinib, die nicht nur den EGF-Rezeptor blockieren, sondern sich durch ein breiteres Wirkspektrum auszeichnen. Auch Anwendungen von aus anderen Indikationen bekannten und dort zugelassenen TKI wie Lapatinib und Vandetanib bei NSCLC werden beleuchtet. Ein wichtiger Aspekt in der Behandlung mit TKI ist neben den reinen Überlebensdaten der Erhalt der Lebensqualität der Patienten, der bei der Wahl der Therapie mit berücksichtigt werden sollte.

Abstract

In this review article we present an overview of recent developments in EGFR TKIs in lung cancer therapy. Besides the approved drugs erlotinib and gefitinib, clinical data on second-generation irreversible TKIs including afatinib, dacomitinib, neratinib, pelitinib, and canertinib are mentioned; these drugs not only inactivate EGFR but show a broader range of activity. We also report on NSCLC data of TKI that are known and approved in other indications, such as lapatinib and vandetanib. We stress the importance of quality of life in the treatment of patients with TKIs, an important aspect of the treatment that should also be considered in the selection of the appropriate NSCLC therapy in advanced stages.

Full Text

References

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