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Front Oncol. 2018 Apr 10;8:94. doi: 10.3389/fonc.2018.00094. eCollection 2018.

First-Line Treatment in EGFR Mutant Non-Small Cell Lung Cancer: Is There a Best Option?

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Department of Hematology/Oncology, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX, United States.
Division of Hematology Oncology, Kymera Independent Physicians, Roswell, Carlsbad, Hobbs, NM, United States.
University of California San Diego, Moores Cancer Center, La Jolla, CA, United States.


First generation or second generation EGFR tyrosine kinase inhibitors are currently the standard of care for the first-line management of non-small cell lung cancer (NSCLC) patients with activating mutations within the kinase domain of the epidermal growth factor receptor gene (1, 2). Resistance to targeted therapy can develop after 9-11 months (3-8). Third generation inhibitors were developed to target the EGFR T790M clone, which is the most common dominant second site resistance mutation after first or second generation inhibitors. Osimertinib received full FDA approval for the second-line treatment of advanced NSCLC based on a phase III study comparing the compound to chemotherapy. Recent data demonstrates an important impact for osimertinib in the front-line space based on results comparing the compound to first-generation erlotinib or gefitinib therapy.


afatinib; epidermal growth factor receptor; erlotinib; gefitinib; lung cancer; osimertinib; targeted therapy

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