INTRODUCTION: This systematic review addresses the use of @entity470 ( @entity470 ) inhibitors in three populations of advanced @entity1149 ( @entity1149 ) @entity1 -unselected, selected, and molecularly selected-in three treatment settings: first line, second line, and maintenance. METHODS: Ninety-six randomized controlled trials found using the medline and embase databases form the basis of this review. RESULTS: In the first-line setting, data about the efficacy of @entity470 @entity4149 kinase inhibitors (tkis) compared with @entity902 -based chemotherapy are inconsistent. Results from studies that selected @entity1 based on clinical characteristics are also mixed. There is high-quality evidence that an egfrtki is preferred over a @entity902 doublet as initial therapy for @entity1 with an activating mutation of the @entity470 gene. The egfrtkis are associated with a higher likelihood of response, longer progression-free survival, and improved quality of life. Multiple trials of second-line therapy have compared an egfrtki with chemotherapy. Meta-analysis of those data demonstrates similar progression-free and overall survival. There is consequently no preferred sequence for second-line egfrtki or second-line chemotherapy. The egfrtkis have also been evaluated as switch-maintenance therapy. No molecular marker could identify @entity1 in whom a survival benefit was not observed; however, the magnitude of the benefit was modest. CONCLUSIONS: Determination of @entity470 mutation status is essential to making appropriate treatment decisions in @entity1 with @entity1149 . @entity1 who are @entity470 mutation-positive should be treated with an egfrtki as first-line therapy. An egfrtki is still appropriate therapy in @entity1 who are @entity470 wild-type, but the selected agent should be administered as second- or third-line therapy.

Use of the XXXX inhibitors gefitinib, erlotinib, afatinib, dacomitinib, and icotinib in the treatment of @entity1149 : a systematic review.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity470 :: ('1956', 'Gene') :: ['egfr', 'EGFR', 'epidermal growth factor receptor'] @entity1149 :: ('MESH:D002289', 'Disease') :: ['non-small-cell lung cancer', 'nsclc'] @entity4149 :: ('D014443', 'Chemical') :: ['tyrosine'] @entity902 :: ('MESH:D010984', 'Chemical') :: ['platinum']
@entity470 :: (1956,Gene) :: ['epidermal growth factor receptor']
