scholarly journals Tyrosine kinase inhibitors for EGFR- and ALK-mutated non-small cell lung cancer

ADMET & DMPK ◽  
2016 ◽  
Vol 4 (3) ◽  
pp. 186
Author(s):  
Jonathan R. Thompson ◽  
Smitha P. Menon ◽  
Grace K. Dy

<p class="ADMETkeywordsheading">Discovery of the epidermal growth receptor (EGFR) activating mutations and anaplastic lymphoma kinase (ALK) rearrangements has expanded the therapeutic landscape in non-small cell lung cancer (NSCLC). Survival outcomes for patients with these mutations have improved dramatically with EGFR and ALK tyrosine kinase inhibitors (TKIs). Multiple generations of EGFR and ALK TKIs have been rapidly developed, and patients and clinicians now have several options for first- and second-line treatments. While these small molecule TKIs have some similarities in therapeutic and pharmacologic profiles, the differences can be clinically substantial, allowing tailored treatment for each unique patient. This review details the clinical efficacy, pharmacology, safety profiles, CNS penetration, and mechanisms of resistance of the four EGFR TKIs and three ALK TKIs that are currently approved by the United States Food and Drug Administration (US FDA).</p>

2019 ◽  
Vol 15 (11) ◽  
pp. 563-570 ◽  
Author(s):  
Vinicius Ernani ◽  
Thomas E. Stinchcombe

Lung cancer is the leading cause of cancer-related death in the United States. Approximately 20% of these patients present with brain metastases (BMs). Surgical resection, stereotactic radiosurgery, and whole-brain radiation therapy have historically been the primary treatment modalities for patients with non–small-cell lung cancer (NSCLC) and BMs. The treatments for BMs have become complex with the discovery of targetable molecular drivers and the development of an astonishing number of tyrosine kinase inhibitors. Many of these tyrosine kinase inhibitors have robust and durable efficacy against CNS metastases. In many circumstances, these drugs can defer local therapy and even reduce the risk of CNS progression. More recently, immune checkpoint inhibitors have changed the treatment landscape for many patients with NSCLC; however, the role of immunotherapy in patients with BMs is the subject of ongoing investigations. This article will review the current data and our approach to patients with NSCLC and BMs.


2018 ◽  
Vol 25 (3) ◽  
pp. 623-637
Author(s):  
Christan M Thomas ◽  
Chung-Shien Lee

The brain is a common metastatic site in lung cancer. Approximately one-third of patients will develop brain metastases during the course of their disease. Median overall survival has been reported between 3 and 14.8 months in patients with brain metastases compared to other metastatic sites. In addition, the lifetime incidence of brain metastases is increasing due to prolonged survival seen in non-small cell lung cancer (NSCLC) patients due to new systemic therapies and improved neuro-imaging techniques. Several targeted therapies—such as tyrosine kinase inhibitors targeting epidermal growth factor receptors and anaplastic lymphoma kinase—are active in NSCLC and have data to suggested possible effectiveness against brain metastases in these patients.


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