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Editorial |

Adjuvant Epithelial Growth Factor Receptor Tyrosine Kinase Inhibitors in Lung Cancer: Yes, No, Maybe So?

Mellar P. Davis, MD, FCCP; Vamsidhar Velcheti, MD; Nathan A. Pennell, MD
Author and Funding Information

FINANCIAL/NONFINANCIAL DISCLOSURES: V. V. is on the advisory board of Clovis Inc and serves as a consultant for Foundation Medicine, Novartis. N. A. P. has served as a consultant for AstraZeneca and Boehringer Ingelheim. None declared (M. P. D.).

CORRESPONDENCE TO: Mellar P. Davis, MD, FCCP, Cleveland Clinic Taussig Cancer Institute, 9500 Euclid Ave, T34, Cleveland, OH 44195


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;149(6):1357-1359. doi:10.1016/j.chest.2016.01.032
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Dr Huang et al performed a systematic review of adjuvant epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) in resected lung cancer. The studies largely comprised patients unselected for sensitive tyrosine kinase mutations (exon 19 deletions and point mutations replacing leucine for arginine at codon 858 in exon 21 [L858R]), and the trials had significant heterogeneity that limited conclusions. Patients receiving adjuvant TKIs (erlotinib or gefitinib) had a disease-free survival (DFS) benefit of 3% at 3 years, and benefits were greater for those receiving ≥ 18 months of TKI therapy. Overall survival was not improved. In the subset with sensitizing EGFR mutations, there was a DFS benefit of 9.5% at 3 years, with evidence of reduced distant relapse (hazard ratio, 0.71 [95% CI, 0.56-0.92]).

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