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 REVIEW ARTICLE
Year : 2017  |  Volume : 54  |  Issue : 5  |  Page : 31-36

Advanced therapeutic options and importance of rebiopsy in epidermal growth factor receptor-tyrosine kinase inhibitor-progressed nonsmall cell lung carcinoma patients: An expert opinion


1 Director, Medical Oncology, Jaslok Hospital & Research centre, Mumbai, India
2 Professor of Medicine and Head Division of Medical Oncology, Birla Cancer Centre, SMS Medical College & Hospital, Jaipur, India
3 Professor, Department of Medical Oncology Christian Medical College & Hospital Vellore, Tamil Nadu, India
4 Consultant, Medical Oncology, Jaslok Hospital and Research Centre, Mumbai, India
5 Professor & Head, Department of Medical Oncology, Amrita Institute of Medical Sciences and Research Center, Cochi, India
6 Consultant, Medical Oncology, Apollo Gleneagles Hospital, Kolkata, India
7 Chief Coordinator-Oncology Services, Medica Super Specialty Hospital, Kolkata, India
8 Assistant Professor, Department of Medicine, Chirayu Medical College & Hospital, Bhopal, India
9 Consultant Oncologist, Department of Oncology and Haematology, Apollo Hospitals International Limited, Ahmedabad, Gujarat, India

Correspondence Address:
Dr. Suresh H Advani
Director, Medical Oncology, Jaslok Hospital & Research centre, Mumbai,
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijc.IJC_520_17

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Advanced nonsmall cell lung cancer (NSCLC) treatment is primarily based on platinum-based chemotherapy. Although epidermal growth factor receptor (EGFR) targeting has shifted the treatment paradigm toward personalized tyrosine kinase inhibitors (TKIs), resistance develops inevitably and EGFR T790M is the most common acquired resistance mechanism. Rebiopsy of resistant NSCLC cases can provide additional information on the underlying resistant mechanisms and therefore can help clinicians in taking better management decisions. An expert panel meeting of renowned cancer oncologists was held to discuss the management of advanced-stage NSCLC. The present paper is based on the recommendations made by the expert panel and is supported by an exhaustive literature search. It was suggested that identification of driver mutation leads to better treatment decisions. TKIs have proven to be better treatment option in EGFR-positive patients as compared to chemotherapy. Third-generation TKIs (osimertinib) promise to bring optimal and improved care for NSCLC cases failing first-line TKI treatment.






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