Abstract:
Lung cancer is the leading cause of cancer-related deaths. Although the current incidence of lung cancer is decreasing, the survival rate of patients remains very low. Non-small cell lung cancer (NSCLC) accounts for more than 85% of lung cancer cases. Furthermore, in more than 60% of cases, NSCLC expresses the epidermal growth factor receptor (EGFR). Such mutations are more common in people with lung adenocarcinoma, women, Asians, and people who have never smoked. EGFR has become an important therapeutic target for NSCLC, and several targeted drugs, including small-molecule tyrosine kinase inhibitors (TKIs) and monoclonal antibodies, have been developed. Fourth-generation EGFR-TKIs have also been developed, and the guidelines for diagnosing and treating patients with EGFR-positive NSCLC have been revised. Among all EGFR mutations, point mutations in exon 18 (G719A/C) and exon 21 (L858R and L861Q) and in-frame deletion mutations in exon 19 (Exon19 del) are highly sensitive to TKIs. Exon19 del is the most sensitive of all mutations. Although EGFR-targeted therapy is very effective for advanced NSCLC, almost all patients eventually develop drug-resistant mutations. The most common drug-resistant mutation is the T790M mutation, and other mutations include D761Y, T854A, and L747S. This study reviews the progress of EGFR-targeted therapy in recent years, particularly in the past year.