CONTEÚDO EXCLUSIVO PARA PROFISSIONAIS DE SAÚDE

NO CÂNCER DE PULMÃO, ALGUMAS AMEAÇAS SÃO CONTROLADAS, MAS AS MUTAÇÕES DE INSERÇÃO

DO EGFR NO ÉXON 20 SÃO DIFERENTES1,2

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Os TKIs disponíveis atualmente não são tão efetivos para pacientes com inserção no éxon 20 no CPNPC. Assim, o tratamento desses casos é mais difícil do que o de indivíduos que possuem mutações clássicas.4-8
A sobrevida livre de progressão (SLP) com TKI de 3a geração é de 5 3.6 meses.9
Em pacientes com inserção do EGFR no éxon 20, com tratamento prévio com platina ou TKI de 1a e 2a geração
Nem a quimioterapia e tampouco os TKIs oferecem benefícios duradouros aos pacientes com éxon 20 do EGFR.10-14
A taxa de resposta objetiva (TRO) com TKI de 3a geração é de 5% em pacientes com mutação de inserção do éxon 20 com tratamento prévio com platina.9

*EGFR = receptor do fator de crescimento epidérmico; TKI = inibidor da tirosina quinase; CPNPC = Câncer de Pulmão de Não Pequenas Células.

 

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Referencias:
1. Goldberg ME et al. Multiple configurations of EGFR exon 20 resistance mutations after first- and third generation EGFR TKI treatment affect treatment options in NSCLC. PLoS ONE 13(11): e0208097. 2. Hasako S et al. TAS6417, A Novel EGFR Inhibitor Targeting Exon 20 Insertion Mutations. Mol Cancer Ther; 17(8); 1648–58. 3. Hasegawa H et al. Efficacy of afatinib or osimertinib plus cetuximab combination therapy for non-small-cell lung cancer with EGFR exon 20 insertion mutations. Lung Cancer. 2019;127:146-52. 4. Robichaux JP, Elamin Y Y, Tan Z , et al. Mechanisms and clinical activity of an EGFR and HER2 exon 20-selective kinase inhibitor in non-small cell lung cancer. Nat Med. 2018; 24(5):638-646. doi:10.1038/s41591-018-0007-9. 5. Arcila ME , Nafa K , Chaft JE , et al. EGFR exon 20 insertion mutations in lung adeno carcinomas: prevalence, molecular heterogeneity, and clinicopathologic characteristics. Mol Cancer Ther. 2013;12(2): 2 20 229. doi:10.1158/1535-7163.MC T-12.0620. 6. Oxnard GR , Lo PC , Nishino M, et al. Natural history and molecular characteristics of lung cancers harboring EGFR exon 20 insertions. J Thorac Oncol. 2013;8(2):179-184. doi:10.1097/JTO.0b013e31827 79d18. 7. Naidoo J, Sima C , Rodriguez K , et al. Epidermal growth factor receptor exon 20 insertions in advanced lung adenocarcinomas: clinical outcomes and response to erlotinib. Cancer. 2015;121(18):3212–3220. doi:10.1002/cncr.29493. 8. C hen D, Song Z , Cheng G. Clinical efficacy of first- generation EGFR-TKIs in patients with advanced non-small-cell lung cancer harboring EGFR exon 20 mutations. Onco Targets Ther. 2016;9:4181-4186. 9. van Veggel B et al. Osimertinib treatment for patients with EGFR exon 20 mutation positive non-small cell lung cancer. Lung Cancer. 2020 Mar;141:9-13. 10. Wang Y, Yang G, Li J, Xu H, Yang L, Xu F, et al. Real-world treatment outcome of advanced Chinese NSCLC EGFR exon 20 insertion patients. Abstract presented at: American Society of Clinical Oncology Annual Meeting; May 31, 2019; Chicago, Illinois, USA. 11. Zhou Y, Chen C, Zhang X, Fu S, Xue C, Ma Y, et al. Immune-checkpoint inhibitor plus chemotherapy versus conventional chemotherapy for first-line treatment in advanced non-small cell lung carcinoma: a systematic review and meta-analysis. J Immunother Cancer. 2018;6(1):155. 12. Girard N, Bazhenova L, Minchom A, Ou SI, Gadgeel SM, Trigo J, et al. Comparative clinical outcomes for patients with NSCLC harboring EGFR exon 20 insertion mutations and common EGFR mutations. Abstract presented at: World Conference on Lung Cancer Annual Meeting; January 29, 2021; Singapore. 13. Cardona AF, Rojas L, Zatarain-Barron ZL, Freitas HC, Granados ST, Castillo O, et al. EGFR exon 20 insertion in lung adenocarcinomas among Hispanics (Geno1.2-CLICaP). Lung Cancer. 2018;125:265-272. 14. Lee CK, Man J, Lord S, Cooper W, Links M, Gebski V, et al. Clinical and molecular characteristics associated with survival among patients treated with checkpoint inhibitors for advanced non-small cell lung carcinoma: A Systematic Review and Meta-analysis. JAMA Oncol. 2018;4(2):210-216.

Material destinado a prescritores e/ou dispensadores de medicamentos. Produzido em Abril de 2021.