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Novel small molecule EGFR inhibitors as candidate drugs in non-small cell lung cancer

Authors Berardi R , Santoni M, Morgese F, Ballatore Z, Savini A, Onofri A, Mazzanti P, Pistelli M, Pierantoni C, De Lisa M, Caramanti M, Pagliaretta S, Pellei C, Cascinu S

Received 4 December 2012

Accepted for publication 17 February 2013

Published 21 May 2013 Volume 2013:6 Pages 563—576

DOI https://doi.org/10.2147/OTT.S28155

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

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Rossana Berardi, Matteo Santoni, Francesca Morgese, Zelmira Ballatore, Agnese Savini, Azzurra Onofri, Paola Mazzanti, Mirco Pistelli, Chiara Pierantoni, Mariagrazia De Lisa, Miriam Caramanti, Silvia Pagliaretta, Chiara Pellei, Stefano Cascinu

Medical Oncology Unit, Universita Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I – GM Lancisi – G Salesi, Ancona, Italy

Abstract: In the last decade, better understanding of the role of epidermal growth factor receptor in the pathogenesis and progression of non-small cell lung cancer has led to a revolution in the work-up of these neoplasms. Tyrosine kinase inhibitors, such as erlotinib and gefitinib, have been approved for the treatment of non-small cell lung cancer, demonstrating an improvement in progression-free and overall survival, particularly in patients harboring activating EGFR mutations. Nevertheless, despite initial responses and long-lasting remissions, resistance to tyrosine kinase inhibitors invariably develops, most commonly due to the emergence of secondary T790M mutations or to the amplification of mesenchymal–epithelial transition factor (c-Met), which inevitably leads to treatment failure. Several clinical studies are ongoing (http://www.clinicaltrials.gov/), aimed to evaluate the efficacy and toxicity of combined approaches and to develop novel irreversible or multitargeted tyrosine kinase inhibitors and mutant-selective inhibitors to overcome such resistance. This review is an overview of ongoing Phase I, II, and III trials of novel small molecule epidermal growth factor receptor inhibitors and combinations in non-small cell lung cancer patients.

Keywords: clinical trials, combined targeted therapy, epidermal growth factor receptor, non-small cell lung cancer, novel targeted agents, tyrosine kinase inhibitors

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