EGFR-mutated stage IV non-small cell lung cancer: What is the role of radiotherapy combined with TKI? - PubMed
Source : https://pubmed.ncbi.nlm.nih.gov/34374490/
Lung cancer is the leading cause of cancer-related death globally and poses a considerable threat to public health. Asia has the highest prevalence of epidermal growth factor receptor (EGFR) mutations in patients with non-small cell lung cancer (NSCLC). Despite the reasonable response and prolonged ...
• Conclusion/Relevance: “This review focuses on these key issues, and provides a flow diagram with proposed treatment options for metastatic EGFRm NSCLC, aiming to provide guidance for clinical practice.”
• The use of radiotherapy (RT) in EGFR-mutated (EGFRm) stage IV NSCLC requires elucidation. Such clarification is particularly important in the context of next-generation TKIs [tyrosine kinase inhibitors], which are more powerful and demonstrate higher central nervous system activity. Important factors include timing, site, dose, fraction, and combination with TKI.
• Radiotherapy involving primary and metastatic lesions could prolong OS and PFS in oligometastatic cases.
• In the oligometastatic setting, RT to both primary and metastatic lesions could prolong both PFS and OS. Promising strategies include reduced-dose thoracic radiotherapy and critical restriction of the mean lung dose before TKI resistance onset. Even though EGFR TKIs can synergize with RT, this combination should be approached gingerly due to the risk of lung damage and other adverse effects.