First- and second-line treatment of non-small-cell lung cancer patients with EGFR mutation-positive tumors

EGFR is a mediator of cell proliferation and is targeted by EGFR tyrosine kinase inhibitors (TKIs) to treat non-small-cell lung cancer (NSCLC). Efficacy of EGFR TKIs (specifically erlotinib and gefitinib) is influenced by mutations in EGFR. We review the evidence for targeted use of EGFR TKIs in the first-line treatment of EGFR mutation- positive NSCLC, considering epidemiology and timing/methodology of diagnosis. First- and second-generation TKIs, and other investigational drugs, also have a role in the second-line treatment of EGFR mutation-positive NSCLC; we discuss this in the context of disease progression and drug resistance. Patients with EGFR mutation-positive tumors should be considered as a separate subpopulation within NSCLC, which is the first step towards individualized treatment of this disease.