Nieuwe middelen voor de behandeling van gemetastaseerd niet-kleincellig longcarcinoom: remmers van de epidermale groeifactorreceptor en van de angiogenese

- The recently developed ‘targeted’ therapies, epidermal growth factor receptor (EGFR) inhibitors and angiogenesis inhibitors, target specific tumour characteristics.

- EGFR inhibitors, such as gefitinib and erlotinib, can lead to remission, particularly in non-small cell lung cancer (NSCLC) with specific EGFR mutations. These mutations occur more frequently in Asians, women, non-smokers and those with adenocarcinomas. Other mutations in EGFR and K-ras genes lead to resistance.

- EGFR inhibitors offered no benefit to untreated patients with advanced NSCLC. In previously treated patients, however, erlotinib increased survival by 2 months.

- Optimal patient selection criteria for EGFR inhibitor therapy is still under investigation.

- The angiogenesis inhibitor bevacizumab is an antibody that targets vascular endothelial growth factor receptor. The addition of bevacizumab to chemotherapy increased median survival by 2 months when given as first-line therapy for advanced NSCLC.

- The combination of EGFR and angiogenesis inhibitors is a rational anticancer treatment and is being studied.

- These new therapies are expected to help improve and individualise the treatment of advanced NSCLC.

Ned Tijdschr Geneeskd. 2008;152:928-32