Is EGFR Tyrosine Kinase Inhibitor Better Than Traditional Chemotherapy to Treat Non-Small Cell Lung Cancer

Yang, Yufang, and Joyce Conley

Statement of the Problem

Lung cancer is the leading cause of cancer deaths in the world. In 2005, lung cancer killed about 1.3 million people worldwide. Of all types of lung cancer, non-small cell lung cancer is the most common, accounting for about 80% of all lung cancers. Despite treatments, such as chemotherapy, surgery, and radiation therapy, median survival for Americans with non-small cell lung cancer is only 8–10 months. New drugs that inhibit epidermal growth factor receptor tyrosine kinase signaling pathway (EGFR TKIs) were developed later. The purpose of this literature review was to analyze and compare the effectiveness between EGFR-TI and a traditional chemotherapy, platinum-based compounds, in non-small cell lung cancer.

Clinical Question

In non-small cell lung cancer patients, what is the effect of tyrosine kinase inhibitor on one-year survival rate compared with traditional chemotherapy?

Search for Evidence/Accepted Practice

MEDLINE search was carried out to obtain papers by using primary subject headings including survival, non-small cell lung cancer, tyrosine kinase inhibitor, first line chemotherapy. Six papers were found based on a limited search. Keywords such as such as clinical trial, Meta-Analysis, Practice Guidelines, and Randomized Controlled Trial were used to limit search.

Presentation and Critical Appraisal of the Evidence

The data derived from randomized controlled clinical trials showed that EGFR tyrosine kinase inhibitor could significantly prolong survival in non-small cell lung cancer patients who failed to respond to first-line treatment. One year survival was prolonged by 41%.

Retrospective studies were employed in two papers. Due to the small sample size, more evidences are needed. Clinical Practice Implications: EGFR tyrosine kinase inhibitor is an effective drug to prolong survival in patients with advanced non small cell lung cancer as a second line treatment.