EGFR-targeted treatments: insights from the adjuvant to the resistant setting
Approximately 20 % to 25 % of non–small-cell lung cancer (NSCLC) patients are eligible for surgical resection with curative intent . To date, cisplatin-based chemotherapy constitutes the adjuvant standard of care for patients with stage II-IIIA completely resected NSCLC. The first-generation EGFR tyrosine kinase inhibitor (TKI) gefitinib is used as standard first-line treatment in patients with advanced EGFR-mutant NSCLC. Gefitinib showed promising results as an adjuvant strategy in the phase III ADJUVANT trial. ADJUVANT was the first prospective randomised study to compare gefitinib with vinorelbine plus cisplatin in patients with completely resected stage II-IIIA (N1/N2) EGFR-mutant NSCLC . In all, 220 patients were randomised to either gefitinib 250 mg/d for 24 months or vinorelbine plus cisplatin every 3 weeks for up to 4 cycles.