Are emerging targeted therapies poised to fill the significant unmet need of patients in the second and subsequent lines of therapy?
Treatment decisions for non-small-cell lung cancer (NSCLC) patients are increasingly based on personalized tumor-specific characteristics. It is now standard practice for patients with advanced NSCLC of nonsquamous-cell—particularly adenocarcinoma—histology to undergo testing for epidermal growth factor receptor (EGFR) mutations. While the first-generation EGFR tyrosine kinase inhibitors (TKIs), erlotinib (Genentech/Roche/Chugai/Astellas’s Tarceva) and gefitinib (AstraZeneca’s Iressa) have revolutionized the first-line treatment of NSCLC (EGFR-mutation-positive; previously treated), no targeted agents are currently approved in the second or subsequent- lines. Consequently, the outcome for patients with NSCLC (EGFR-mutation-positive; previously treated) remains bleak. Going forward, the market is expected to become increasingly competitive following the approval of the targeted second-generation and third-generation EGFR TKIs for NSCLC (EGFR-mutation-positive; previously treated). Despite this development, significant clinical and commercial opportunity remains for therapies that can provide greater survival benefits than current standards of care.