Abstract
Non-small cell lung carcinoma (NSCLC) is a genetically non-homogeneous group of tumours, and this genetic variation leads to individualized treatment based on predictive factors that predict treatment efficacy. One of the predictive factors in the treatment of NSCLC are the activation EGFR (epidermal growth factor receptor) mutations, in which case a treatment by EGFR tyrosine kinase inhibitors (EGFR-TKIs) is indicated.
Currently, we have three generations of these products. Even with this treatment, however, we must expect the emergence of resistance.
Mechanisms of its formation during the treatment of EGFR-TKI of the 1st and 2nd generation are different, most frequently (up to 60%) it is the T790M mutation on exon 20. In 11/2015 FDA and 2/2016 EMA approved EGFRTKI 3. generation osimertinib to treat patients with locally advanced or metastatic NSCLC with a proven T790M EGFR mutation.
Currently, osimertinib is also approved for a firstline treatment in patients with proven activation mutation of the EGFR gene (FDA from 4/2018 and from 6/18 EMA).