Authors' objectives: AZD9291 is intended to be used as a second line therapy for the treatment of locally advanced or metastatic, EGFR and T790M mutation positive non-small cell lung cancer (NSCLC). If licensed, AZD9291 will offer an additional treatment option for such patients, who have progressed on a prior EGFR-TKI therapy due to the emergence of the T790M secondary mutation; a group who currently have no well-tolerated, effective therapies available. In the UK, lung cancer is the second most common cancer diagnosed after breast cancer, but it is the most common cause of cancer death in the UK. In England there were 34,889 cases of lung cancer in 2011. The majority of lung cancers are diagnosed in the later stages of the disease. Inhibition of EGFR kinase activities by EGFR-TKIs has provided an effective treatment for patients with EGFR mutation positive NSCLC. However, acquired TKI resistance ultimately develops in the vast majority of patients, and EGFR mutation at T790M is estimated to account for more than 50% of acquired TKI resistance. The aim of treatment for locally advanced or metastatic NSCLC is to prolong survival, improve quality of life, and control disease-related symptoms. In patients with activating EGFR mutations (except EGFR wild-type mutations), EGFR-TKI therapy should be considered as front-line therapy. Erlotinib and gefitinib are options for patients with epidermal growth factor receptor tyrosine kinase (EGFR-TK) positive metastatic NSCLC. Afatinib is also an option, for EGFR-TK positive metastatic NSCLC not previously treated with another EGFR-TKI. AZD9291 is currently in one phase III clinical trial comparing its effect on progression free survival against treatment with platinum-based doublet-chemotherapy. This trial is expected to complete in February 2018.

Authors' recommendations: http://www.hsric.nihr.ac.uk/topics/azd9291-for-locally-advanced-or-metastatic-egfr-and-t790m-mutation-positive-non-small-cell-lung-cancer-second-line/

Project Status: Completed

Year Published: 2015

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: NIHR Horizon Scanning Centre

Contact Address: The NIHR Horizon Scanning Centre, Department of Public Health, Epidemiology, and Biostatistics, School of Health and Population Sciences, University of Birmingham, 90 Vincent Drive, Edgbaston, Birmingham, B15 2SP. United Kingdom. Tel: +44 121 414 7831, Fax: +44 121 2269

Contact Name: c.packer@bham.ac.uk

Contact Email: c.packer@bham.ac.uk

Copyright: NIHR Horizon Scanning Research&Intelligence Centre (NIHR HSRIC)