[New therapies for the treatment of advanced non-small cell lung cancer: inhibitors of the epidermal growth factor receptor and angiogenesis]. / Nieuwe middelen voor de behandeling van gemetastaseerd niet-kleincellig longcarcinoom: remmers van de epidermale groeifactorreceptor en van de angiogenese.

The recently developed 'targeted' therapies, epidermal growth factor receptor (EGFR) inhibitors and angiogenesis inhibitors, target specific tumour characteristics. EGFR inhibitors, such as gefitinib and erlotinib, can lead to remission, particularly in non-small cell lung cancer (NSCLC) with specific EGFR mutations. These mutations occur more frequently in Asians, women, non-smokers and those with adenocarcinomas. Other mutations in EGFR and K-ras genes lead to resistance. EGFR inhibitors offered no benefit to untreated patients with advanced NSCLC. In previously treated patients, however, erlotinib increased survival by 2 months. Optimal patient selection criteria for EGFR inhibitor therapy is still under investigation. The angiogenesis inhibitor bevacizumab is an antibody that targets vascular endothelial growth factor receptor. The addition of bevacizumab to chemotherapy increased median survival by 2 months when given as first-line therapy for advanced NSCLC. The combination of EGFR and angiogenesis inhibitors is a rational anticancer treatment and is being studied. These new therapies are expected to help improve and individualize the treatment of advanced NSCLC.