Iressa Trocaine in the treatment of EGFR-mutated non-small cell lung cancer

The FDA recently approved Iressa as a single-agent therapy for metastatic non-small cell lung cancer (NSCLC) positive for epidermal growth factor receptor (EGFR) mutations, confirmed by an FDA-approved companion diagnostic kit. Iressa was the first molecularly targeted drug for the treatment of lung cancer in China, officially launched with the approval of the State Food and Drug Administration in 2005, opening a new era of treatment for patients with advanced non-small cell lung cancer. On the sixth anniversary of its listing, Iressa was further approved as a first-line treatment for non-small cell lung cancer, bringing more optimized treatment options to patients in China to improve their quality of life and prolong survival.

Lung cancer is the number one cancer among tumor-related death rates in China, with non-small cell lung cancer (NSCLC) accounting for approximately 85% of all lung cancer cases. At present, the treatment of lung cancer remains primarily surgery, radiation therapy, and drug therapy, with drug therapy including both chemotherapy and molecularly targeted drug therapy such as EGFR tyrosine kinase inhibitors (EGFR-TKIs).

The treatment of non-small cell lung cancer advocates an individualized treatment model based on the driver gene expression status of patients — specifically, whether lung cancer patients carry driver genes. The epidermal growth factor receptor (EGFR) belongs to the tyrosine kinase receptor family, and its signal transduction pathway regulates cell growth, proliferation, and differentiation. Various mutations in the EGFR tyrosine kinase region are closely related to the efficacy of tyrosine kinase inhibitors, making EGFR mutation both an important cancer driver and a strong predictor of sensitivity to TKI treatment. The EGFR mutation rate among lung cancer patients in China is 30% to 40%.

EGFR gene mutation sites determine whether non-small cell lung cancer patients can benefit from targeted drugs such as Iressa and Tarceva. Mutations in exons 18, 19, 20, and 21 are particularly relevant — especially deletion of exon 19 or mutation of exon 21, both of which show significant responses to these drugs. It is therefore strongly recommended that patients with non-small cell lung cancer undergo genetic testing before using targeted drugs such as Iressa or Tarceva, so that treatment decisions are guided by accurate molecular information rather than assumption. Cancer genetic testing that identifies effective targeted drugs and clinical trials remains the core technology for precise cancer treatment, and every cancer patient should pursue it to obtain the most accurate and personalized treatment plan.