Tyrosine kinase inhibitor toxicity in the treatment of non-small-cell lung cancer: A bibliometric analysis (2009-2025).

BACKGROUND

Lung cancer incidence is increasing worldwide. Despite being cornerstone treatment modalities, both chemotherapy and targeted therapy are accompanied by treatment-related toxicities. The aim of this study is to identify key authors, leading countries, core journals, and keywords in research on treatment-related toxicities of tyrosine kinase inhibitors (TKIs) used for non-small-cell lung cancer (NSCLC).

METHODS

A literature search was conducted in the Web of Science Core Collection database on June 28, 2025. The search strategy used the terms "non-small cell lung cancer," "toxicity," and "tyrosine kinase inhibitors," and their combination with Boolean operators (AND, OR, NOT). Bibliometric analyzes were conducted using the Bibliometrix R-package along with the Biblioshiny interface for visualization and data exploration.

RESULTS

A total of 366 publications on TKIs in NSCLC were identified between 2009 and 2025. Annual scientific production increased from 2 to 56 publications, with an average annual growth rate of 20%. China led with 580 papers, followed by Japan (381) and the United States (358). Harvard University ranked first among institutions (n = 46), followed by its medical affiliates, Pfizer, and the University of California System. The most productive journal was Lung Cancer (n = 18), whereas the Journal of Clinical Oncology had the highest impact factor (IF = 41.9). The most cited publication was Peters et al, which received 1830 citations, while average citation per article is 23. Analysis of author keywords revealed 3 major thematic clusters, encompassing strategies to overcome resistance, approaches to manage TKI-related toxicities, and studies on specific molecular subtypes (anaplastic lymphoma kinase, epidermal growth factor receptor). The most prevalent keywords were "non-small cell lung cancer" (32%) and "osimertinib" (23%), reflecting the central focus on third-generation TKIs in current research.

CONCLUSIONS

Optimizing NSCLC therapy with TKIs requires proactive toxicity monitoring and integration of predictive biomarkers and real-world evidence to enhance efficacy and patient safety.