Expert insights on the treatment of patients with non–small cell lung cancer positive for EGFR mutations and what the PAPILLON study seeks to address.
Case: A 73-Year-Old Man with EGFR+ NSCLC
Clinical Presentation:
Past Medical History:
Social History:
Initial Clinical Workup and Diagnosis:
Physical Examination
Pulmonary Function Tests
Imaging Studies:
Diagnostic Procedure:
Neoadjuvant Therapy and Surgical Resection:
Surgical Pathology Report:
Six Months Later:
Second Line Systemic Therapy:
Repeat Imaging at 8 Weeks:
This is a video synopsis/summary of a Case-Based Peer Perspectives featuring Joshua K. Sabari, MD.
EGFR exon 20 insertions are rare, comprising about 5% to 10% of EGFR mutations and 1% of non–small cell lung cancer. Standard EGFR tyrosine kinase inhibitors like osimertinib are ineffective for exon 20–mutated lung cancer due to steric hindrance preventing drug binding.
Mobocertinib initially showed promise but failed to improve outcomes over chemotherapy in a phase 3 trial, leading to its removal from clinical use. More recently, the antibody-drug conjugate amivantamab demonstrated response rates around 40% in exon 20-inserted NSCLC.
The phase 3 PAPILLON trial of amivantamab plus chemotherapy vs chemotherapy alone as first-line treatment was recently presented and published, nearly doubling progression-free survival from 6 to 7 months with chemotherapy alone to 11.5 to 12 months with amivantamab plus chemotherapy, with a hazard ratio under 0.4. This establishes a new standard of care for this patient population.
Video synopsis is AI-generated and reviewed by Targeted Oncology™ editorial staff.
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