S. Michelle Shiller, DO, AP/CP, MGP
Articles
Potential Immunotherapy Use in Patients with mNSCLC and RET Alterations
A focused discussion on whether immunotherapy might be an effective treatment option for patients with RET-positive mNSCLC.
The panel reviews LIBRETTO-001 and ARROW safety data on selpercatinib and pralsetinib in RET fusion-positive mNSCLC, and share their clinical experience in adverse event (AE) management in patients who are receiving one of these therapies.
Selpercatinib and Pralsetinib for RET Fusion-Positive mNSCLC and Supporting Efficacy Data
Dr Piotrowska outlines the RET tyrosine kinase inhibitors (TKIs) selpercatinib and pralsetinib, which are available for patients with RET fusion-positive mNSCLC, then Dr Neal follows with a discussion of supporting efficacy data from the LIBRETTO-001 and ARROW trials.
RET Fusion-Positive mNSCLC: Case 2 Presentation and Molecular Testing Strategies
Joel Neal, MD, presents a second case of a 67-year-old man with no smoking history who was diagnosed with RET-rearranged mNSCLC, while Michelle Shiller, DO, AP/CP, MGP, touches on molecular testing approaches in patients who are suspected of having a RET alteration.
Mobocertinib Treatment-Emergent EGFR Mutations and Subsequent Therapy Selection
Zosia Piotrowska, MD, explains how she might treat a patient with EGFR exon 20-mutated mNSCLC who develops an EGFR T790M mutation after mobocertinib treatment.
Management of Adverse Events Following Mobocertinib and Strategies for Treatment Modification
Dr Neal outlines second-line targeted treatment selection for the patient case, while Lauren Welch, MSN, NP-C, AOCNP, shares her experience with managing the adverse effects of mobocertinib in patients with EGFR exon 20-mutated mNSCLC and comments on potential strategies for treatment modification.
Dr Piotrowska and Lauren Welch offer insight into results interpretation and subsequent treatment decision-making for patients with mNSCLC who are found to harbor an EGFR exon 20 insertion mutation through biomarker testing.
Dr Shiller emphasizes the heterogeneity between the various EGFR exon 20 mutations seen in patients with NSCLC, and describes strategies for effectively communicating actionable information about a patient’s mutation status to the clinicians receiving the reports.
CHRYSALIS Data on Amivantamab and a Comparative Efficacy Analysis of Mobocertinib vs Amivantamab
Dr Neal discusses the design and outcomes of the CHRYSALIS study, investigating amivantamab for the treatment of EGFR exon 20-mutant advanced or metastatic lung cancer, and then briefly comments on a matched analysis of efficacy data on mobocertinib and amivantamab.
Mobocertinib Safety and Efficacy Data in Patients with mNSCLC and an EGFR Exon 20 Mutation
Dr Joel Neal reviews data from the pivotal clinical trial leading to the FDA approval of mobocertinib for EGFR exon 20-mutated advanced or metastatic lung cancers.
Repeat Liquid and Tissue Biopsy Practices in mNSCLC
Nurse Practitioner Lauren Welch and Dr Michelle Shiller explain if and when they would offer repeat liquid or tissue biopsies to a patient with mNSCLC, and discuss how often patients request “serial biopsies” for detecting treatment response and/or disease progression.
Considerations for First-Line Treatment Selection for Patients with mNSCLC and Brain Metastases
A key opinion leader muses on the treatments she would consider for a patient with mNSCLC, an EGFR exon 20 mutation, and brain metastases.
First- and Second-Line Treatment Options for Patients with mNSCLC and an EGFR Exon 20 Mutation
The panel reviews the first- and second-line treatment options for the patient in the presented case, before and after knowing her molecular testing results.
A Pathologist Outlines Typical Tumor Tissue Processing Steps after Biopsy in NSCLC
Michelle Shiller, DO, AP/CP, MGP, describes the process of tissue biopsy testing at her institution from start to finish, and Zosia Piotrowska, MD, explains the likelihood of targetable alterations in cases of mNSCLC in patients with no smoking history.
Case 1: Metastatic NSCLC with an EGFR Exon 20 Insertion
Joel Neal, MD, PhD, presents the case of a 66-year-old woman with no smoking history and a diagnosis of EGFR exon 20 mutation-positive mNSCLC.
Common Biomarker Testing Methodologies Utilized in NSCLC
Zosia Piotrowska, MD, explains molecular testing methods that can discover molecular alterations in common biomarkers in patients with mNSCLC.
Reflex Testing of Next Generation Sequencing (NGS)-Based Panels in NSCLC
Nurse Practitioner Lauren Welch and Dr Michelle Shiller share whether next-generation sequencing is reflexively ordered at their institutions, turnaround times for this type of testing, and which panels they typically choose.
Broad Molecular Testing Use in Adenocarcinoma versus Squamous Cell Carcinoma
Drs Shiller and Piotrowska discuss use of broad genomic profiling according to the patient’s histologic subtype of NSCLC.
A Commentary on High PD-L1 Expression in NSCLC
Lauren Welch, MSN, NP-C, AOCNP, describes how she approaches management of patients with NSCLC and known high PD-L1 expression while she waits for pending biomarker testing results.
Biomarkers and Biomarker Testing in NSCLC
Zosia Piotrowska, MD, and Michelle Shiller, DO, AP/CP, MGP, explain the frequency of the different biomarkers in NSCLC, and steps clinicians might take to ensure timely and effective molecular testing for their patients.
