EGFR+ Lung Cancer

Experts in lung oncology review 3 clinical cases and discuss individualized treatment approaches for each patient.

This is the first report to date that has demonstrated inferior survival outcomes among African American patients with NSCLC harboring an EGFR mutation relative to non-African American patients.

Research into mutations in the gene encoding the epidermal growth factor receptor protein has revolutionized non–small cell lung cancer treatment in recent years, yet the science supporting targeting of this oncogene is still being elucidated.

Leora Horn, MD, MSc, discusses the data accrued from Flatiron and from a phase 1/2 trial of patients with refractory non–small cell lung cancer with EGFR exon 20 insertions receiving mobocertinib compared with currently approved therapies.

Physicians are at the early stages of realizing the varying mechanisms of resistance to EGFR tyrosine kinase inhibitors and the methods for managing and/or overcoming resistance.

The FDA granted Breakthrough Therapy designation to osimertinib as adjuvant treatment of patients with stage IB-IIIA EGFR-mutated non–small cell lung cancer following complete tumor resection with curative intent.

Leora Horn, MD, MSc, discusses the real-world data outcomes compared with clinical trial data of mobocertinib from a retrospective study in patients with refractory non–small cell lung cancer with EGFR exon 20 insertions.

In an interview with Targeted Oncology, Balazs Halmos, MD, MS, discussed the current treatment landscape of EGFR-mutant NSCLC and how this space is evolving based on recent clinical trials.

Osimertinib may not be as effective for the treatment of with non–small cell lung cancer who harbor complex EGFR mutations as it is for those who harbor traditional EGFR mutations, according to a recent study.

Balazs Halmos, MD, MS, discusses the role of EGFR mutations in patients with advanced non—small cell lung cancer.

MET amplifications are found in up to 10% of patients with EGFR-mutant NSCLC who progress on first- or second-generation EGFR TKIs and in up to 25% of those who progress on a third-generation EGFR TKIs, necessitating the need for treatment options in the population.

Julia K. Rotow, MD, discusses the excitement of EGFR tyrosine kinase inhibitors for the treatment of patients with EGFR-mutant lung cancers.

Amivantamab (JNJ-61186372) induced durable responses and demonstrated a manageable safety profile in patients with EGFR exon 20-mutant non–small cell lung cancer (NSCLC), according to results from the phase I CHRYSALIS study (NCT02609776) presented during the 2020 American Society of Clinical Oncology Virtual Scientific Program.

In a subgroup analysis of cohort 1 of the phase 2 ZENITH20 study, patients with previously treated non-small cell lung cancer and EGFR exon 20 insertions demonstrated clinical activity when receiving poziotinib, including those with central nervous system metastatic disease, which was not impacted by prior lines of therapy.

A daily dose of osimertinib at 160 mg was well-tolerated with clinical activity observed in patients with EGFR exon 20-mutant non–small cell lung cancer, according to results from the phase 2 ECOG-ACRIN 5162 trial.

Treatment with high-dose osimertinib showed positive survival and central nervous system progressive disease control in a real-world cohort of patients with EGFR-mutant non–small cell lung cancer, but these results were not statistically significant.

The FDA has approved ramucirumab in combination with erlotinib for the first-line treatment of patients with metastatic non–small cell lung cancer harboring EGFR exon 19 deletions or exon 21 mutations.

"Adjuvant osimertinib is the first targeted agent in a global randomized trial to show a statistically significant and clinically meaningful improvement in disease-free survival in patients with stage IB/II/IIIA EGFR mutation–positive non–small cell lung cancer."

Suresh S. Ramalingam, MD, discusses the phase III FLAURA trial.

The study results indicated clinical efficacy against central nervous system metastases in a cohort of patients. Almonertinib also displayed an overall favorable safety profile.

Interim findings of the ongoing phase II ZENITH20 trial demonstrated that poziotinib induced a 68.7% disease control rate when used as treatment of patients with pretreated non–small cell lung cancer harboring an EGFR exon 20 insertion.

In a Targeted Oncology case-based peer perspectives live discussion, Charu Aggarwal, MD, MPH, discussed systemic treatment options for stage III non–small cell lung cancer, based on a real case of a 63-year-old male patient.