Zofia Piotrowska, MD, MHS

Case: A 59-Year-Old Female with Lung Cancer

BC is a 59 y/o Asian female who presents to her physician complaining of shortness of breath, fatigue, and persistent right- sided neck pain.

BC believes she is experiencing neck pain because of her new sleeping pillow.

Since her last examination 6 months ago, BC has lost close to 10 lbs. BC has not changed her eating habits or style.

SMH: no history of smoking; drinks socially

FH: she lives with her partner and 2 dogs; mother passed away from ovarian cancer 3 years ago.

PE: LLL auscultation reveals decreased breath sounds visible bruising


CT Chest: LLL primary, mediastinal LNs; bone metastases

MRI brain is negative for brain metastases

CT scan of abdomen and pelvis shows additional bone metastases

Biopsy of mediastinal lymph nodes shows stage 4 lung adenocarcinoma

NGS has been ordered and the results are pending.

Patient initiated on a chemotherapy doublet.

Videos

Before closing out her discussion on novel therapy for EGFR exon 20–positive NSCLC, Zofia Piotrowska, MD, shares her hopes for future developments in care. 

EGFR Exon 20–Positive NSCLC: Future Directions in Care

Practical advice regarding the selection and management of amivantamab or mobocertinib in patients diagnosed with EGFR exon 20–positive NSCLC.

Real-World Use of Targeted Agents in EGFR Exon 20–Positive NSCLC 

Comprehensive insight on the two novel, targeted agents approved for the management of EGFR exon 20–positive NSCLC following frontline therapy. 

Novel Targeted Therapy for EGFR Exon 20–Positive NSCLC

Expert oncologist Zofia Piotrowska, MD, reviews the case of a patient managed with frontline chemotherapy after receiving a diagnosis of stage 4 NSCLC.

Expert Perspectives on a Case of Stage 4 NSCLC 

Zofia Piotrowska, MD, MHS, a medical oncologist at Massachusetts General Hospital and an instructor at Harvard Medical School, discusses the rationale for conducting the FLAURA trial in patients with

-mutant nonsmall cell lung cancer (NSCLC) and how the use of osimertinib (Tagrisso) impacted the treatment landscape for this patient population.

FLAURA was a large randomized phase III trial that was conducted in multiple countries. It aimed to answer the question of which EGFR inhibitor is best for frontline use in patients with

mutant NSCLC. At the time the study was conducted, first- and second-generation EGFR inhibitors were the standard of care, but Piotrowska says many patients who progressed on these drugs went on to develop the

For these patients, osimertinib appeared to work as an excellent second-line option. The agent had a great safety profile, says Piotrowska, as well as low rates of diarrhea and rash. The agent also had good central nervous system penetration, so all of this activity led investigators to wonder if it would be a better option in the first-line setting.

<< View more resources and information regarding EGFR-positive lung cancer

Zofia Piotrowska, MD, MHS, discusses the rationale for conducting the FLAURA trial in patients with&nbsp;<em>EGFR</em>-mutant non&ndash;small cell lung cancer and how the use of osimertinib impacted the treatment landscape for this patient population.

Examining the Impact of the FLAURA Trial in EGFR-Mutant NSCLC

Zofia Piotrowska, MD, MHS, a medical oncologist at Massachusetts General Hospital and an instructor at Harvard Medical School, discusses the data from the randomized phase III FLAURA trial, which led to the widespread use of frontline osimertinib (Tagrisso) for the treatment of

Prior to these data, the standard of care was first-generation EGFR inhibitors, such as erlotinib (Tarceva) or gefitinib (Iressa). Osimertinib showed promising responses in the second-line setting for patients who developed a T790M resistance mutation as well, Piotrowska says. The agent had a great safety profile and encouraging activity, so it was evaluated in the FLAURA trial as a frontline option, according to Piotrowska.

The primary end point of the study was progression-free survival, and the data demonstrated

improvement with osimertinib. Based on recent data, the overall survival findings were also positive and demonstrated improvement compared with the standard of care, erlotinib or gefitinib.&nbsp;

These positive results led many physicians to use osimertinib as the preferred frontline treatment of

<< View more resources and information regarding the FLAURA trial

Zofia Piotrowska, MD, MHS, discusses the data from the randomized phase III FLAURA trial, which led to the widespread use of frontline osimertinib for the treatment of&nbsp;EGFR-mutant lung cancers.

Zofia Piotrowska, MD, MHS | Authors

Articles

EGFR Exon 20–Positive NSCLC: Future Directions in Care

Real-World Use of Targeted Agents in EGFR Exon 20–Positive NSCLC

Novel Targeted Therapy for EGFR Exon 20–Positive NSCLC

Expert Perspectives on a Case of Stage 4 NSCLC

Examining the Impact of the FLAURA Trial in EGFR-Mutant NSCLC

Phase III Data Support Frontline Osimertinib in EGFR-Mutant Lung Cancers