EGFR+ Lung Cancer

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.

Brain metastasis responses were elicited from treatment with pembrolizumab in patients with non–small cell lung cancer, in a PD-L1–positive cohort of a phase II clinical trial conducted by researchers at Yale Cancer Center. According to a YCC press release, pembrolizumab prolonged overall survival with limited toxicity in these patients.

The FDA has provided clearance to an Investigational New Drug application for GT103 for the treatment of solid tumors. A phase I clinical trial will be initiated to evaluate this novel targeted immunotherapy in patients with refractory non–small cell lung cancer, announced Grid Therapeutics, LLC.

The combination of tislelizumab, a PD-L1 antibody, pemetrexed and platinum-based chemotherapy achieved a statistically significant prolongation in progression-free survival compared with pemetrexed and platinum chemotherapy alone as first-line treatment of patients with nonsquamous non–small cell lung cancer, meeting the primary end point of a phase III BGB-A317-304 trial.

A 69-Year Old Man With Metastatic BRAF V600E-Mutated Metastatic NSCLC