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Selecting EGFR Tyrosine Kinase Inhibitors for EGFR-Mutant Lung Cancer

Julie R. Brahmer, MD
Published Online:4:38 PM, Fri March 20, 2020


Julie R. Brahmer, MD, co-director of the Upper Aerodigestive Department, Bloomberg Kimmel Institute for Cancer Immunotherapy, and professor of oncology at John Hopkins Medicine, discusses the circumstances in which a physician can choose the third-generation EGFR tyrosine kinase inhibitor (TKI) osimertinib (Tagrisso) over other EGFR TKIs for patients with EGFR-mutant lung cancer.

For most patients with the standard EGFR abnormalities on next-generation sequencing, Brahmer says osimertinib can be chosen over first-generation EGFR TKIs, erlotinib (Tarceva) and gefitinib (Ireesa). On occasion, physicians may run into problems with adverse events (AEs), but the dose can be reduced from the standard dose.

If AEs remain a problem, physicians can switch to either of the other EGFR TKIs to see if patients may tolerate a different agent better. However, Brahmer notes this does not happen often because osimertinib is generally well-tolerated.

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