Evaluating the Role of EGFR Mutations in the Treatment of Advanced NSCLC

Balazs Halmos, MD, MS, director of the Multidisciplinary Thoracic Oncology Program and director of the Section of Thoracic Medical Oncology for Montefiore Health Systems; first director of Clinical Cancer Genetics and professor of clinical medicine at the Albert Einstein College of Medicine, discusses the role of EGFR mutations in patients with advanced non—small cell lung cancer (NSCLC).

EGFR mutations make up for about 10% to 15% of all cases of advanced NSCLC, says Halmos. These mutations also tend to be more enriched among women, adenocarcinomas, younger patients, and non-smokers.

The most common EGFR mutations include L858R and exon 19 deletions, which tend to be very responsive to first-, second-, and even third-generation targeted therapies. However, there is a small subset that is highly refractory to these agents that have been used for years, which includes EGFR exon 20 insertions.

Because science has continued to advance, Halmos says we can understand the reason for the resistance. This understanding has led to the development of a number of compounds and advances, including some which were recently presented during the 2020 American Society of Clinical Oncology Virtual Scientific Program.

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