Reviewing Erlotinib/Binimetinib Combo in EGFR+ or KRAS+ NSCLC

Andreas Saltos, MD, discusses the key takeaways of the phase 1/1b clinical trial exploring the use of binimetinib plus erlotinib in patients with non–small cell lung cancer harboring either KRAS or EGFR mutations.

Andreas Saltos, MD, medical oncologist and clinical research medical director in the department of thoracic oncology at Moffitt Cancer Center, discusses the key takeaways for community oncologists in regard to his presentation on the phase 1/1b clinical trial exploring the use of binimetinib (Mektovi) plus erlotinib (Tarceva) in patients with non–small cell lung cancer (NSCLC) harboring either KRAS or EGFR mutations given at the 2022 American Association for Cancer Research (AACR) Annual Meeting.

Findings of the study showed that the combination of binimetinib and erlotinib did not demonstrate signals of increased efficacy in patients with EGFR mutations. Further studies are needed to see if strategies like this may be valuable in patients with these mutations.

Though little efficacy was noted in the populations administered this combination, Saltos remains hopeful and notes that the field of NSCLC with KRAS or EGFR mutation is growing. There are emerging targeted drugs currently under examination, all of which can potentially provide patients with targeted care in the future.

Transcription:

0:08 | From this presentation, you can start to see that although there was limited efficacy in our populations with this combination, likely because we weren't able to achieve very highly therapeutic doses of both drugs through tolerability, we did see signals including in 1 or 2 patients with KRAS mutations who had some degree of durable benefit from the combination.

0:32 | I think with the up and coming, newer, more targeted, tailored drugs like the targeted G12C inhibitors, we may start to see some headway that these patients may be candidates for targeted therapy, where typically we would think that targeted therapy is not an option. We've already seen that in the KRAS G12C space for patients upfront.

1:12 | We're also seeing preliminary data, some that was also shared at AACR. Recently, the KRAS G12C specific inhibitor, sotorasib [Lumakras] has been explored in some combinations where we see even more promising signals of efficacy with EGFR and MEK combinations. Again, tolerability toxicity remains an issue. I think with emerging, tailored targeted drugs, that the field will bring us to a point where we'll be able to offer targeted therapy to more patients. Keep in mind that these patients have specific mutations, be on the lookout for clinical trial opportunities, and hopefully new drug approvals in the coming years for these patients.