VIDEO: Treating lung cancer with EGFR exon 20 mutation

Editor’s note: This is a previously posted video, and the below is an automatically generated transcript to be used for informational purposes. Please notify editor@healio.com if there are concerns regarding accuracy of the transcription.

So, EGFR exon 20 are different mutations, so they're not associated to response with osimertinib (Tagrisso; AstraZeneca) of other EGFR tyrosine kinases, at least at standard doses. Except there is association with response at higher doses of osimertinib, double dose. However, what is very exciting now is that the exon 20 EGFR mutations actually are, insertion, are, they have specific treatments.

So one is, and they're approved, it's standard of care, after chemotherapy, and one is mobocertinib (Ekivity; Takeda) and the other is amivantamab (Rybrevant; Janssen). So, these are two options that patients with EGFR exon 20 insertion have at the moment. I would say to my oncologist, especially the ones who might not have a lot of experience with these EGFR exon 20 insertions, they are very different to that than EGFR sensitizing mutation. These are very aggressive tumors. They often metastasize to the brain. I would say I would not use osimertinib, at least at standard doses. I know that there are some insurance plans that might not allow actually treatment with EGFR exon 20 specific treatments such as mobocertinib and amivantamab, but I would say, you know, try to really get patients into clinical trials.

We do have new inhibitors, they're coming up, and they're currently on Phase I trials. So, I would say, if you're not able to get a patient on a specific exon 20 insertion treatment after chemotherapy failure, then definitely contact us, because we can direct you towards clinical trials that may benefit actually those patients.