VIDEO: Treatment options for early-stage EGFR-mutated non-small cell lung cancer

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.

We happened to look into early-stage non-small cell lung cancer, EGFR mutated, and there has been the approval after surgical resection of adjuvant osimertinib (Tagrisso; AstraZeneca), which is the EGFR tyrosine kinase inhibitor, that will be done for three years. It's the same dose of the metastatic treatment, which is 80 milligram daily. And then for stage 4 non-small cell lung cancer, EGFR-mutated patients. So, the first line is osimertinib, but then there are lots of other possibilities.

So, if patients progress after the first line osimertinib, of course there is always chemotherapy, but there are also other options. And the way we look at treatment is according to repeating the liquid biopsy or the molecular test on the tumor biopsy upon progression. So, there are many co-mutations that can be targeted. For example, let's say, existence of EGFR and the RET fusions, or for example, BRAF mutations. So, in those cases there are specific protocols, mainly clinical trials, but also, and also, for example, the MEK alterations that can be targeted after progression on osimertinib.

I always encourage enrollment of patients into clinical trials, and at our institution, but also all over United States, there are many clinical trials open for patients who progressed after osimertinib. One of the main important factors in determining the further treatment is really understanding what is the underlying mechanism of resistance to osimertinib. So, biopsy is important, but also liquid biopsies are very important.