VIDEO: Expert offers advice for residents seeing patients with EGFR-mutated lung cancer

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For any resident, especially a resident who's interested in potentially going into oncology, I think it's really important they understand, again, the same thing that I would potentially say to a primary care doctor or a pulmonologist. And that's really the importance of kind of upfront biomarker testing. You know, if you're a new resident, you know, rotating through an oncology clinic and you're seeing a new patient diagnosed with lung cancer, whether it's in the metastatic setting or even in the early-stage setting, it's really important that you do kind of a full, comprehensive biomarker testing, looking for particular oncogene-driver mutations, like EGFR.

The other thing that I would really think is important for new residents to kind of really understand is that we do have really good therapies for our patients, whether they're oncogene-driven tumors or non-oncogene-driven tumors. I mean, patients with EGFR disease in particular have really good therapies and I think it's important for all residents to kind of really understand that.

Another thing that I think is really important for residents to know is that these targeted therapies, while they are highly effective and can work really well and are generally very well-tolerated by patients with EGFR disease, they also come with some unique toxicities and some potentially life-threatening toxicities. Now, you know, these potential kind of side effects that are life-threatening are generally rare, but it's actually our residents who are practicing in the hospital who might be on the kind of the internal medicine wards who might be seeing some of these toxicities more than anyone. So, for instance, you know, a targeted, you know, third-generation TKI, like osimertinib, in rare cases can cause, you know, lung inflammation, cause pneumonitis. In rare cases, might even cause heart failure. And frequently, the internal medicine resident who's, you know, working the night shift and the patient comes in through the ED with new shortness of breath or new lower-extremity edema, they're the first people kind of on the front lines seeing these patients who might be suffering from these rare, but potentially life-threatening toxicities. And I think that's something that all internal medicine residents or residents in general just really need to kind of keep in mind and have some knowledge on.