VIDEO: Treatment flow employed for EGFR-mutated lung cancer

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When I encounter a newly diagnosed EGFR mutation lung cancer, especially a metastatic stage patient, usually tell them that the patient will sequentially receive different type of treatment. Basically, we rotate different weapons to hit the cancer so that we could maximize our time of survival. Currently we start with targeted therapeutic, TKI, either osimertinib or losartan with chemo or with amivantamab. Sometimes we still go to osimertinib monotherapy. So the frontline is targeted therapy, TKI. After people progress, then we start to think about chemo combination. Because although chemo is a old type of drug, but it still works, especially with the new data.

When chemo is combined with PD-1 VEGF inhibition, we could potentially see a better efficacy than just chemo itself. So the second line, and we're thinking about chemotherapy-based approach. After patient progress on those two, I start to think about antibiotic drug conjugates. I start to think about clinical trial options, novel agents. So that's usually in my head. It is a treatment flow for those patients. We try to educate our patient early that chemotherapy is not necessarily a useless thing for EGFR patients. And we also try to educate our patients, immunotherapy with a enhancer could also benefit patients.