How do you treat a patient with widely metastatic, non T790M mutated, EGFR exon 20 insertion mutated lung cancer?
Are there any data to support a specific TKI therapy for non-T790M exon 20 mutations/insertions?
Answer from: Medical Oncologist at Academic Institution
The EGFR exon 20 insertion mutations represent approximately 9% of all EGFR mutations, and affect a similar demographic/clinical group - never/light smokers, adenocarcinoma, tending towards a younger age (Oxnard, JTO 2013;8:179-184). Unfortunately, the data (preclinical and clinical) to date do not...
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Medical Oncologist at MultiCare Tacoma General Hospital There is significant heterogeneity among exon 20 m...
Answer from: Medical Oncologist at Academic Institution
Aside from poziotinib study, TAK-788 has shown signs of clinical activity in early clinical testing reported in ASCO 2018 (http://abstracts.asco.org/214/AbstView_214_209573.html).
Based on IMPOWER 150 results first reported in late 2017, updated results shown in ASCO 2018 (http://abstracts.asco.org...
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Medical Oncologist at Cancer Care Specialists/Renown Oncology/UNR Looks like most of the benefit is driven by Bevaci...
Answer from: Medical Oncologist at Academic Institution
I agree with @Gregory A. Otterson. Patients with EGFR exon 20 mutation tend to have disease that is refractory to 1st and 2nd generation TKIs. There are no standard targeted therapies for this subgroup of patients. I generally treat with standard platinum/pemetrexed chemotherapy or consider clinical...
Answer from: Medical Oncologist at Academic Institution
What a difference 3 years make! Aside from poziotinib and mobocertinib (aka TAK-788), we now also have early data regarding other small molecules in development (CLN-081) and even an EGFR-MET bispecific antibody (amivantamab) showing response rates up to 40% for amivantamab which received US FDA bre...
There is significant heterogeneity among exon 20 m...