How would you approach patients with EGFR mutation positive (exon 19) NSCLC who rapidly progress on front line EGFR inhibition with first generation TKI at first imaging?

Can T790M mutation develop within this early time frame, or are these perhaps patients who may benefit from switch to chemotherapy?

Answer from: Medical Oncologist at Academic Institution

This is a difficult challenging situation. I usually repeat tissue biopsy or at least order a liquid bx, confirm that in fact they did have the EGFR mutation and assess for the T790M. I do consider switching to osimertinib if they have the T790M and this was not the EGFR TKI they were on. Howev...

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How would you approach patients with EGFR mutation positive (exon 19) NSCLC who rapidly progress on front line EGFR inhibition with first generation TKI at first imaging?

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