How would you approach post-chemoradiation consolidation in a patient with stage III lung adenocarcinoma with an EGFR exon 18 G719A mutation and highly positive PD-L1 level?
These mutations were not eligible in the LAURA trial. Afatinib has a more durable PFS than osimertinib in these patients.
How would you choose between durvalumab, osimertinib, and afatinib?
Answer from: Medical Oncologist at Academic Institution
Based on currently available FDA-approved therapies, osimertinib is a suitable choice. While G719A is an atypical EGFR TK mutation and some studies show that this variant may be less sensitive to osimertinib compared to the other classic mutations, the same retrospective studies also show clinical e...
Answer from: Medical Oncologist at Community Practice
Responsiveness of G719X mutations in exon 18 to EGFR-TKIs has been reported (Otsuka et al., PMID 26124334, Leduc et al., PMID 28945865). A combined posthoc analysis of LUX-Lung 2, LUX-Lung 3, and LUX-Lung 6 clinical trials has demonstrated that NSCLC patients harboring G719X had an objective respons...