Dr. Lynch Discusses Resistance to EGFR TKIs in Lung Cancer

Thomas J. Lynch, Jr., MD
Published: Saturday, Nov 08, 2014



Thomas J. Lynch, MD, director, Yale Cancer Center, physician-in-chief, Smilow Cancer Hospital at Yale-New Haven, Giant of Lung Cancer Care, explains how resistance occurs when treating patients with lung cancer using EGFR TKIs.

Lynch says that while EGFR TKIs help patients with EGFR-mutated lung cancer, the vast majority of these patients will develop resistance. Half of the time, resistance is caused by the T790M mutation, Lynch says. The other instances of resistance are caused by other factors, such as amplification of the MET gene, mutations in the PI3K gene, or mutations or amplification of the HER2 gene.

This variation in the resistance mechanism warrants rebiopsy for patient who develop resistance to frontline therapy, Lynch notes. Biopsying a patient after resistance can help physicians decide which agent to give their patient next. Novel next-generation EGFR inhibitors are being developed that are targeted against the T790M acquired mutation. These therapies, AZD9291 and rociletinib (CO-1686), have demonstrated response rates near 60% in clinical trials.

<<< View more from the 2014 Annual Lung Cancer Symposium



Thomas J. Lynch, MD, director, Yale Cancer Center, physician-in-chief, Smilow Cancer Hospital at Yale-New Haven, Giant of Lung Cancer Care, explains how resistance occurs when treating patients with lung cancer using EGFR TKIs.

Lynch says that while EGFR TKIs help patients with EGFR-mutated lung cancer, the vast majority of these patients will develop resistance. Half of the time, resistance is caused by the T790M mutation, Lynch says. The other instances of resistance are caused by other factors, such as amplification of the MET gene, mutations in the PI3K gene, or mutations or amplification of the HER2 gene.

This variation in the resistance mechanism warrants rebiopsy for patient who develop resistance to frontline therapy, Lynch notes. Biopsying a patient after resistance can help physicians decide which agent to give their patient next. Novel next-generation EGFR inhibitors are being developed that are targeted against the T790M acquired mutation. These therapies, AZD9291 and rociletinib (CO-1686), have demonstrated response rates near 60% in clinical trials.

<<< View more from the 2014 Annual Lung Cancer Symposium




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Online CME Activities
TitleExpiration DateCME Credits
Community Practice Connections™: 18th Annual International Lung Cancer Congress®Oct 31, 20181.5
Clinical Interchange™: Translating Research to Inform Changing Paradigms: Assessment of Emerging Immuno-Oncology Strategies and Combinations across Lung, Head and Neck, and Bladder CancersOct 31, 20182.0
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