Sukhmani K. Padda, MD, discusses treatment selection following osimertinib resistance in patients with non–small cell lung cancer.
Sukhmani K. Padda, MD, director of thoracic medical oncology at Cedars-Sinai Medical Center, discusses how she selects treatment following osimertinib (Tagrisso) resistance in patients with non–small cell lung cancer.
Reassessing the patient's molecular tumor profile is an important step that needs to be taken after a patient progresses on osimertinib, Padda explains. A number of methods can be utilized including liquid biopsy and circulating tumor DNA, which can provide an assessment of all tumor sites throughout the body that shed their DNA into circulation.
Another step that needs to be considered is tumor biopsy, Padda says. This step is even more important following progression on osimertinib, as the rate of histologic transformation appears to be reported at slightly higher rates than first- and second-generation drugs. It is important that a transformation to small cell lung cancer, squamous cell carcinoma, or even pleomorphic undifferentiated cancers is not missed, Padda concludes.