Dr. Subramanian on Real-World Data With EGFR TKIs in Advanced NSCLC

Janakiraman Subramanian, MD

Janakiraman Subramanian, MD, discusses the use of EGFR TKIs in the treatment of patients with non–small cell lung cancer.

Janakiraman Subramanian, MD, a medical oncologist and director of Thoracic Oncology, Center for Precision Medicine, at Saint Luke’s Cancer Institute, discusses the use of EGFR TKIs in the treatment of patients with non–small cell lung cancer (NSCLC).

All patients should be tested for EGFR mutations and if positive, they should receive frontline treatment with an EGFR TKI, according to Subramanian. However, this does not appear to be happening on a global level, Subramanian says. In an effort to better understand this, and to identify barriers to the use of EGFR TKIs, Subramanian and colleagues investigated real-world treatment patterns of the agents in patients with advanced NSCLC harboring an EGFR mutation in clinical practice.

The data, which were presented during the 2021 European Lung Cancer Virtual Congress, showed that even when accounting for different practice patterns across multiple countries, the majority of patients analyzed who tested positive for EGFR mutations were treated with an EGFR TKI, Subramanian says. However, some patients with EGFR-positive disease never received targeted therapy, a problem that needs to be addressed, Subramanian explains.

According to the data presented, some countries are doing better in this area than others, Subramanian notes. For example, in Canada, the majority of patients with EGFR-positive disease are treated with EGFR TKIs across any line. However, in other countries, including the United States, up to one-quarter of patients whose tumors harbor EGFR mutations did not receive treatment with an EGFR TKI in any line, Subramanian concludes.