Josephine L. Feliciano, MD
Clinical familiarity with driver mutations, including BRAF V600
, continues to grow as seen with FDA approvals of novel therapies, according to Josephine L. Feliciano, MD, an assistant professor of oncology at Johns Hopkins Medicine. Other molecular targets, including RET, MET,
continue to be explored with new agents.
State of the Science Summit™ on Advanced Non–Small Cell Lung Cancer, Feliciano spoke about both established and emerging therapeutic developments for patients with less common driver mutations, also acknowledging the importance of rebiopsying in directing therapy decisions.
OncLive: What therapies are available for some of these uncommon mutations?
V600 [is a] mutation that is also found in other cancers, such as melanoma and cholangiocarcinoma. The study I focused on [in my presentation] included both a BRAF
and MEK inhibitor—dabrafenib and trametinib for patients with BRAF
V600–positive NSCLC. Essentially, that combination was approved by the FDA for patients with BRAF
V600 mutations based on very high response rates.
Are therapies in melanoma also successful in NSCLC?
Yes. What we are also seeing is that many of these drugs and trials are starting to become less cancer-specific. They’re starting to incorporate broader categories of malignancies, but with the same driver mutation.
What options are available for those with ROS1 fusions?
is a mutation similar to an ALK
translocation. It has a similar configuration in the receptor. Many of the TKIs that are effective for ALK
are similarly effective for ROS1
. Crizotinib is approved for patients with ROS1
mutations. It’s effective, has high response rates, and has long durations of response for NSCLC. This mutation occurs in about 1% of NSCLC and tends to be mutually exclusive of ALK
... to read the full story