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Thoracic Oncologist Highlights EGFR TKI Advances in NSCLC

Brandon Scalea
Published: Monday, Oct 29, 2018

Missak Haigentz, MD

Missak Haigentz, MD

The identification of sensitizing mutations along with the development of EGFR tyrosine kinase inhibitors (TKI) has been crucial to selecting the right treatment for select patients with non–small cell lung cancer (NSCLC), said Missak Haigentz, MD.

State of the Science Summit™ on Non–Small Cell Lung Cancer, Haigentz discussed the impact of EGFR TKIs on the treatment of patients with NSCLC.

OncLive: Please provide an overview of your presentation.

Haigentz: The way that we view lung cancer compared with how we have viewed lung cancer in the past has drastically changed. It has changed over the last 20 years since I have been a fellow. We viewed lung cancer as a single disease where we knew of histological entities. Now, we view it as a large number of molecularly defined cancer types and genotypes for which we now have targetable mutations that are actionable and making huge differences in patients' lives.

Even in the past year, we now have 2 FDA-approved agents added to the armamentarium. I spoke about these 2 agents, which are osimertinib and dacomitinib. These are third- and second-generation TKIs, respectively. With dacomitinib as a single agent, we've finally seen a change in OS, which has been elusive. The question is, "Where do these fit into the landscape?"

Has the September 2018 approval of dacomitinib had an immediate impact on your practice?

It's going to be an interesting challenge as far as selecting these agents for frontline treatment. In the ARCHER 1050 study, which is what led to the FDA approval, we saw an improvement in OS. It was a secondary endpoint, but it was the first time we saw an improvement in this area in a head-to-head comparison of 2 EGFR inhibitors. Dacomitinib was compared with gefitinib.
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