Dr. Goldberg Discusses Resistance to EGFR TKI Therapy in NSCLC

Sarah B. Goldberg, MD, MPH, an assistant professor of medicine at the Yale School of Medicine and Yale Cancer Center, discusses testing for and treating resistance to EGFR tyrosine kinase inhibitor (TKI) therapy in non—small cell lung cancer (NSCLC).

In December 2017, the FDA granted a priority review designation to a supplemental new drug application for the use of osimertinib (Tagrisso) as a first-line treatment for patients with NSCLC whose tumors harbor EGFR mutations (exon 19 deletions or exon 21 [L858R] substitution mutations). Osimertinib is now being used both on and off trial, which has cause a shift in the testing and treatment landscape of NSCLC, says Goldberg. Although investigators do not fully understand resistance after osimertinib, Goldberg suggests that it may be different after use as first- and second-line treatment.

Goldberg says that many clinicians are using both liquid and tissue biopsies to test their patients for mutations. The debate between liquid and tissue biopsy is continually evolving, and while a liquid biopsy is more comfortable for the patient, it can sometimes provide limited information, says Goldberg.