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Dr. Goldberg on Sequencing Following Treatment With Osimertinib in NSCLC

Sarah B. Goldberg, MD, MPH, an assistant professor of medicine at the Yale School of Medicine and Yale Cancer Center, discusses sequencing after therapy with osimertinib (Tagrisso) in EGFR-positive non–small cell lung cancer.

Sarah B. Goldberg, MD, MPH, an assistant professor of medicine at the Yale School of Medicine and Yale Cancer Center, discusses sequencing after therapy with osimertinib (Tagrisso) in EGFR-positive non—small cell lung cancer.

Results from the FLAURA trial indicated that using frontline osimertinib does improve progression-free survival compared with a first-generation EGFR tyrosine kinase inhibitor (TKI). Goldberg says that this poses a potential sequencing challenge, because there is no established second-line treatment after frontline treatment with osimertinib. The standard therapy would probably be chemotherapy, Goldberg says.

There has been some emerging data that shows, depending on the mechanism of resistance, that there may be options in the targeted therapy realm. For example, if a secondary mutation arises in EGFR called C797S, a first-generation EGFR TKI could potentially be effective after osimertinib. Goldberg says that these data are just emerging, but it could be considered an option.