Dr. Chittoor on Targetable Mutations and Respective Treatments in NSCLC

Sreeni Chittoor, MD, FACP, a medical oncologist and hematologist at Texas Oncology, discusses targetable mutations and respective treatment options for patients with metastatic non—small cell lung cancer (NSCLC).

When performing molecular tests on patients with metastatic NSCLC, the focus is typically on EGFR, ROS1, ALK, BRAF, NTRK, RET, MET, AKT1, PTEN, and HER2 mutations, as these are druggable targets, explains Chittoor.

Some mutations have more than 1 treatment available. For example, if a patient has an exon 19 deletion, patients can receive or gefitinib (Iressa), erlotinib (Tarceva), or osimertinib (Tagrisso) in the first-line setting. Osimertinib, a third-generation EGFR TKI, was compared head-to-head with first-generation gefitinib and second-generation erlotinib. Results showed a significant improvement in progression-free survival and duration of response. Osimertinib also crosses the blood-brain barrier. With 3 EGFR TKIs approved for use in NSCLC, data must be considered carefully when choosing a treatment for a patient with an EGFR-activating mutation, concludes Chittoor.