Dr. Santos on Identifying Mechanisms of Resistance in Lung Cancer

Edgardo S. Santos, MD, FACP, clinical affiliate associate professor, Charles E. Schmidt College of Medicine, Florida Atlantic University, founding partner, Florida Precision Oncology, discusses the importance of identifying mechanisms of resistance in lung cancer.

When a patient progresses on first-line osimertinib (Tagrisso), it is important to molecularly restage the patient with a liquid biopsy to identify mechanisms of resistance, Santos explains. If the liquid biopsy is positive for an actionable alteration, the patient can proceed with targeted therapy, dual-targeted therapy, or a clinical trial, Santos says. If the liquid biopsy is negative, another option is to do a tissue biopsy if the patient has an accessible lesion, Santos adds.

Moreover, it is important to use a platform in which the next-generation sequencing investigates the RNA in addition to the DNA, Santos continues. This is important to do because evaluating the RNA and DNA makes it very difficult for protein escape, Santos concludes.