Dr. Shaw on Overcoming Resistance in Lung Cancer

Alice Tsang Shaw, MD, PhD, thoracic oncologist, Massachusetts General Hospital Cancer Center, discusses overcoming resistance to targeted therapy in lung cancer.

Resistance is sometimes caused by new genetic changes in the target kinase itself. One common type of resistance occurs when a kinase acquires a new mutation so that the drug can no longer bind, explains Shaw. This often happens in EGFR-mutated lung cancer with the T790M “gatekeeper” mutation.

Secondary resistance mutations also occur in patients who have relapsed on anaplastic lymphoma kinase (ALK) inhibitors such as crizotinib, says Shaw. A better understanding of resistance at the genetic molecular level is needed to develop new treatments to overcome it, says Shaw.