Mark A. Socinski, MD: As I mentioned initially, this group of patients—the exon 20 insertion population—remains an unmet need. We have the recent approval of amivantamab in the second-line setting, and we expect more approvals to be coming along for drugs like mobocertinib, or perhaps poziotinib. Other drugs are under development. It’s still a little early to know how we’ll incorporate them into clinical practice. We do understand that there’s heterogeneity in exon 20 insertion mutations, so I don’t think we should assume that 1 size fits all here. We have a lot to learn. There are subsets of patients that, for instance, are more suitable for a drug like mobocertinib vs poziotinib or others and vice versa. I don’t think we know that yet, but that would be 1 of the questions.

I’ve mentioned amivantamab, which was recently FDA-approved in this setting. This is a bispecific antibody that has activity in the second-line setting and certainly is an option there. How do the TKIs [tyrosine kinase inhibitors] work? Should they be used before an antibody, or after an antibody? All these issues need to be sorted out. They are nice issues to have, because we have a number of drugs that are coming with activity that will aid us in sorting out the appropriate patient for which drug and the appropriate sequence of things ahead of us. I don’t think we have any specific guidelines with regard to how to do this.

The bottom line is this is a target that oncologists should be testing for. They should recognize that this is different from other EGFR mutations where FDA-approved TKIs are quite active. This is a separate group of patients with different challenges that require a different strategy with regard to other agents, as we’ve discussed in this brief interaction. It will be a helpful addition to the therapeutic armamentarium, as we’ve said.

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