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Re-biopsy after relapse of targeted therapy. T790M after epidermal growth factor mutation, where and why based on a
Paul Zarogoulidis1, Aggeliki Rapti2, Chrysanthi Sardeli3
1Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Abstract:
Guidelines for the treatment of non-small cell lung cancer adenocarcinoma positive in epidermal growth factor mutations indicate tyrosine kinase inhibitors. There are currently three tyrosine kinase inhibitors that can be used as first line treatment: gefitinib, erlotinib and afatinib. Regarding erlotinib and afatinib dosage can be modified in the case of severe adverse effects. In the case of disease relapse investigation for T790M mutation has to be made either with re-biopsy or liquid biopsy and osimertinib has to be administered when T790M is diagnosed. Based on a case series we indicate which is the best approach for T790M mutation.
Insights
For advanced non-small cell lung cancer with EGFR mutations, tyrosine kinase inhibitors are recommended. This case series details the best approach for managing T790M mutations upon relapse, guiding treatment decisions.
Area of Science:
- Oncology
- Molecular Biology
- Pharmacology
Background:
- Non-small cell lung cancer (NSCLC) adenocarcinoma with epidermal growth factor receptor (EGFR) mutations is typically treated with tyrosine kinase inhibitors (TKIs).
- First-line treatment options include gefitinib, erlotinib, and afatinib, with dosage adjustments possible for severe adverse events.
- Disease progression or relapse necessitates re-evaluation for the T790M mutation.
Observation:
- A case series was analyzed to determine the optimal management strategy for T790M mutations in EGFR-mutated NSCLC.
- Testing for T790M can be performed via re-biopsy or liquid biopsy.
- Osimertinib is indicated for patients diagnosed with the T790M mutation.
Findings:
- The study identifies the most effective approach for managing T790M mutations in non-small cell lung cancer.
- The findings provide a clear pathway for treatment selection post-relapse in EGFR-mutated NSCLC patients.
Implications:
- This research offers valuable insights for oncologists in tailoring treatment for NSCLC patients with specific mutations.
- The recommended approach can potentially improve patient outcomes by ensuring timely and appropriate TKI therapy.
- The study highlights the importance of molecular testing in guiding personalized cancer treatment strategies.
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