Dr. Konduri on Sequencing Therapy in EGFR+ NSCLC

Kartik Konduri, MD, co-medical director of the Lung Cancer Center of Excellence, Baylor Charles A. Sammons Cancer Center, on the campus of Baylor University Medical Center, discusses sequencing therapy in patients with EGFR-positive non—small cell lung cancer.

Even though osimertinib (Tagrisso) is established as the frontline standard of care in this space, Konduri says that the older-generation EGFR TKIs still have a role in treatment. The question moving forward is where these drugs will fit in as far as sequencing and in which patients they will benefit. Researchers know that agents like erlotinib (Tarceva) and dacomitinib (Vizimpro) can be more effective than other first- and second-generation EGFR TKIs. Konduri says the field will have to sort out whether patients treated with these drugs will develop a secondary T790M resistance mutation that can allow for osimertinib treatment later on.

Moreover, emerging data appear to be positive with the combination of erlotinib and the antiangiogenic agent ramucirumab (Cyramza) as second-line treatment of these patients. As the data read out, the question of where these treatment strategies fit into the paradigm may be more clear.