Dr. Padda on Novel Combinations for EGFR+ NSCLC

Sukhmani Padda, MD, assistant professor of medicine, Stanford University Medical Center, member, Stanford Cancer Institute, discusses novel combinations in the treatment of patients with EGFR-positive non—small cell lung cancer (NSCLC).

The third-generation EGFR TKI osimertinib (Tagrisso) has emerged as a highly effective frontline option for these patients, with encouraging central nervous system activity. However, despite the agent’s efficacy, these patients will still progress at some point. Beyond the frontline setting, investigators are exploring combinatory approaches. Padda says that among the most interesting strategies under investigation are EGFR TKIs in combination with EGFR monoclonal antibodies.

In fact, Padda adds that this was a promising strategy before the rise of osimertinib in the second-line setting. With patients who progressed on erlotinib (Tarceva) or gefitinib (Iressa)—with or without evidence of T790M—when they went on to receive this combination, investigators saw responses in both of those categories. Similar approaches are now being studied following osimertinib resistance.

For example, osimertinib plus necitumumab (Portrazza) is being evaluated in a trial sponsored by National Cancer Institute. Another trial, led by Leora Horn, MD, MSc, of Vanderbilt University Medical Center, is evaluating the use of afatinib (Gilotrif) plus necitumumab.