Dr Abughanimeh on the Evolution of Targeted Therapy in EGFR+ NSCLC

Omar Abughanimeh, MD, assistant professor, Division of Hematology and Medical Oncology, the University of Nebraska Medical Center, discusses the evolution of targeted therapies for patients with EGFR-positive non-small cell lung cancer (NSCLC).

In light of strides made in the field of oncology, particularly the advent of immunotherapy and targeted therapies, lung cancer prognoses have transformed, Abughanimeh begins. The significance of EGFR-targeted therapy in this context has ushered in enhanced survival rates for patients with EGFR-mutated NSCLC, he emphasizes. In the past, patients with stage IV NSCLC who received chemotherapy alone had an average overall survival of approximately 1 year, he explains. However, the introduction of agents such as osimertinib (Tagrisso) has redefined these statistics, he says. Approximately 90% of patients who receive osimertinib reach the 1-year survival milestone, he emphasizes. Extending the horizon to 3 years, approximately 54% of patients continue to survive, Abughanimeh says. This shift in prognoses is not exclusively because of EGFR-targeted therapy; various other targeted therapies have contributed to survival improvements in this popuation as well, he notes.

Testing for EGFR mutations and other targetable genetic markers has now become a standard of care (SOC) in the management of advanced lung cancer, he expands. In clinical practice, it has become customary to initiate treatment only after conducting these essential tests, Abughanimeh says. He notes that such testing provides patients with invaluable insights into their expected treatment outcomes, survival projections, and the anticipated duration of their therapeutic journey. From this vantage point, EGFR testing has evolved into an indispensable component of the decision-making process for stage IV NSCLC treatments, Abughanimeh adds.

Genetic testing is routinely conducted in patients with lung adenocarcinoma and squamous cell carcinoma, in whom national guidelines recommend testing, Abughanimeh continues. Thesignificant number of patients with squamous cell carcinoma who exhibit targetable mutations in genes such as EGFR affirm the utility of comprehensive testing in guiding treatment decisions, Abughanimeh says. As such, the integration of these genetic assessments into the SOC has emerged as a pivotal aspect of managing lung cancer, promising to bring about tangible improvements in patient outcomes and personalized treatment strategies, he concludes.