Learning Objectives Introduction

Introduction

This educational touchFEATURE explores how treatment of patients with epidermal growth factor receptor positive non-small cell lung cancer (EGFR+ NSCLC) can be optimized.

Recognizing the role of EGFR in NSCLC, the potential impact of EGFR tyrosine kinase inhibitors (TKIs) and therefore the importance of identifying patients with EGFR mutations, are key to optimizing the management of this population. As new therapies for EGFR+ NSCLC emerge, it is important to understand both the differences and similarities, as these can inform treatment choices. Treatment resistance is extremely common, so it is also important to identify the underlying mechanism – such as the presence of a T790M mutation or mutations in other pathways – as this can be a key factor influencing the choice of subsequent EGFR TKIs.1 The availability of first-, second- and third-generation TKIs and the possibility of using these agents across therapeutic lines,2 offer valuable options for patients with EGFR+ NSCLC. However, the sequencing of these therapies is a key clinical consideration when optimizing outcomes for these patients.

The information in this activity is intended for oncologists, nurses and other healthcare professionals involved in the treatment of patients with lung cancer.

This touchFEATURE is an ACCME-accredited activity.

Learning objectives

After accessing our interactive touchFEATURE, you should be able to:

1 AMA PRA Category 1 Credits™ Date of original release: 03 May, 2019 Date credits expire: 03 May, 2020

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touchFEATURE

How do we optimize first-line treatment selection and sequencing for patients with EGFR+ NSCLC in the era of third-generation tyrosine kinase inhibitors?

1 AMA PRA Category 1 Credits™ Date of original release: 03 May, 2019 Date credits expire: 03 May, 2020

Module 1: How can we use EGFR TKIs to optimize outcomes for patients with EGFR+ advanced NSCLC?

Professors Frank Griesinger, Solange Peters, David Planchard, Enriqueta Felip and Dr. Raffaele Califano consider the role of EGFR in NSCLC, how EGFR TKIs vary and the emergence of treatment resistance, as well as the use of biomarkers and treatment sequencing.

The constitutive activation of the EGFR signalling pathways leads to tumorigenesis. Several agents target EGFR to inhibit the signalling, and these have different efficacy and safety profiles that should be considered when making treatment choices. The EGFR TKIs improve outcomes for patients with EGFR+ disease, which illustrates the need to identify eligible patients.7 Overcoming the almost inevitable development of treatment resistance and optimizing treatment sequencing are ongoing clinical challenges.6,8,9 Improving outcomes after disease progression on third-generation EGFR TKI therapy and how this influences the sequence in which it is used is also an important consideration.

Key Learnings

Please test your knowledge about the information presented. The following questions will need to be completed to progress.

Q1. Third-generation EGFR TKIs are characterized by reversible binding.

a) True
b) False

Third-generation EGFR TKIs selectively and irreversibly target EGFR with activating mutations, including T790M. They have reduced affinity for wild-type EGFR, which is thought to contribute to the improved tolerability profile compared with first- and second-generation agents.12

Third-generation EGFR TKIs selectively and irreversibly target EGFR with activating mutations, including T790M. They have reduced affinity for wild-type EGFR, which is thought to contribute to the improved tolerability profile compared with first- and second-generation agents.12

Next Question

You have successfully completed: Module 1: How can we use EGFR TKIs to optimize outcomes for patients with EGFR+ advanced NSCLC?

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