Resistance Mechanisms May Steer Therapy Sequences in EGFR-Mutated Lung Cancer

Recent advances in the lung cancer space have expanded the available treatment options for patients with non-small cell lung cancer whose disease harbors an EGFR mutation, especially with more information on resistance mechanisms to specific regimens, an expert said.

Results from a study analysis presented at the recent 2024 ESMO Congress demonstrated that treatment with Rybrevant [amivantamab] plus Leclaza [lazertinib] had lower rates of EGFR and MET resistance alterations. CURE spoke with Benjamin Besse, medical oncologist and Director of Clinical Research at Gustave Roussy in Villejuif, France, who presented these findings to learn more about the benefits of new treatment options in this space.

Transcript:

Today, as a physician, when I see a patient with an EGFR-mutated non-small cell lung cancer, I have many options. I have, let's say, the usual one up to now that was single-agent osimertinib [Tagrisso]. I can give osimertinib with chemotherapy up front, and I know it will improve the duration of control of the disease.

And I have also now a new option that is a combination of an EGFR inhibitor and an antibody that is injected. So it's a pill, an injection or a [subcutaneous administration]. These drugs are called amivantamab [Rybrevant] and lazertinib [Leclaza]. It has been shown that it’s — the combination prolongs the control of the disease compared to osimertinib. Now in [the] second-line [setting] after osimertinib, there are also studies that suggest that amivantamab can be combined to chemotherapy.

So what is important for me is to know for my patients and probably to individualize on each patient's characteristic what will be the best sequence. So it's not only what treatment I should give first line, it's what will be my global strategy. And to make that, you have to understand how the resistance mechanism of the drug might impact the subsequent line. And this is the importance of these results, understanding the resistance mechanism to amivantamab plus lazertinib.

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