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Thoracic Malignancies • Medical Oncology
For patients with metastatic NSCLC with sensitizing EGFR mutations who progress on first line TKI therapy who do not have evidence of T790M mutation, do you add cetuximab (with afatinib) or bevacizumab (with erlotinib) at progression?
Based on JO25567 and the phase Ib trial of afatinib and cetuximab, for patients otherwise tolerating therapy would you consider adding these agents or would you prefer to move on to chemotherapy?
Answer from: Medical Oncologist at Academic Institution
Treatment paradigms have altered considerably over the past two years for patients with EGFR mutations There are now three approved TKIs (afatinib, gefitinib, erlotinb) that all have demonstrated improved outcomes when compared to chemotherapy. In addition, the addition of bevacizumab to erlotinib ...
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Answer from: Medical Oncologist at Academic Institution
I agree with @Benjamin P. Levy's answer and would really underscore that transitioning to conventional chemotherapy, often with a platinum-pemetrexed combination, would be a more favored option than either of these. I might consider adding bevacizumab to an EGFR TKI in a patient with slowly but mult...