Article and Video CATEGORIES

Cancer Journey

Search By

Does the Specific EGFR Mutation (Including "Rare" Mutations) Matter When Choosing an Oral EGFR Inhibitor?
Thu, 12/10/2015 - 06:00
Author
GRACE Videos and Articles

WCLC_2015_12_Specific_EGFR_Rare_Mutations_Matter_Oral_EGFR_Inhibitor

 

Drs. Leora Horn, Ben Solomon, & Jack West discuss the open question of whether there are clinically significant differences among leading EGFR tyrosine kinases based on the specific EGFR mutation to be treated.

[powerpress]

Download Transcript

[ratingwidget post_id=0]

Please feel free to offer comments and raise questions in our Discussion Forums.

 

Transcript

Dr. West:  What about rare mutations? They’ve really been excluded from a lot of things, but we got a little bit of information at this meeting, the World Conference on Lung Cancer, and there was a publication by James Yang in Lancet Oncology that looked at aggregate results from three different studies with afatinib (Gilotrif), that suggested that at least some of these rare mutations could have a good response to afatinib. What are your thoughts — do you really view all of these rare mutations as one basket, or do you hone it further and treat accordingly, and if you do feel that there are patients who benefit from EGFR inhibitors, is it preferentially afatinib because of these results, or any of them? Leora, what do you think?

Dr. Horn:  So, I thought that James Yang paper was very nice, but I think my bias is that, probably, those rare mutations, would have responded to the first generation inhibitors, as well. We have our database that we’re collecting this data — the DIRECT database, and we’ve got about 3,000 individual mutation patient information in there, so that’s my go-to place when I get information that I’m not sure what to make of a mutation, and I think we’re going to see more and more rare mutations as next generation sequencing is adopted in more places around the world, and we may not always know what to do with that information, and sometimes it may be trial and error.

Dr. Solomon:  Yeah, so I actually have to say your mycancergenome.org is my go-to place, as well, to find out about rare mutations, and I think for patients, and even doctors, who get an EGFR mutation result with a rare mutation, it’s hard to keep track of all these mutations, and at this meeting, for instance, we learned that the group of mutations we call G719X, which includes three different mutations — two of those mutations seem to respond, and one of those, the G719C, doesn’t seem to respond, and so I would encourage people who are uncertain about the significance of mutations to go to mycancergenome.org and make query of the DIRECT database.

Dr. West:  To me, that was one of the themes, both from the Yang paper, and from several of the still relatively small data presentations on rare mutations, is that, de novo T790m mutations, that is, the ones that appear from the time of diagnosis, are associated with a poor outcome, but some of the others, Exon 18, and some Exon 20 insertions, could respond well to these therapies, and it would be a mistake to: A., lump all of these together, because they’re not, we’re missing things, and B., to completely discount the possibility that an EFGR inhibitor could help them.

Next Previous link

Previous PostNext Post

Related Content

Forum Discussions

Hi sbunit and welcome to Grace.  I'm sorry about your mom and you need to be here looking for answers.  Unfortunately there just aren't good answers to these questions.  But yes...

As a follow up to my original question, the specific mutations my mom has are S768l and G719S. It’s very difficult finding concrete information regarding these mutations and treatment outcomes. Was...

Hi patneo and welcome to Grace.  I'm so sorry your wife is going through this.  It isn't possible or even legal to give advice to someone online unless it's in a...

Will doing an ct pet scan to look blood clot in lungs plus onc will be issuing an light dosage of Pemetrexed and carboplatin for a course and after that an...

Hi patneo,


 


I'm sorry but your wife's situation sounds too complicated to make judgments about possible best practices. I think our language barrier may be complicating our communication as well...because...

Recent Comments

JOIN THE CONVERSATION
As a follow up to my…
By sbunit on Thu, 11/17/2022 - 16:51
Hi sbunit and welcome to…
By sbunit on Thu, 11/03/2022 - 14:19
I don't know what your first…
By JanineT Forum … on Wed, 11/02/2022 - 12:26
Staying on tagrisso will…
By JanineT Forum … on Wed, 11/02/2022 - 12:17