Tarceva (erlotinib) has greatly helped EGFR positive lung cancer patients, but eventually it stops working. Dr. Jonathan Goldman of UCLA Jonsson Comprehensive Cancer Center talks about the next generation EGFR inhibitors that may soon become available. February 2014.

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Here's the pdf for this presentation: Inherited T790M EGFR Mutation

Since the introduction of the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) for patients with lung cancer, we have seen a subset of patients do remarkably well, with dramatic and long lasting responses. Unfortunately, within a few months of those impressive responses, we learned that people invariably develop acquired resistance to these agents.

Dr. Ravi Salgia from University of Chicago explains his approach to management of acquired resistance to a targeted therapy for advanced NSCLC, both in the setting of a single area of progression and also when disease progression is more diffuse.

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Dr. Greg Riely from Memorial Sloan-Kettering reviews strategies for managing acquired resistance to EGFR inhibitors and other targeted therapies in advanced non-small cell lung cancer.

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Dr. Geoffrey Oxnard describes the new finding of individuals with an inherited T790M mutation in the EGFR gene, the unclear significance of it, and a study being conducted to learn more about it.

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One of the current controversies in the field of lung cancer is whether we should be doing biopsies routinely when a patient develops progression of their disease, particularly in the setting of acquired resistance to a molecularly targeted therapy.  There are some academic oncologists who favor this approach, but I think there's a very good reason why this isn't and shouldn't be the current standard of care.

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Here's the final piece of the webinar with our own Dr. Jared Weiss on Highlights in Lung Cancer from 2011 -- the question and answer session that followed his presentation.  Below is the transcript, figures, and the audio and video versions of the podcast.

Continued from part 1 Dr. West: You have a huge portion of your patients who have an EGFR mutation and we know that over time patients develop acquired resistance. So how do you approach the patients who have a great response initially, have a known EGFR mutation, and then you see that slipping away at slow progression? Do you continue the EGFR inhibitor? Do you add something to it? Do you change the dose? How do you approach that?

The third and last podcast from our discussions with Dr. Lecia Sequist, of Massachusetts General Hospital and Harvard Medical School, covers the question & answer session that followed her excellent