What are ASCO recommendations for second-line therapy for stage IV non–small cell lung cancer (NSCLC) in patients with sensitizing endothelial growth factor receptor (EGFR) mutation?

Updated: Jun 05, 2020
  • Author: Winston W Tan, MD, FACP; Chief Editor: Nagla Abdel Karim, MD, PhD  more...
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Answer

For patients with a sensitizing EGFR mutation who experienced disease progression with a first-line EGFR tyrosine kinase inhibitor (TKI) recommendations include the following:

  • If the T790M resistance mutation is present, recommend osimertinib
  • If the T790M mutation is not present, clinicians offer treatment with a platinum-based doublet
  • If the patient had an initial response to first-line treatment but then experienced slow or minimal disease progression at isolated sites, EGFR TKI treatment can be continued, with local therapy to the isolated sites

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