View all CPC CME

Share a PER® activity with your colleagues or friends. Connect with the PER® social network.



Accreditation/ Credit Designation

Physicians’ Education Resource®, LLC, is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. These activites are not approved for AMA PRA Category 1 Credit™.

Acknowledgement of Commercial Support

This activity is supported by an educational grant from AstraZeneca.


Community Practice Connections™: Oncology Best Practice™: Choosing Therapies for Patients with EGFR-mutant Lung Cancers: More Options... More Decisions... Better Outcomes PER Pulse™ Recap

PER Pulse Recap

PER Pulse™ Recap


1 of 3
PER Pulse™ Recap

First-Line Treatment of Patients with EGFR-Mutant Lung Cancers

Featuring key lung cancer experts Alexander Drilon, MD; Balazs Halmos, MD; Mark G. Kris, MD; and Helena A. Yu, MD, this first of 3 PER Pulse™ Recaps from Oncology Best Practice™: Choosing Therapies for Patients with EGFR-Mutant Lung Cancers: More Options... More Decisions... Better Outcomes focuses on frontline therapy for patients with non–small cell lung cancers (NSCLCs) and mutations in the epidermal growth factor receptor (EGFR) gene:

  • Currently, the standard approach for patients with EGFR mutation-positive NSCLCs is single-agent therapy with a first- or second-generation EGFR tyrosine kinase inhibitor (TKI), such as erlotinib, afatinib, or gefitinib. Although there are few data on direct comparisons among these 3 EGFR TKIs, the phase 2b LUX-Lung 7 trial indicated a benefit in progression-free survival (PFS) with afatinib compared with gefitinib. No difference in overall survival was noted between the 2 TKIs, however, and there was also an increase in certain toxicities, including diarrhea and rash, with afatinib.
  • Potential future first-line approaches include the addition of bevacizumab to erlotinib and the use of third-generation EGFR TKIs. Early-phase data suggest improved PFS with both of these approaches compared with the current standard of care, although randomized trials are ongoing to confirm these results.

For additional commentary about this topic and others, visit www.gotoper.com.


2 of 3
PER Pulse™ Recap

Challenging Situations: Biopsy for Acquired Resistance and Managing Leptomeningeal Disease

Featuring key lung cancer experts Alexander Drilon, MD; Balazs Halmos, MD; Mark G. Kris, MD; and Helena A. Yu, MD, this second of 3 PER Pulse™ Recaps from Oncology Best Practice™: Choosing Therapies for Patients with EGFR-Mutant Lung Cancers: More Options... More Decisions... Better Outcomes focuses on the challenges that patients with non–small cell lung cancers (NSCLCs) and mutations in the epidermal growth factor receptor (EGFR) gene face from acquired resistance and leptomeningeal disease:

  • When acquired resistance occurs during therapy with an EGFR tyrosine kinase inhibitor (TKI), the faculty in this activity mention the importance of first assessing the need for the patient to change therapy. If there is limited progression or oligoprogression, local therapy may be appropriate. However, if progression is more extensive, then a change in therapy is likely required and molecular testing needed. Approximately 50% to 60% of patients experiencing acquired resistance will have the T790M-resistance mutation, for which the third-generation EGFR TKI osimertinib is indicated.
  • In the case of central nervous system (CNS) metastases, it is informative to know if the CNS relapse is due to emergence of the T790M-resistance mutation or pharmacologic failure of the EGFR TKI to penetrate the CNS. The expert recommendation is therefore to request assistance from a specialist, such as a neuro-oncologist or a neurologist, who can facilitate a lumbar puncture that can be used to determine if the CNS disease is positive for T790M. If T790M is detected, data from the BLOOM trial indicate a potential role for osimertinib. If the CNS progression is T790M-negative, however, chemotherapy with or without bevacizumab is a reasonable option.

For additional commentary about this topic and others, visit www.gotoper.com.


3 of 3
PER Pulse™ Recap

Second-Line and Subsequent Therapy

Featuring key lung cancer experts Alexander Drilon, MD; Balazs Halmos, MD; Mark G. Kris, MD; and Helena A. Yu, MD, this third of 3 PER Pulse™ Recaps from the Oncology Best Practice™: Choosing Therapies for Patients with EGFR-Mutant Lung Cancers: More Options... More Decisions... Better Outcomes focuses on second-line and subsequent lines of therapy for patients with non–small cell lung cancers (NSCLCs) and mutations in the epidermal growth factor receptor (EGFR) gene:

  • In the case of a patient with T790M-positive progression on a first-line EGFR tyrosine kinase inhibitor (TKI), the expert recommendation is to first assess the locations of progression. Progressive disease at multiple sites would warrant changing therapy to osimertinib, while in the case of more limited progression, local therapy and continuation of the original TKI might be appropriate.
  • For patients who progress during therapy with osimertinib and a subsequent platinum doublet, there are few definitive clinical data. However, subset analyses of phase III trials suggest that patients with EGFR mutation-positive NSCLCs do not benefit from immunotherapy compared with docetaxel. Therefore, experts would still favor docetaxel-based therapy, with or without ramucirumab, following a platinum doublet. Afatinib/cetuximab is another potential option. Additionally, further molecular testing may be carried out, as other actionable oncogenic drivers may be identified.

For additional commentary about this topic and others, visit www.gotoper.com.





Calendar of Events
SUNMONTUESWEDTHURSFRISAT
     12
3456789
10111213141516
17181920212223
24252627282930
Filter By