WCLC Sept 2021 | Current treatments and challenges for patients with EGFR exon 20 insertion-positive NSCLC

Sanjay Popat, BSc, MBBS, FRCP, PhD, The Royal Marsden NHS Foundation Trust, London, UK, comments on the current therapeutic landscape for patients with lung cancer with EGFR exon 20 insertions in the US and in the UK. In the US, the bispecific EGFR/MET antibody amivantamab was recently approved by the FDA based on data from the CHRYSALIS trial (NCT02609776). Mobocertinib was also recently approved for patients with metastatic non-small cell lung cancer (NSCLC) with EGFR exon 20 insertion mutations following the Study 101 trial (NCT02716116). In particular the single-arm extension cohort (EXCLAIM) including platinum-pretreated patients reported significant efficacy for this drug in terms of response rate (RR) and progression-free survival (PFS). In addition, the ZENITH20 study is currently evaluating poziotinib in EGFR exon 20 insertion-positive patients with NSCLC (NCT03318939). Although amivantamab and mobocertinib haven’t been approved yet in the UK, it is expected that they will be available soon. Prof. Popat explains that currently, the challenge is to identify patients with those insertions to ensure that they have access to clinical trials and drugs that they may benefit from. Indeed, whilst next-generation sequencing (NGS) is the gold standard for detection of EGFR exon 20 insertions due to its high sensitivity, it is not commonly used in the UK. This interview took place at the World Conference on Lung Cancer (WCLC) 2021.