2023 World Conference on Lung Cancer (Posters)-EP16.01. Optimizing Treatment Outcomes for L858R EGFR+ NSCLC

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A recent study published in the Lancet reveals that patients diagnosed with stage IV L858R EGFR NSCLC had a median overall survival of 17.7 months after first-line treatment with the EGFR TKI Osimertinib. Resistance to EGFR TKIs is often assumed to be inevitable, and chemotherapy and immunotherapy have not significantly improved outcomes for these patients. Therefore, finding alternative treatment approaches is crucial.<br /><br />EGFR TKIs are commonly used as the first-line treatment for EGFR NSCLC. However, the actual drug concentration in the blood can vary significantly among patients, which puts them at risk of disease progression or experiencing more side effects. Monitoring drug concentration in the blood is rarely done.<br /><br />There is limited research on alternative schedules or doses of EGFR TKIs. However, there are anecdotal reports of patients who have had success with unorthodox dosing. For example, one patient with stage IV L858R EGFR NSCLC has been taking a once-weekly high dose of Afatinib for the past four years and is still alive with a good quality of life. Similar cases using pulsed Afatinib for brain metastases have also shown positive results.<br /><br />The rationale behind pulsed Afatinib is that higher doses can inhibit the development of resistance and have a significant effect on EGFR signaling. However, there is a lack of published reports and clinical trials on this approach.<br /><br />There is an urgent need for further clinical trials to determine the safety and efficacy of once-weekly high-dose Afatinib compared to daily dosing. This approach could potentially improve progression-free survival, overall survival, reduce the risk of brain metastases, and improve quality of life for patients.<br /><br />Unfortunately, funding for such studies is difficult to obtain, and there is a lack of published data on alternative doses of Afatinib for brain metastases. It is essential to publish both positive and negative patient outcomes in peer-reviewed journals to advance the field and improve treatment options.<br /><br />The FDA has initiatives focused on patient-reported outcomes and reducing toxicity, but there is a need to protect the brain while lowering drug doses. Patient-centered organizations are working towards these goals, but their impact needs to be scaled up.<br /><br />Ultimately, improving the use of existing drugs like Afatinib can have significant benefits for patients, but there are challenges in terms of funding and the focus on new drug development. Patient advocates and organizations play a crucial role in pushing for research and better treatment options.<br /><br />Reference:<br />- Jo Monsen, Norway, Patient Advocate. "Optimizing Treatment Outcomes for L858R EGFR NSCLC."

Asset Subtitle

Jo Monsen

Meta Tag

Speaker Jo Monsen

Topic Patient Advocacy

Keywords

stage IV L858R EGFR NSCLC

median overall survival

first-line treatment

EGFR TKI Osimertinib

resistance to EGFR TKIs

alternative treatment approaches

drug concentration in the blood

pulsed Afatinib

clinical trials

patient advocates