In cases where EGFR NSCLC has transformed into small-cell lung cancer after treatment with osimertinib, and with no CNS involvement, is it advisable to continue osimertinib alongside chemotherapy?

Furthermore, should adding immunotherapy be considered?

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Do you continue EGFR inhibition in patients with EGFR mutated lung adenocarcinoma that progress on 3rd gen TKI and transform into small cell lung cancer?

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2 Answers

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Medical Oncology · University of Colorado Anschutz Medical Center

Answered on

There is a paucity of data to guide treatment decisions in this context. Transformed small cell lung cancer is a complex phenomenon wherein some oncogene-driven lung cancer clones undergo a series of transcriptomic and epigenetic changes (such as EMT-like changes and methylation-driven events) as a ...

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Mednet Member

Medical Oncology · Cancer Care Specialists/Renown Oncology/UNR

Answered on

Also, tarlatamab doesn’t work well in these despite high DLL3 expression, per this small series Cooper et al., PMID 41166675.

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