Would you add bevacizumab to osimertinib for a patient with NSCLC who is progressing on osimertinib with no other actionable resistance mutations?

This is a good question. This likely stems from the fact there are studies that show the combination of erlotinib with bevacizumab is associated with improved PFS, compared to single agent erlotinib in the first line setting. The combination of osimertinib, a superior EGFR TKI, to bevacizumab is being studied in the first line setting as well. However at this time, there is no convincing data that adding VEGF inhibition to osimertinib upon progression would be associated with benefit. A repeat biopsy to determine mechanism of resistance to osimertinib is important. I try to tailor the next line of treatment to biopsy result whenever possible, for example giving platinum/etoposide if it is due to SCLC transformation, etc.; if there is no tar...

I would certainly consider this option.