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Clinical Trials For EGFR Lung Cancer

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Published on August 6, 2020

What Clinical Trials Are Available for EGFR Mutation Positive NSCLC Lung Cancer?

What clinical trials are available for EGFR lung cancer and how can patients find them? How can you advocate for an EGFR clinical trial?
 
In this segment from a recent Lung Cancer Answers Now Program, host Andrea Hutton talks to two lung cancer experts, Dr. Alex Spira from Virginia Cancer Specialists and Dr. Bruce Johnson from Dana-Farber Cancer Institute about available EGFR trials and what questions to ask your oncologist. Patient Advocates Mike Smith and Jill Feldman share how patient groups are working to demystify EGFR clinical trials. Tune in to learn more.
 

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Transcript | Clinical Trials For EGFR Lung Cancer

Andrea Hutton:

Love how you're talking about it's a combination of, new and things we already know, and there's no way to get anything new without clinical trials. You've made references to them and it's incredibly important. And of course now in the news, all we hear about are clinical trials, but I think it's really important to talk about, what clinical trials are out there right now for EGFR lung cancer patients and how they might be able to find them? Dr. Spira do you want to talk about what you're working on right now?

Dr. Spira:

Yeah, so there's a few exciting ones, Dr. Johnson alluded to one of the relatively easier clinical studies that we have, which is the first line study of osimertinib (Tagrisso) plus or minus chemotherapy, answers a very fundamental question of whether or not patients should be getting chemotherapy first along with their osimertinib. And it's a great study and it's, like most things that we do, it's a very straightforward study. There's also a lot of studies, I think we've alluded to a lot in terms of resistance, there's a few studies now being looked at post osimertinib.

Obviously that's been a very challenging area with not as I like to say, a clear, exciting path forward. The standard is to, as Dr. Johnson alluded to, do radiation where you can. We think about chemotherapy as well in those scenarios, but we know the mechanism of a lot of the resistance. There's a gene called c-Met that you can either develop a mutation or be amplified. There's another mutation called C797S. And for the first time there was the beginning of these new drugs that are being studied both with osimertinib or in lieu of that. So there's a little bit of excitement around there, so look for those things.

Andrea Hutton:

Talk to your own oncologist about, see if you're eligible for any clinical trials?

Dr. Spira:

The standard thing that we always hear, Andrea, talk to your oncologist and ask. The challenge is that they're a little bit more cumbersome. The first line study is relatively straightforward. The resistance ones are a little bit more complicated because you do have to look for these resistance mutations and it's not necessarily done in a lot of places. But talking to your oncologist like everybody often does, are there options for me? Should I be looking elsewhere? What do you think? And looking for those, I think would be, always has been super important.

Mike Smith:

I think there's some challenges with just getting some volunteers for clinical trials. I've gone through one myself and I would highly recommend doing it the same if I was presented that. And I think what's not sold about, "Hey, this is something we're studying. You're not necessarily a Guinea pig." But the other thing is the standard of care you're getting. You go from an A to an A plus plus, because you're actually getting report cards, you're getting measurements of your tumors and stuff like that. And I don't know necessarily if all that type of information is shared with onboarding somebody and in discussions with your general oncologist. But it's certainly worthwhile to point that out that, the type of difference in care between on a clinical trial and a standard therapy drug.

Jill Feldman:

I think you're right, Mike. And I think a lot of times clinical trials are sometimes the best treatment for a patient. And a lot of times it's the only treatment. So it's really important that they are out there and they do have options. And I know there are a lot of people working on making consent forms more patient-friendly, and also as advocates, we work on demystifying clinical trials and really educating our community on what they are, as opposed to, a lot of people walk into the cancer space and they think clinical trials are only for last resort.

So as a community, we really are trying to work on that. And I think a lot of the first line clinical trials are really exciting.

Dr. Johnson:

I've been writing in designing trials for 35 years and when our patients come in, one of the things I try to do to reassure them is that, we don't write any trials or bring in any trials where we don't think this treatment has a substantial chance of being better than the existing treatments or they're not worth doing. And for me personally, I've never tried to do any equivalence trials, meaning that, if you think the therapeutic outcome is going to be similar, but with less toxicity, that isn't the type that we choose to do. Other people may choose to do that, there's nothing wrong with that, but in lung cancer, we would like to make headway on this. The second is, is that, and one of the places where I get the most enthusiastic about designing new trials is the combination trials of using novel approaches. We already heard the discussions about using the MET inhibitors and you bring up the idea of C797S.

And our goal is the same as the way it worked with the development of osimertinib is, have a drug that works both with the sensitizing mutation, as well as that potential mechanism. And you can attempt to do that with a combination or with the design of a new drug.

Andrea Hutton:

I do want to thank you all for coming and give you all a chance to leave our audience with, one or two things that you would like them to focus on or think about or questions to go to their doctors with, or just a message of hope. So Dr. Johnson, thank you so much for joining us and for all the work that you're doing.

Dr. Johnson:

Okay. You're very welcome.

Andrea Hutton:

Dr. Spira, thank you very much for joining us as well, and for the work that you're doing in your work in clinical trials. And I don't know if there's any last sentences you want to leave us with?

Dr. Spira:

Thanks for having me. It's great having you. And just to appreciate what Jill and Mike said. I mean, getting people enrolled in clinical trials is first and foremost, one of the most important things. Those consent forms look scary, but in the end, trust your doctor and trust, as Dr. Johnson said, people are doing things to try and make things better. So those are my last parting words.

Andrea Hutton:

Thank you so much. And Jill, thank you so much for being an advocate and for all the work you're doing with patients and your experience.

Jill Feldman:

Thank you. I just want to thank Dr. Johnson and Dr. Spira as well for their passion and dedication to bettering the lives of all of us with lung cancer. And just say to all the people out there with lung cancer and their loved ones, caregivers, that there's hope. And the research is moving at a rate it's never moved before and keep being your own advocate and asking those questions because doctors will answer them.

Andrea Hutton:

Absolutely. Thank you so much. And Mike, thank you for joining us today.

Mike Smith:

Great. Thank you. I appreciate the time and the collaborative forum with Dr. Spira, Dr. Johnson and your team. Thank you.

Andrea Hutton:

So, thank you very much for watching today. I'm Andrea Hutton and remember knowledge can be the very best medicine of all.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

 


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