Talking About EGFR-Mutated Non-Small Cell Lung Cancer Treatments

This article is for people who have epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC), or their care partners, as well as others who want to learn more about specific treatments for this type of cancer. The goal is for patients to learn about targeted treatments available for EGFR-mutated non-small cell lung cancer.

You will learn:

• What an EGFR mutation is

• What it means to have EGFR-mutated NSCLC

• What treatments are available for EGFR-mutated NSCLC

• How to discuss your treatment goals, preferences, and options with your cancer care team

• How to work with your cancer care team to create a treatment plan that is right for you

• Questions to ask your cancer care team

A mutation is when a gene is changed or damaged. There are many types of mutations that can affect many different genes.

The EGFR mutation is the most common mutation found in NSCLC.

EGFR is a protein that is part of healthy cells that helps these cells to grow. When a mutation occurs in the EGFR gene, the EGFR protein is damaged. That damage, or mutation, then helps cancer cells to grow.

No. There are different types of mutations, depending on what the damage is and where it is located. Two common mutations are called exon 19 deletions and exon 21 L858R substitutions.

A specific mutation can be identified through gene testing.

Your EGFR mutation may help your doctor determine what treatments are right for you.

Your doctor will identify which mutation you have, and consider your preferences and treatment goals to determine which treatment is right for you.

The treatments have some differences. For example, one medicine:

• May be more effective against a particular EGFR mutation

• May have fewer side effects

• May work for a longer period of time

These differences are important in determining the treatment that is right for you.

There are 5 medicines that target EGFR mutations:

• Afatinib (Gilotrif®): targets multiple EGFR mutations, including exon 19 deletions and exon 21 L858R substitutions

• Dacomitinib (Vizimpro®): targets exon 19 deletions and exon 21 L858R substitutions

• Erlotinib (Tarceva®): targets exon 19 deletions and exon 21 L858R substitutions

• Gefitinib (Iressa®): targets exon 19 deletions and exon 21 L858R substitutions

• Osimertinib (Tagrisso®): targets exon 19 deletions and exon 21 L858R substitutions, as well as the T790M mutation that can develop in patients receiving EGFR-targeted therapy

If your cancer has EGFR mutations, targeted therapy may be the right choice for you.

Once you are diagnosed, you will work with a team of professionals to ensure you're getting quality care. Your cancer care team may include:

• Your primary care doctor

• A cancer doctor (oncologist) who specializes in lung cancer

• A doctor who specializes in lung diseases

• Nurses who are experienced working with cancer patients

• Pharmacists who will help with your medicines

• A patient navigator who helps you work with your cancer care team

You may see other specialists as needed, in case you need surgery, rehabilitation, diet guidance, or help with pain management or stress.

Patients today hear a lot about being their own advocates. With cancer, advocating for yourself means taking an active role in your diagnosis and treatment plan.

No one knows you better than you, which makes you the most important member of your cancer care team.

Being your own advocate means working together with your cancer care team to come up with the best approach for you.

Just as there are a number of different EGFR mutations, there are often multiple decisions to be made to determine the right treatment plan for you. This is where your voice is essential. Be sure to talk with your cancer care team about:

• Your goals for treatment

• Your beliefs

• Your preferences (side effects you cannot tolerate)

• What treatments are available for you

Your cancer care team will consider the specific EGFR mutation you have, as well as other health conditions you have. This information, combined with your goals, beliefs, and preferences, will help identify the best treatment plan for you. This is just the start, though.

EGFR-targeted medicines may stop working. Sometimes the EGFR gene changes or becomes resistant to the medicine. It's important to stick with your follow-up appointments and to keep your cancer care team informed of any changes you feel. This way, they can adjust your treatment if needed.

It is important that you understand your condition and what to expect from treatment. Some questions you may want to ask include:

• What treatments do you recommend for the mutation I have?

• Will I need additional scans or other tests before my treatment starts?

• Will I need chemotherapy or radiation therapy?

• What do I need to do to prepare for treatment?

• How can I manage the side effects of my treatment?

• What symptoms should I tell you about right away?

• How can I find out about support groups for my particular type of cancer?

Congratulations!

You have successfully completed the program: Talking About EGFR-Mutated Non-Small Cell Lung Cancer Treatments