Patients with non-small cell lung cancer (NSCLC) who have mutations in the EGFR gene often improve significantly when treated with EGFR inhibitors like erlotinib (Tarceva) or gefitinib (Iressa). However, in virtually all cases, patients eventually develop resistance to these drugs. Resistance to EGFR inhibitors is frequently associated with patients developing an additional mutation in the EGFR gene called T790M. Hope for these patients may come from a new EGFR inhibitor designed to target the T790M mutation, called CO-1686. Preliminary results from an ongoing early clinical trial of CO-1686 show that the drug shrank tumors in at least a subset of patients with EGFR-mutant advanced NSCLC who were resistant to EGFR inhibitors and carried the T790M mutation.
Many lung cancer patients have never smoked. Some nonsmokers may be at high risk of developing lung cancer due to inherited genetic mutations. While lung cancer patients often have mutations in their tumor tissue, some also carry genetic mutations in all cells of their body, which were present even before the cancer. The INHERIT EGFR clinical trial by the Dana-Farber Cancer Institute and the Addario Lung Cancer Medical Institute studies a specific mutation in the EGFR gene called T790M. The trial is recruiting patients with the T790M mutation in their tumors who have a high chance of carrying the otherwise very rare mutation in all of their body cells, along with their relatives, who may also carry the mutation. Researchers will investigate whether people with the T790M mutation indeed have a higher risk of developing lung cancer. The findings may help to develop better ways to detect lung cancer sooner or to reduce the risk of developing the disease.