Figure 1.

Current treatment sequencing options in EGFR mutation–positive non–small cell lung cancer (NSCLC).⁷ EGFR indicates epidermal growth factor receptor; NCCN; National Comprehensive Cancer Network; T790M, threonine to methionine substitution in codon 790 of EGFR; TKI, tyrosine kinase inhibitor.

^aRarely seen prior to EGFR TKI therapy,⁴⁶ and NCCN Guidelines (accessed in November 2019)⁷ do not explicitly state that testing specifically for the T790M mutation should be done prior to first-line EGFR TKI therapy.

^bPreferred treatment, regardless of T790M mutation status, according to NCCN Guidelines (accessed in November 2019).⁷

^cWith no targeted therapy currently available, the recommended treatment depends largely on the extent of disease (eg, symptoms, type of progression, histology). Systemic treatment is recommended for patients with multiple lesions. For more localized disease, patients may continue the initially prescribed EGFR TKI or undergo definitive local therapy, although various other options may be applicable.