Corey J. Langer, MD, FACP of the University of Pennsylvania discusses how T790M testing is practically standard for EGFR activating patients. Recently FDA has recognized whats supposedly become standard clinical practice, at least in the world of patients with EGFR activating mutations. For two years, since early 2016, T790 testing is routinely obtained on tissue or tissues not available on blood specimen. Based on the results on individuals whose disease have progressed on front-line TKIs, either erlotinib gefitinib or afatinib, if T790 is detected, physicians are routinely been switching to osimertinib, which is better tolerated agent.
For those patients who are already on their first generation TKI, T790 testing is standard, its routine, and 60% of individuals who have T790 either alone or in combination with other potential acquired resistance mutations.