*March 2019* Overview written by Donald Ox. This article deals with a case study of the latest clinical data of brigatinib + cetuximab combo that has stabilized a triple-mutant EGFR patient with concomitant EGFR-T790M and C797S mutations.
Brigatinib, the dual EGFR-ALK inhibitor, especially when used in combination of with anti-EGFR antibody, has shown to be a powerful candidate to overcome triple-mutant EGFR after osimertinib treatment on EGFR-mutant patients (i.e., C797S/T790M/EGFR mutant patients) at least preclinically as reported in Nature since 2017. Now there is finally some latest promising clinical data about brigatinib used in real EGFR-mutant NSCLC patients. The latest case report from China published from Journal of Thoracic Oncology reports the first clinical evidence of efficacy using a combination of brigatinib and cetuximab to target concomitant EGFR-T790M and C797S mutations in cis. The patient appears to have been stable for more than 14 months on chest CT (not sure if the small brain metastasis developed before or after this combo treatment). The patient received a combination of brigatinib (90 mg daily) and cetuximab (600 mg monthly, IV)). The hospital is a university hospital and a reputable one in China. Even though this treatment might not be available in the US yet, I think it still can be highly interesting to our group. For more information on this topic see this article and review.