A couple of decades ago it was fun to follow and write about the first generation of EGFR inhibitors and the EGFR mutation versus wild-type race in non-small cell lung cancer (NSCLC).
A number of resistance mechanisms have since evolved and these also vary according to what is given in each line. One increasing area of interest has been exon 20 insertions, which can be seen with both EGFR and HER2+ lung cancer.
I’m willing to bet no one back then would have imagine we would be talking about a highly competitive sub-niche of exon 20 insertion small molecule inhibitors and bispecifics twenty years on.
We wrote about this niche a few times last year and with increasing competition the landscape is heating up so it’s time for a strategic look at the various developments…