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EGFRm NSCLC Progression on Osimertinib

CE / CME

Management of a Patient With EGFR-Mutated NSCLC and Progression on First-line Osimertinib

Physician Assistants/Physician Associates: 0.50 AAPA Category 1 CME credit

Pharmacists: 0.50 contact hour (0.05 CEUs)

Physicians: maximum of 0.50 AMA PRA Category 1 Credit

Nurse Practitioners/Nurses: 0.50 Nursing contact hour

Released: April 17, 2026

Expiration: October 16, 2026

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Case Follow-up
Biopsy of the liver lesion confirms recurrent lung adenocarcinoma. Comprehensive next-generation sequencing shows persistent EGFR exon 19 deletion without a new actionable resistance alteration and no evidence of small cell transformation.

Given isolated progression, she undergoes microwave ablation of the liver lesion and continues osimertinib. Nine months later, imaging shows multifocal extracranial progression (new bilateral pulmonary nodules and enlarging mediastinal nodes) while her brain MRI remains stable.

Which approach would you recommend as the best next step for this patient at this time?