EGFR

34 EU-approved indications of 18 drugs need a EGFR result, in 2 tumour types, most of them in non-small cell lung cancer and colorectal cancer.

Approved indications34

DrugBiomarker requirementRegimenSettingConditions
Non-small cell lung cancer31
Imfinzi
+ platinum-based chemotherapy
Neoadj.
early
Then adjuvant monotherapy after surgery; High risk of recurrence
Imfinzi
Monotherapy
Adj.
early
After neoadjuvant durvalumab + platinum-based chemotherapy and surgical resection; High risk of recurrence
Tagrisso
Exon 19 deletions or exon 21 (L858R)
Monotherapy
Adj.
After complete tumour resection; Stage IB-IIIA
Rybrevant
Exon 20 insertion
+ carboplatin and pemetrexed
1L
advanced
None
Rybrevant
Exon 19 deletions or exon 21 L858R
+ lazertinib
1L
advanced
None
Tecentriq
EGFR/ALK-negative
+ bevacizumab, paclitaxel and carboplatin
1L
metastatic
Non-squamous only
Tecentriq
EGFR/ALK-negative
+ nab-paclitaxel and carboplatin
1L
metastatic
Non-squamous only
+ erlotinib
1L
advanced
Non-squamous only
Vizimpro
EGFR-activating mutation
Monotherapy
1L
advanced
None
Imfinzi
No sensitising EGFR mutations or ALK positive mutations
+ tremelimumab and platinum-based chemotherapy
1L
metastatic
None
Tarceva
Monotherapy
1L
advanced
None
No sensitising EGFR mutation or ALK translocation
+ nivolumab and 2 cycles of platinum-based chemotherapy
1L
metastatic
None
Lazcluze
Exon 19 deletions or exon 21 L858R
+ amivantamab
1L
advanced
None
Opdivo
No sensitising EGFR mutation or ALK translocation
+ ipilimumab and 2 cycles of platinum-based chemotherapy
1L
metastatic
None
Tagrisso
Exon 19 deletions or exon 21 (L858R)
+ pemetrexed and platinum-based chemotherapy
1L
advanced
None
Tagrisso
Monotherapy
1L
advanced
None
EGFR/ALK-negative
+ pemetrexed and platinum chemotherapy
1L
metastatic
Non-squamous only
+ erlotinib
1L
metastatic
None
Hetronifly
+ carboplatin and pemetrexed
1L
advanced
Non-squamous only; Not candidates for surgery or radiotherapy (if locally advanced)
No sensitising EGFR mutations, or ALK, ROS1 or RET genomic tumour aberrations
+ platinum-based chemotherapy
1L
metastatic
None
No sensitising EGFR mutations or ALK positive mutations
+ durvalumab and platinum-based chemotherapy
1L
metastatic
None
Tarceva
Monotherapy
Maint.
advanced
Stable disease after first-line chemotherapy
Tagrisso
Exon 19 deletions or exon 21 (L858R)
Monotherapy
Consol.
locally adv.
After platinum-based chemoradiation therapy without disease progression; Unresectable; disease has not progressed during or following platinum-based chemoradiation therapy
Rybrevant
Exon 19 deletions or exon 21 L858R
+ carboplatin and pemetrexed
2L
advanced
After failure of prior therapy including an EGFR tyrosine kinase inhibitor (TKI)
Rybrevant
Exon 20 insertion
Monotherapy
2L
advanced
After failure of platinum-based therapy
Tecentriq
+ bevacizumab, paclitaxel and carboplatin
2L
metastatic
Non-squamous only; After failure of appropriate targeted therapies
Tarceva
Monotherapy
2L
advanced
After failure of at least one prior chemotherapy regimen
Tarceva
Monotherapy
2L
advanced
After failure of at least one prior chemotherapy regimen; When other treatment options are not considered suitable
Giotrif
Activating EGFR mutation(s)
Monotherapy
Any line
advanced
EGFR TKI-naïve
Iressa
Activating mutations of EGFR-TK
Monotherapy
Any line
advanced
None
Tagrisso
T790M
Monotherapy
Any line
advanced
None
Colorectal cancer3
Erbitux
RAS wild-type, EGFR-expressing
+ FOLFOX
1L
metastatic
None
Erbitux
RAS wild-type, EGFR-expressing
Monotherapy
3L+
metastatic
Failed oxaliplatin- and irinotecan-based therapy; Intolerant to irinotecan
Erbitux
RAS wild-type, EGFR-expressing
+ irinotecan-based chemotherapy
Any line
metastatic
None

EGFR by tumour

Label wording34

The sentence from section 4.1 of the SmPC that each indication above comes from.

  1. Pembrolizumab (Keytruda)
    KEYTRUDA, in combination with pemetrexed and platinum chemotherapy, is indicated for the first-line treatment of metastatic non-squamous non-small cell lung carcinoma in adults whose tumours have no EGFR or ALK positive mutations.
  2. Nivolumab (Opdivo)
    OPDIVO in combination with ipilimumab and 2 cycles of platinum-based chemotherapy is indicated for the first-line treatment of metastatic non-small cell lung cancer in adults whose tumours have no sensitising EGFR mutation or ALK translocation.
  3. Sugemalimab (Cejemly)
    Cejemly in combination with platinum-based chemotherapy is indicated for the first-line treatment of adults with metastatic non-small-cell lung cancer (NSCLC) with no sensitising EGFR mutations, or ALK, ROS1 or RET genomic tumour aberrations.
  4. Dacomitinib (Vizimpro)
    Vizimpro, as monotherapy, is indicated for the first-line treatment of adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR)-activating mutations.
  5. Gefitinib (Iressa)
    IRESSA is indicated as monotherapy for the treatment of adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with activating mutations of EGFR-TK (see section 4.4).
  6. Durvalumab (Imfinzi)
    IMFINZI in combination with platinum-based chemotherapy as neoadjuvant treatment, followed by IMFINZI as monotherapy as adjuvant treatment, is indicated for the treatment of adults with resectable NSCLC at high risk of recurrence and no EGFR mutations or ALK rearrangements (for selection criteria, see section 5.1).
  7. Durvalumab (Imfinzi)
    IMFINZI in combination with platinum-based chemotherapy as neoadjuvant treatment, followed by IMFINZI as monotherapy as adjuvant treatment, is indicated for the treatment of adults with resectable NSCLC at high risk of recurrence and no EGFR mutations or ALK rearrangements (for selection criteria, see section 5.1).
  8. Durvalumab (Imfinzi)
    IMFINZI in combination with tremelimumab and platinum-based chemotherapy is indicated for the first-line treatment of adults with metastatic NSCLC with no sensitising EGFR mutations or ALK positive mutations.
  9. Lazertinib (Lazcluze)
    Lazcluze in combination with amivantamab is indicated for the first-line treatment of adult patients with advanced non-small cell lung cancer (NSCLC) with EGFR exon 19 deletions or exon 21 L858R substitution mutations.
  10. Serplulimab (Hetronifly)
    HETRONIFLY in combination with carboplatin and pemetrexed is indicated for the first-line treatment of adult non-squamous NSCLC patients with no EGFR, ALK or ROS1 positive mutations and who have:  locally advanced NSCLC who are not candidates for surgery or radiotherapy, or  metastatic NSCLC.
  11. Bevacizumab (Avastin)
    Bevacizumab, in combination with erlotinib, is indicated for first-line treatment of adult patients with unresectable advanced, metastatic or recurrent non-squamous non-small cell lung cancer with Epidermal Growth Factor Receptor (EGFR) activating mutations (see section 5.1).
  12. Osimertinib (Tagrisso)
    the adjuvant treatment after complete tumour resection in adult patients with stage IB-IIIA non-small cell lung cancer (NSCLC) whose tumours have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 (L858R) substitution mutations (see section 5.1).
  13. Osimertinib (Tagrisso)
    the treatment of adult patients with locally advanced, unresectable NSCLC whose tumours have EGFR exon 19 deletions or exon 21 (L858R) substitution mutations and whose disease has not progressed during or following platinum-based chemoradiation therapy.
  14. Osimertinib (Tagrisso)
    the first-line treatment of adult patients with locally advanced or metastatic NSCLC with activating EGFR mutations.
  15. Osimertinib (Tagrisso)
    the treatment of adult patients with locally advanced or metastatic EGFR T790M mutation-positive NSCLC.
  16. Osimertinib (Tagrisso)
    pemetrexed and platinum-based chemotherapy for the first-line treatment of adult patients with advanced NSCLC whose tumours have EGFR exon 19 deletions or exon 21 (L858R) substitution mutations.
  17. Atezolizumab (Tecentriq)
    Tecentriq, in combination with bevacizumab, paclitaxel and carboplatin, is indicated for the first-line treatment of adult patients with metastatic non-squamous NSCLC. In patients with EGFR-mutant or ALK-positive NSCLC, Tecentriq, in combination with bevacizumab, paclitaxel and carboplatin, is indicated only after failure of appropriate targeted therapies (see section 5.1).
  18. Atezolizumab (Tecentriq)
    In patients with EGFR-mutant or ALK-positive NSCLC, Tecentriq, in combination with bevacizumab, paclitaxel and carboplatin, is indicated only after failure of appropriate targeted therapies (see section 5.1).
  19. Atezolizumab (Tecentriq)
    Tecentriq, in combination with nab-paclitaxel and carboplatin, is indicated for the first-line treatment of adult patients with metastatic non-squamous NSCLC who do not have EGFR-mutant or ALK-positive NSCLC (see section 5.1).
  20. Amivantamab (Rybrevant)
    in combination with lazertinib for the first-line treatment of adult patients with advanced non-small cell lung cancer (NSCLC) with EGFR Exon 19 deletions or Exon 21 L858R substitution mutations.
  21. Amivantamab (Rybrevant)
    in combination with carboplatin and pemetrexed for the treatment of adult patients with advanced NSCLC with EGFR Exon 19 deletions or Exon 21 L858R substitution mutations after failure of prior therapy including an EGFR tyrosine kinase inhibitor (TKI).
  22. Amivantamab (Rybrevant)
    in combination with carboplatin and pemetrexed for the first-line treatment of adult patients with advanced NSCLC with activating EGFR Exon 20 insertion mutations.
  23. Amivantamab (Rybrevant)
    as monotherapy for treatment of adult patients with advanced NSCLC with activating EGFR Exon 20 insertion mutations, after failure of platinum-based therapy.
  24. Cetuximab (Erbitux)
    Erbitux is indicated for the treatment of patients with epidermal growth factor receptor (EGFR)-expressing, RAS wild-type metastatic colorectal cancer • in combination with irinotecan-based chemotherapy,
  25. Cetuximab (Erbitux)
    Erbitux is indicated for the treatment of patients with epidermal growth factor receptor (EGFR)-expressing, RAS wild-type metastatic colorectal cancer • in combination with irinotecan-based chemotherapy, • in first-line in combination with FOLFOX,
  26. Cetuximab (Erbitux)
    Erbitux is indicated for the treatment of patients with epidermal growth factor receptor (EGFR)-expressing, RAS wild-type metastatic colorectal cancer • in combination with irinotecan-based chemotherapy, • in first-line in combination with FOLFOX, • as a single agent in patients who have failed oxaliplatin- and irinotecan-based therapy and who are intolerant to irinotecan.
  27. Ipilimumab (Yervoy)
    YERVOY in combination with nivolumab and 2 cycles of platinum-based chemotherapy is indicated for the first-line treatment of metastatic non-small cell lung cancer in adults whose tumours have no sensitising EGFR mutation or ALK translocation.
  28. Afatinib (Giotrif)
    Epidermal Growth Factor Receptor (EGFR) TKI-naïve adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with activating EGFR mutation(s);
  29. Tremelimumab (Imjudo)
    IMJUDO in combination with durvalumab and platinum-based chemotherapy is indicated for the first-line treatment of adults with metastatic non-small cell lung cancer (NSCLC) with no sensitising EGFR mutations or ALK positive mutations.
  30. Ramucirumab (Cyramza)
    Cyramza in combination with erlotinib is indicated for the first-line treatment of adult patients with metastatic non-small cell lung cancer with activating epidermal growth factor receptor (EGFR) mutations (see section 5.1).
  31. Erlotinib (Tarceva)
    Tarceva is indicated for the first-line treatment of patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with EGFR activating mutations.
  32. Erlotinib (Tarceva)
    Tarceva is also indicated for switch maintenance treatment in patients with locally advanced or metastatic NSCLC with EGFR activating mutations and stable disease after first-line chemotherapy.
  33. Erlotinib (Tarceva)
    Tarceva is also indicated for the treatment of patients with locally advanced or metastatic NSCLC after failure of at least one prior chemotherapy regimen.
  34. Erlotinib (Tarceva)
    In patients with tumours without EGFR activating mutations, Tarceva is indicated when other treatment options are not considered suitable.