Neratinib

Neratinib has demonstrated high efficacy for mutations in exon 18 - these mutations are highly sensitive to this drug.

More recently, the interim results of the SUMMIT study suggest that Neratinib is a very effective drug also for patients who have already progressed on previous TKI inhibitor treatment. Almost all patients with exon 18 mutations in the study benefited from Neratinib. These were patients in the higher lines of treatment and all of them had previously used erlotinib, afatinib, gefitinib or osimertinib. This drug therefore seems to be able to cover common mechanisms of progression on previous TKI inhibitors in exon 18.

Also in the support group of patients with mutations in exon 18 there have been several patients who have taken Neratinib. All have benefited from its use, even though they had been pretreated with other TKIs including Afatinib.

https://www.targetedonc.com/view/neratinib-is-effective-against-egfr-exon-18-mutations-in-nsclc?fbclid=IwAR0MDukBBCfIz5xKJgHYveSwpLF-lfuOebyilmp32Cj4E9IB5jZKCj8y4Gw

https://www.cancernetwork.com/view/interim-results-announced-for-summit-trial-evaluating-neratinib-for-metastatic-nsclc

https://www.biospace.com/article/releases/puma-biotechnology-announces-interim-results-from-the-phase-ii-summit-trial-of-neratinib-for-egfr-exon-18-mutated-metastatic-non-small-cell-lung-cancer-/

detailed analysis of data from the trial :

https://s24.q4cdn.com/201644000/files/doc_presentations/2020/11/110520-EGFR-Exon-18-Cohort-Presentation-for-Earnings-Call-Final.pdf?fbclid=IwAR1I22GDajC3TQbCV7GELH3HEbnQpB2bPyebZn9S6s_bcos9UleNjnQy-cA