Osimertinib Plus Chemotherapy Gains Ground

  • New FLAURA2 trial data suggest that combining Osimertinib with platinum-based chemotherapy and pemetrexed as first-line treatment led to improved overall survival compared to Osimertinib alone in EGFR-mutant NSCLC.
  • “Starting with that combination upfront leads to a longer overall survival in patients compared to starting with a pill by itself,” Dr. Pasi A. Jänne of Dana-Farber Cancer Institute, the principal investigator for the clinical trial, explained.
  • While previous data published a few years earlier showed a nine-month delay in disease progression, Dr. Jänne says the latest findings confirm that the benefits go beyond progression-free survival.

Dr. Pasi A. Jänne of Dana-Farber Cancer Institute is the principal investigator for the FLAURA2 trial, which evaluated the efficacy and safety data for first-line osimertinib plus platinum–pemetrexed as compared with osimertinib monotherapy in patients with EGFR-mutated advanced NSCLC.

While Osimertinib (Tagrisso) remains the current standard of care, new clinical trial data suggest that a combination therapy may deliver superior outcomes.

“The current standard of care for patients with EGFR mutant lung cancer is a single agent, Osimertinib. We know that that is effective, but we also know that the effectiveness of that medication is lost over some period of time,” Dr. Jänne stated.

To address resistance and extend treatment durability and efficacy, investigators examined the impact of integrating Osimertinib with standard chemotherapy. According to findings released, patients receiving the triple regimen experienced longer overall survival.

Dr. Jänne says the trial data follow earlier publication of progression-free survival data, showing a roughly nine-month delay in progression when using the combination therapy.

According to trial data published in the New England Journal of Medicine, among the patients participating in the study at the 24-month mark, 57-percemt of them in the combination group were alive and progression-free compared to 41-percent in the monotherapy group only taking Osimertinib. The median duration of response to treatment among patients taking the combination of drugs lasted 24 months compared to 15 months taking Osimertinib alone.

Dr. Jänne also promotes the use of more molecular testing among lung cancer patients.

“Patients who get genetic testing of their cancer and get a therapy matched…live longer than those who don’t get a matched therapy or don’t get tested at all,” Dr. Jänne said.

What It Means for Practice

  • Treatment Planning: Osimertinib monotherapy may no longer be optimal for all newly diagnosed EGFR-mutant NSCLC patients. Discussing combination therapy as a first-line option should now be part of the decision-making process, especially for patients.
  • Expect Data Evolution: As final survival figures are pending, oncologists are advised to remain cautiously optimistic. Comparative data across regimens will require head-to-head trials before any definitive superiority can be claimed.