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Osimertinib Improves Survival in EGFR+ NSCLC, Poses New Challenges for Resistance

Kazuhiko Nakagawa, MD, PhD
Published Online:1:00 PM, Fri September 13, 2019

Kazuhiko Nakagawa, MD, PhD, of the Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan, discusses the role of EGFR tyrosine kinase inhibitors (TKIs) for the frontline treatment of patients with EGFR-positive non–small cell lung cancer (NSCLC).

A number of EGFR TKIs are available for the treatment of EGFR-positive NSCLC, including first-, second-, and third-generation TKIs, says Nakagawa. Osimertinib (Tagrisso), in particular, has shown a median progression-free survival (PFS) of 18.9 months in this patient population. According to Nakagawa, this is the longest PFS that has been seen in this setting. However, a major challenge physicians face in the management of this patient population is resistance to osimertinib.

Although the third-generation EGFR TKI osimertinib has an impressive PFS compared with other agents in this setting, there are no TKIs currently that can overcome resistance to the drug, says Nakagawa. However, osimertinib can be used for almost half of the patients with an EGFRT790M resistance mutation after a first- or second-generation EGFR TKI.
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