Joshua K. Sabari, MD, reviews clinical trial data from FLAURA2 on osimertinib plus chemotherapy in patients with EGFR-mutated advanced lung cancer.
Case: A 73-Year-Old Man with EGFR+ NSCLC
Clinical Presentation:
Past Medical History:
Social History:
Initial Clinical Workup and Diagnosis:
Physical Examination
Pulmonary Function Tests
Imaging Studies:
Diagnostic Procedure:
Neoadjuvant Therapy and Surgical Resection:
Surgical Pathology Report:
Six Months Later:
Second Line Systemic Therapy:
Repeat Imaging at 8 Weeks:
This is a video synopsis/summary of a Case-Based Peer Perspectives featuring Joshua K. Sabari, MD.
This video features a discussion on 2 emerging frontline treatment options for EGFR-mutant metastatic non–small cell lung cancer (NSCLC): the FLAURA2 trial of osimertinib plus chemotherapy vs osimertinib monotherapy.
The FLAURA2 trial showed improved progression-free survival with osimertinib plus pemetrexed chemotherapy compared to osimertinib alone (25-26 months vs 16-17 months) but no difference in overall survival so far. An exploratory analysis suggested less centra nervous system progression with chemotherapy added, though routine brain MRI was not done. Toxicity is higher with chemotherapy, so overall survival data will be important to determine if combination therapy is beneficial upfront vs sequencing chemotherapy after osimertinib progression.
The potential overall survival benefit, if confirmed, would be practice-changing, but the benefit may just reflect progression-free survival prolongation until second-line therapy. Using all options upfront must balance efficacy and toxicity.
These data may help inform optimal sequencing of osimertinib and chemotherapy for eligible patients with EGFR-mutated NSCLC.
Video synopsis is AI-generated and reviewed by Targeted Oncology™ editorial staff.
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