Options for Patients With Lung Cancer and Genetic Alterations
April 11, 2020 06:00pm
By Luis E. Raez, MD
Suresh S. Ramalingam, MD, discusses the phase III FLAURA trial.
Suresh S. Ramalingam, MD, deputy director of the Winship Cancer Institute and director of the Division of Medical Oncology in the Department of Hematology and Medical Oncology at Emory University, discusses the phase III FLAURA trial (NCT02296125).
Ramalingam says that this study showed that the EGFR tyrosine kinase inhibitor (TKI) osimertinib (Tagrisso) improved overall survival (OS) over another TKI in patients with EGFR-mutated non–small cell lung cancer (NSCLC). Patients with exon 19 or exon 21 mutations were randomized to receive either osimertinib in the experimental arm or gefitinib (Iressa) or erlotinib (Tarceva) as the control. When patients in the control group progressed, if they developed the EGFR T790M mutation, they could crossover to osimertinib.
The median progression-free survival (PFS) for these patients improved from 10 months in the control group to about 19 months with osimertinib, with a hazard ratio of 0.46. The study showed a statistically significant improvement in the median OS of about 7 months with osimertinib.
Ramalingam feels that these positive results with osimertinib solidifies its position as a frontline therapy in this patient population because it is mutation-specific, active in the brain, and has a better tolerability profile compared to other generations. In the United States, osimertinib is the preferred EGFR TKI, and he thinks this will be the case in other parts of the world as well.