AURA3 Overall Survival Analysis: Osimertinib Versus Chemotherapy for Advanced Lung Cancer
Posted: Monday, January 4, 2021
Osimertinib does not appear to offer an overall survival benefit over platinum/pemetrexed for patients with EGFR T790M advanced non–small cell lung cancer (NSCLC) and disease progression on previous tyrosine kinase inhibitors, according to the final overall survival results of the AURA3 trial. Previous results from the AURA3 trial showed that osimertinib conveyed a significant progression-free survival and response benefit in the same patients. Yi-Long Wu, MD, of the Guangdong Lung Cancer Institute in China, and colleagues published their results in Annals of Oncology.
“The continued tolerable safety profile reported here for osimertinib, together with superior progression-free survival, improved patient quality of life, and longer time to symptom deterioration, versus platinum/pemetrexed, reinforces osimertinib as standard-of-care second-line treatment for patients with T790M advanced NSCLC and disease progression on a prior EGFR tyrosine kinase inhibitor,” the authors wrote.
The study included 419 patients with EGFR T790M advanced NSCLC who had radiologic evidence of disease progression after treatment with a first-line EGFR tyrosine kinase inhibitor. Patients were randomly assigned 2:1 to receive either 80 mg of osimertinib once daily (279 patients) or intravenous platinum/pemetrexed (pemetrexed plus carboplatin/cisplatin) every 3 weeks (140 patients). If patients experienced disease progression, they could cross over to osimertinib.
The authors found no statistically significant difference in overall survival between osimertinib and platinum/pemetrexed. Median overall survival was 26.8 months with osimertinib compared with 22.5 months with platinum/pemetrexed. However, according to the authors, osimertinib showed a statistically significant and clinically meaningful benefit in the time to first subsequent therapy or death compared with platinum/pemetrexed, with a hazard ratio of 0.21.
The authors speculated that the lack of overall survival benefit for osimertinib could be the result of the high crossover rate. As of data cutoff, 73% patients in the platinum/pemetrexed arm had crossed over to osimertinib; of these patients who crossed over, 67% had died.
Disclosure: The study authors’ disclosure information may be found at annalsofoncology.org.
