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ESMO 2017: Osimertinib as First-Line Therapy for EGFR Mutation–Positive Lung Cancer

The third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor osimertinib appears to be more effective than the standard of care in the first-line treatment of patients with advanced EGFR mutation–positive non–small cell lung cancer (NSCLC). Suresh S. Ramalingam, MD, of Winship Cancer Institute of Emory University, Atlanta, presented the results of the phase III FLAURA trial at the 2017 European Society for Medical Oncology (ESMO) Congress in Madrid (Abstract LBA2_PR).

A total of 556 patients were randomized to treatment with either osimertinib or the standard of care, which consisted of gefitinib or erlotinib. The median progression-free survival favored osimertinib over the standard of care (18.9 vs. 10.2 months). The progression-free survival hazard ratio was 0.46, with a P value of .0001.

Furthermore, the benefit of osimertinib was consistent across all subgroups of patients, including those with or without central nervous system metastases at the start of the study. “The progression-free survival benefit for patients with and without brain metastases was almost identical, suggesting osimertinib is active in the brain as well as in systemic sites,” revealed Dr. Ramalingam in an ESMO press release. “This is important because brain metastasis is a common problem in EGFR-mutated patients.”



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