For patients with EGFR-mutated advanced non-small cell lung cancer (NSCLC), osimertinib with chemotherapy leads to significantly longer progression-free survival (PFS) compared with osimertinib alone, according to a study publishedonline Nov. 8 in the New England Journal of Medicine.
David Planchard, M.D., Ph.D., from Institut Gustave Roussy in Villejuif, France, and colleagues randomly assigned 557 patients with EGFR-mutated advanced NSCLC who had not previously received treatment for advanced disease to receive osimertinib (80 mg once daily) with chemotherapy (pemetrexed plus either cisplatin or carboplatin) or to receive osimertinib monotherapy (80 mg once daily) in a 1:1 ratio.
The researchers found that investigator-assessed PFS was significantly longer in the osimertinib-chemotherapy group versus the osimertinib group. Overall, 57 and 41 percent of patients in the osimertinib-chemotherapy group and osimertintib group, respectively, were alive and progression-free at 24 months.
Consistent with the primary analysis, PFS as assessed according to blinded independent review was significantly longer in the combination group. An objective (complete or partial) response was observed in 83 and 76 percent of patients in the osimertinib-chemotherapy and osimertinib groups; median response duration was 24.0 and 15.3 months, respectively. The combination group had a higher incidence of grade 3 or higher adverse events from any cause than the monotherapy group.
“Osimertinib plus chemotherapy with pemetrexed and a platinum-based agent significantly improved progression-free survival as compared with osimertinib alone in the context of first-line treatment of patients with EGFR-mutated advanced NSCLC,” the authors write.
Several authors disclosed ties to AstraZeneca, which manufactures osimertinib and funded the study.
More information:
David Planchard et al, Osimertinib with or without Chemotherapy in EGFR-Mutated Advanced NSCLC, New England Journal of Medicine (2023). DOI: 10.1056/NEJMoa2306434
Yi-Long Wu et al, Combination Therapy for EGFR-Mutated Lung Cancer, New England Journal of Medicine (2023). DOI: 10.1056/NEJMe2311559
Journal information:
New England Journal of Medicine
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