Clinical Trials Excite Treatment Landscape for Early-Stage EGFR-Mutated NSCLC

Balazs Halmos, MD, MS, director of the Multidisciplinary Thoracic Oncology Program and director of the Section of Thoracic Medical Oncology for Montefiore Health Systems; first director of Clinical Cancer Genetics and professor of clinical medicine at the Albert Einstein College of Medicine, discusses 2 major presentations from the 2020 American Society of Clinical Oncology (ASCO) Virtual Scientific Program that appeared promising for the treatment of patients with EGFR-mutant non–small cell lung cancer (NSCLC).

The first study was a follow-up from the CTONG1104 clinical trial, which used adjuvant gefitinib (Iressa) versus chemotherapy in patients with resected EGFR-mutant lung cancer. The study showed a nice improvement in disease-free survival (DFS) but there was not an improvement in overall survival in this particular pivotal phase 3 study, Halmos says.

More exciting data were observed in the ADAURA study, Halmos says. The study compared osimertinib (Tagrisso), a third-generation EGFR tyrosine kinase inhibitor, after appropriate adjuvant chemotherapy in patients with stage IB to IIIA resected disease. The study was unblinded early in April by the Independent Data Monitoring Committee based on the exceeding improvements in DFS, which had a hazard ratio of 0.7.

Whether this dramatic improvement in DFS translated to an overall survival benefit remains unknown, but at the same time, Halmos says the degree of benefit made it important for us to be able to see these data.