Osimertinib Plays a Role for Patients With EGFR-Mutant NSCLC

Masahiro Tsuboi, MD, a surgeon at the National Cancer Center Hospital East in Japan, discusses treatment with osimertinib (Tagrisso) for patients with EGFR-mutated non–small cell lung cancer (NSCLC) and central nervous system (CNS) disease recurrence.

EGFR tyrosine kinase inhibitors (TKIs) are standard of care for patients with NSCLC and EGFR mutations in the adjuvant setting. Previous studies have suggested their use in the resectable setting, according to Tsuboi. Disease recurrence can be local or distant for patients with resected NSCLC, and the type of recurrence impacts outcome after surgery. Local recurrence is associated with a longer survival outcome compared with distant recurrence.

CNS metastases are common for patients with EGFR mutations. Tsuboi says an example of this is the adjuvant RADIANT study (NCT00373425), where 77% of the recurrence in patients with NSCLC receiving erlotinib (Tarceva) had CNS involvement. CNS metastases indicate a poor prognosis for these patients and remains an unmet need in this setting. By preventing CNS recurrence, patient outcomes will improve, Tsuboi says.

Osimertinib has shown clinical significance for exposure in the brain compared with other EGFR TKIs and has shown greater penetration of the blood-brain barrier.