Comment: Front-line osimertinib significantly lengthens overall survival in EGFR-mutation positive NSCLC

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Published: 28 Sep 2019
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Dr Marina Garassino - National Tumour Institute, Milan, Italy

Dr Marina Garassino speaks to ecancer at ESMO 2019 in Barcelona commenting on the FLAURA trial.

The trial was looking at first-line osimertinib in patients with Ex19del/L858R EGFR mutated advanced non–small cell lung cancer (NSCLC) compared with older generation EGFR-TKIs.

Dr Garassino comments because smaller facilities may not have the capability to do full sequencing, having multiple treatment options is still important in order to personalise treatment for these patients where possible.
 

ecancer's filming has been kindly supported by Amgen through the ecancer Global Foundation. ecancer is editorially independent and there is no influence over content.

Also for EGFR mutant nowadays we have multiple options. We have the possibility to treat patients with osimertinib. The good news of the FLAURA is that starting with a third generation EGFR tyrosine kinase inhibitor increases the overall survival of our patients. It was the secondary endpoint of the trial but it’s a relevant endpoint and 36 months of survival is a huge number. But we saw other possibilities for treating these patients. Again, one is the combination with antiangiogenic, so the combination with chemotherapy. There is also perhaps room for the first generation of tyrosine kinase inhibitors of first generation, first and second generation.

So, again, I think that we have to go back to the biology, to go back to the patients, to discuss with the patients the possibility to sequence, the possibility to give everything upfront. In my opinion also to be very aware that maybe if we are in a small centre we are unable to do the T790M. If we want to sequence it’s better to give everything from the beginning if we do not have the technology to do the sequence. So there will be multiple possibilities to personalise also the treatment of EGFR mutants.