Osimertinib improves progression-free survival compared to standard first line therapy in Asian patients with EGFR-mutated non-small-cell lung cancer (NSCLC). The findings are based on the Asian subset analysis of the FLAURA trial presented at the ESMO Asia 2017 Congress published in The New England Journal of Medicine.
EGFR mutations occur in 30-40% of NSCLC in Asian populations compared to 10-15% in Western populations. The phase III FLAURA trial compared osimertinib, a third generation EGFR-tyrosine kinase inhibitor (TKI), to standard of care EGFR-TKIs (erlotinib or gefitinib) as first line therapy in NSCLC patients with EGFR mutations. A total of 556 patients from Asia, Europe, and North America were randomised 1:1 to treatment with osimertinib or standard of care. Osimertinib improved progression-free survival by 54%.
Study Analyses EGFR Mutations in Cerebrospinal Fluid of Lung Cancer Patients
Study analyses epidermal growth factor receptor (EGFR) mutations in cerebrospinal fluid of patients with lung cancer.
Advertisement
‘Osimertinib, an EGFR-tyrosine kinase inhibitor improved progression-free survival by 54%.’
Tweet it Now
This subset analysis included the 322 Asian patients in the FLAURA trial, of whom 46 were Chinese, 120 were Japanese, and 156 were from other parts of Asia.
The median progression-free survival was 16.5 months with osimertinib compared to 11.0 months for the standard therapy, with a hazard ratio of 0.54 (95% confidence interval, 0.41-0.72; p<0.0001).
![Cell Signaling Interaction Prevents Lung Cancer Progression]( "Cell Signaling Interaction Prevents Lung Cancer Progression")
Lung cancers are often diagnosed in later stages, with very few treatment options available, and often patients develop a resistance to a targeted therapy.
The median duration of response was two-fold higher for patients treated with osimertinib (17.6 months) compared to standard of care (8.7 months). The overall response rate was 80% with osimertinib compared to 75% with standard of care treatment. Median overall survival was not reached. The incidence of grade 3 or higher toxicities was lower for osimertinib (40%) than the standard treatment (48%).
Lead author Professor Byoung Chul Cho, Yonsei Cancer Center, Seoul, Korea, said: "As in the overall trial population, osimertinib provided a significant progression-free survival benefit in Asian patients with EGFR-mutated NSCLC. Asian patients had similar toxicities with osimertinib as the overall FLAURA population. Osimertinib should be the preferred first line treatment for EGFR-mutant NSCLC in Asia."
Commenting on the findings Professor James CH Yang, Chairman, Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei City, Taiwan, said: "The results of this subset analysis are quite compatible with the findings in the overall population presented at the ESMO 2017 Congress in Madrid. We can therefore conclude that osimertinib can be considered as the standard of care for the first line treatment of Asian advanced NSCLC patients with EGFR mutations."
"The proportion of patients having adverse events that caused them to stop taking osimertinib was similar in the overall (13%) and Asian (15%) populations," added Yang. "We tend to think osimertinib is a well tolerated drug so these discontinuation rates were surprisingly high and need further investigation."
Yang continued: "Although there was no statistical difference between the hazard ratios for progression-free survival, it was numerically lower in non-Asians (0.34) compared to Asians (0.54). There is an ongoing debate as to whether Asian and non-Asian patients with EGFR mutations have distinct responses to EGFR-TKIs. This might be due to variations in clinical practice rather than biology. A meta-analysis of all relevant studies could shed light on this issue."
"It will also be important to know whether Asian and non-Asian patients in the FLAURA trial with brain metastases had similar outcomes," said Yang.
Source: Eurekalert
Cell Signaling Interaction Prevents Lung Cancer Progression
Lung cancers are often diagnosed in later stages, with very few treatment options available, and often patients develop a resistance to a targeted therapy.
Advertisement
The median duration of response was two-fold higher for patients treated with osimertinib (17.6 months) compared to standard of care (8.7 months). The overall response rate was 80% with osimertinib compared to 75% with standard of care treatment. Median overall survival was not reached. The incidence of grade 3 or higher toxicities was lower for osimertinib (40%) than the standard treatment (48%).
Lead author Professor Byoung Chul Cho, Yonsei Cancer Center, Seoul, Korea, said: "As in the overall trial population, osimertinib provided a significant progression-free survival benefit in Asian patients with EGFR-mutated NSCLC. Asian patients had similar toxicities with osimertinib as the overall FLAURA population. Osimertinib should be the preferred first line treatment for EGFR-mutant NSCLC in Asia."
Commenting on the findings Professor James CH Yang, Chairman, Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei City, Taiwan, said: "The results of this subset analysis are quite compatible with the findings in the overall population presented at the ESMO 2017 Congress in Madrid. We can therefore conclude that osimertinib can be considered as the standard of care for the first line treatment of Asian advanced NSCLC patients with EGFR mutations."
"The proportion of patients having adverse events that caused them to stop taking osimertinib was similar in the overall (13%) and Asian (15%) populations," added Yang. "We tend to think osimertinib is a well tolerated drug so these discontinuation rates were surprisingly high and need further investigation."
Yang continued: "Although there was no statistical difference between the hazard ratios for progression-free survival, it was numerically lower in non-Asians (0.34) compared to Asians (0.54). There is an ongoing debate as to whether Asian and non-Asian patients with EGFR mutations have distinct responses to EGFR-TKIs. This might be due to variations in clinical practice rather than biology. A meta-analysis of all relevant studies could shed light on this issue."
"It will also be important to know whether Asian and non-Asian patients in the FLAURA trial with brain metastases had similar outcomes," said Yang.
Source: Eurekalert
Chronic Stress May Cause Resistance to Lung Cancer Drug
Chronic stress hormones may promote resistance to EGFR inhibitors in lung cancer patients. Research suggests beta-blockers may improve treatment response.
Advertisement
Nearly 15% of Lung Cancers are Caused by EGFR MutationBy pairing an anti-EGFR drug with a tail , tarloxitinib brings the drug to tumors while keeping concentrations safe in surrounding tissues. | Advertisement
|
Advertisement
Recommended Reading
Latest Drug News
The FDA advises consumers not to use compounded medications as an alternative to known diabetic and weight reduction medications Ozempic, Rybelsus, and Wegovy.
Addressing the unmet needs of Parkinson's Disease by providing disease-modifying therapies could bring about a major shift in the way that patients are treated.
Microrobots could swirl through a person's blood stream, search for targeted areas to treat for various ailments.
Supplementation with multivitamins is an inexpensive way for older adults to slow down memory loss.
Some people with an aggressive blood cancer called acute myeloid leukemia (AML) may soon have a new drug option called Ivosidenib that blocks the activity of IDH1 gene.