Adjuvant Osimertinib and Advanced EGFR-Mutated NSCLC | NEJM

NEJM Group
15 Aug 202401:48

Summary

TLDRA phase 3 clinical trial has shown that osimertinib, an EGFR tyrosine kinase inhibitor, significantly improves progression-free survival in patients with unresectable stage III non-small-cell lung cancer with EGFR mutations. The trial, involving 216 patients, demonstrated a median progression-free survival of 39.1 months for osimertinib versus 5.6 months for placebo. Although 36-month overall survival did not show a significant difference, the treatment reduced the risk of disease progression, with adverse events occurring in 35% of the osimertinib group. These findings are published on NEJM.org.

Takeaways

  • 🚫 Patients with unresectable stage III non-small-cell lung cancer (NSCLC) and an EGFR mutation previously had no approved targeted treatments available.
  • πŸ’Š Osimertinib, an EGFR tyrosine kinase inhibitor, is a recommended adjuvant treatment for resected EGFR-mutated NSCLC but was being tested for unresectable cases in this trial.
  • πŸ”¬ The trial was a phase 3, randomized, double-blind, placebo-controlled study involving 216 patients with stage III disease.
  • πŸ“ˆ Patients were assigned in a 2-to-1 ratio to receive daily oral osimertinib or placebo, following chemoradiotherapy without progression.
  • πŸ“Š The primary endpoint, median progression-free survival, was significantly longer with osimertinib at 39.1 months compared to 5.6 months with placebo.
  • πŸ“‰ Interim data showed no statistically significant difference in 36-month overall survival between the osimertinib and placebo groups.
  • ⚠️ Adverse events of grade 3 or higher occurred in 35% of patients in the osimertinib group, compared to 12% in the placebo group.
  • 🌐 Radiation pneumonitis was a common adverse event but was mostly mild or moderate in severity.
  • 🎯 Osimertinib demonstrated an improvement in progression-free survival for patients with unresectable EGFR-mutated stage III NSCLC.
  • πŸ“š Full trial results are available for further review at NEJM.org, providing comprehensive data on the study's findings.

Q & A

  • What is the current status of targeted treatments for unresectable stage III non-small-cell lung cancer with an EGFR mutation?

    -There are no approved targeted treatments available for patients with unresectable stage III non-small-cell lung cancer with an EGFR mutation.

  • What is the role of osimertinib in treating EGFR-mutated non-small-cell lung cancer?

    -Osimertinib is an EGFR tyrosine kinase inhibitor and is recommended as an adjuvant treatment for resected EGFR-mutated non-small-cell lung cancer.

  • What was the purpose of the new trial mentioned in the script?

    -The new trial aimed to assess the efficacy and safety of adjuvant osimertinib among patients with unresectable, EGFR-mutated advanced disease.

  • How was the trial designed to test the efficacy of osimertinib?

    -The trial was a phase 3, randomized, double-blind, placebo-controlled trial involving 216 patients with stage III disease.

  • What was the ratio of patients assigned to receive osimertinib versus placebo in the trial?

    -Patients were randomly assigned in a 2-to-1 ratio to receive daily oral osimertinib or placebo.

  • What was the primary endpoint of the trial?

    -The primary endpoint of the trial was median progression-free survival.

  • What were the results for median progression-free survival with osimertinib and placebo?

    -The median progression-free survival was 39.1 months with osimertinib and 5.6 months with placebo.

  • What was the interim data regarding the 36-month overall survival between the two groups?

    -According to interim data, the between-group difference in 36-month overall survival was not statistically significant.

  • What was the incidence of grade 3 or higher adverse events in the osimertinib and placebo groups?

    -Grade 3 or higher adverse events occurred in 35% of the patients in the osimertinib group and 12% of those in the placebo group.

  • Was radiation pneumonitis a common adverse event in the trial? If so, what was its severity?

    -Yes, radiation pneumonitis was common, but most cases were mild or moderate in severity.

  • What conclusion did the authors draw from the trial regarding osimertinib's impact on patients with unresectable EGFR-mutated stage III non-small-cell lung cancer?

    -The authors concluded that osimertinib improved progression-free survival among patients with unresectable EGFR-mutated stage III non-small-cell lung cancer.

  • Where can the full trial results be found?

    -The full trial results are available at NEJM.org.

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Related Tags
Lung CancerEGFR MutationOsimertinibClinical TrialSurvival RatesAdjuvant TherapyNon-Small CellProgression-FreePhase 3 TrialCancer TreatmentMedical Research