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Dana-Farber Cancer InstituteDana-Farber Study Finds Up-front Chemotherapy Boost Could Benefit Patients with Non-Small Cell Lung Cancer

FLAURA2 Trial Reveals Significant Improvement in Progression-Free Survival for NSCLC Patients with EGFR Mutation

In a pivotal update from the FLAURA2 clinical trial, researchers have established that adding chemotherapy to standard therapy with osimertinib can extend progression-free survival for patients with non-small cell lung cancer (NSCLC) with an EGFR mutation. The international study presents promising data that might guide the intensification of initial treatment plans.

HCN Medical Memo
The FLAURA2 study offers a compelling reason to consider a more aggressive initial treatment plan involving chemotherapy in addition to osimertinib. Although more adverse events were associated with the added chemotherapy, the marked improvement in progression-free survival could present a significant advantage for certain patients. Further studies are expected to elucidate who stands to gain the most from this intensified approach.

Key Points
  • Led by Dana-Farber Cancer Institute and Institut Gustav Roussy, the phase 3 trial showed a nearly 9-month median increase in progression-free survival for patients on the combination therapy compared to those on standard therapy alone.
  • About 10-15% of NSCLC patients in the US and 50% in Asia have tumors with EGFR mutations.
  • Patients on the combination therapy had a median progression-free survival of 25.5 months versus 16.7 months for those taking only osimertinib.

“Some patients already do very well for an extended time on osimertinib alone. If we have a better sense of who needs the added chemotherapy, we can convey that to patients and discuss the risks and benefits.”
– Pasi A. Jänne, MD, PhD, Director of the Lowe Center for Thoracic Oncology at Dana-Farber and Co-Principal Investigator

Additional Points
  • Osimertinib is a third-generation EGFR-tyrosine kinase inhibitor that has shown more effectiveness than its predecessors.
  • Patients can develop resistance to osimertinib; adding chemotherapy upfront aims to stave off this resistance.
  • The trial randomized 557 patients to receive either osimertinib alone or in combination with pemetrexed plus either cisplatin or carboplatin.
  • The study is still ongoing to determine if overall survival is improved with the intensified treatment regimen.

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