New FLAURA2 Data Suggests Enhanced PFS but at the Cost of Increased Toxicity
The FLAURA2 clinical trial has revealed that a combination of osimertinib and chemotherapy could be good news for patients with EGFR-mutated advanced non-small cell lung cancer (NSCLC). However, the increased progression-free survival (PFS) comes with a higher rate of adverse events, sparking debate among experts about the risk-benefit ratio of this new treatment approach.
HCN Medical Memo
The FLAURA2 data presents a compelling but complex picture. Although the combination of osimertinib and platinum-pemetrexed shows promise in extending PFS, it does so at the cost of increased toxicity. Therefore, the decision to adopt this regimen as a first-line treatment should be made cautiously, weighing the risks and benefits for each individual patient.
- The FLAURA2 trial showed that patients treated with osimertinib plus platinum-pemetrexed had a 38% reduced risk for death or disease progression compared to osimertinib alone (HR=0.62; 95% CI, 0.49-0.79; P<.0001).
- Median PFS for the combination therapy was 25.5 months, compared to 16.7 months for osimertinib alone.
- Dr. Pasi A. Jänne, director of the Lowe Center for Thoracic Oncology at Dana-Farber Cancer Institute, suggests that the combination offers a new first-line treatment option.
- Dr. Yi-Long Wu of Guangdong Lung Cancer Institute questioned the risk-benefit ratio, citing an increase in grade 3 or worse adverse events from 11% to 53%.
“PFS was consistent for all predefined subgroups in favor of the combination, including patients of different race, EGFR mutation method testing, smoking history, CNS status at baseline, and more.”
– Pasi A. Jänne, MD, Director of the Lowe Center for Thoracic Oncology at Dana-Farber Cancer Institute in Boston
- At 24 months, the PFS rate was 57% for the combination therapy compared to 41% for osimertinib alone.
- The objective response rate was 83.2% with the combination and 75.5% with monotherapy.
- Most common adverse events in the combination arm were related to chemotherapy toxicities, including hematologic toxicities and nausea.
More in Lung Cancer